With age, many things start to change. As our activity level decreases, so does our muscle mass. Our dietary and caloric intake requirements also change. But, even with fewer calories, the value of the nutrients we consume should not change. In any case, we may need to increase the intake of certain nutrients.
It’s a challenging balancing act that can be made worse when caring for a loved one with dementia.
Calorie intake and aging
There is a need to reduce calorie intake with age. Between the ages of 60 and 70, our calorie intake needs to be reduced to about 2000 per day.
Although daily caloric needs vary by gender, age, height, weight, muscle mass and activity level, with all contributing factors.
Women over the age of 50 typically need about 1,600 daily calories to live a sedentary lifestyle; 1,800 when moderately active, and 2,000 to 2,200 with regular physical activity, including walking more than 3 miles per day at a pace of 3 to 4 mph.
For men, the same number increases to 2,000-2,200 calories per day if sedentary, 2,200-2,400 for moderate, and 2,400-2,800 for more active individuals.
As we age, the balance of nutrients is important.
It is important for older adults to eat a variety of whole foods, such as fruits, vegetables, fish and lean meats. In addition, protein, vitamin D, calcium and vitamin B12 are important; and fiber to fight constipation.
Eating challenges for people with dementia
It is not unusual for patients with dementia to experience a lack of interest in food.
They may refuse to eat and may even become belligerent to even spitting out the food. Timing meals and ensuring proper nutritional levels and balance can be challenging for any caregiver.
However, not eating a balanced nutritional diet or consuming the proper amount of calories can make it more difficult to fight off illness, infection, virus or injury. It can also contribute to weight and muscle loss, lethargy, laziness. Older people who do not get proper nutrition may also be more prone to falls or cracks in the skin.
There are many reasons why someone with dementia may have a loss of appetite. They include:
- Difficulty chewing, somewhat common in older adults
- Pain due to dentures, pain in the gums or pain in the teeth. Poorly fitting dentures can chew 75% to 85% less efficiently than natural teeth. Dentures should be adjusted regularly. Soft foods are easier to chew. Oral hygiene and regular mouth checks are important
- Difficulty swallowing (dysphagia)
- Medicines that reduce appetite or make food less tasty
- Dry mouth can leave a bitter taste due to treatments or medications.
- Depression and feelings of isolation. If you suspect that someone you are caring for has depression, consult a doctor.
- Inability to communicate when hungry or if the food is unpleasant, too hot or cold
- Insecurity or inability to handle food
- Fatigue that causes people with dementia to not eat or partially give up. Offer food when they are most alert
- Constipation due to insufficient fiber or fluid and physical inactivity. It is important to include whole grain breads and cereals, legumes, vegetables and fruits.
- Inactivity and lack of stimulation that reduce appetite. The activity is beneficial overall
Your pharmacist or doctor may be able to make minor adjustments to help with many of the above problems.
How to encourage a person with dementia to eat
Here are some tips to encourage dementia patients to eat:
- While focusing on nutrition, don’t ignore personal preferences for taste or texture.
- Use smaller plates to reduce the amount of food
- Dessert is fine even if they haven’t eaten their food
- Give gentle reminders to eat, and be reminded of the enjoyment of food
- Ensure proper setting and state of mind: If agitated or distressed, wait until they have calmed down before offering food or drink. Remember that these reactions are not “tough” or a deliberate attempt at personal attack.
- Use eating and drinking as an opportunity for conversation about activity, social stimulation, and memories
- Prepare easy to handle finger foods like sandwiches, slices of fruits and vegetables. Consider baby carrots, pre-washed and shredded salad ingredients in a bag, cottage cheese and low-fat yogurt or pudding
- Plan meals in advance for easy availability and also for food conversations. Prepare large quantities of stews, soups, casseroles or roasts. Package in small containers and freeze leftovers to reheat. Include rewarming instructions for other caregivers
- Cereal and instant oatmeal are a great quick breakfast. Eggs and Yogurt Could Be Even Better
- Be careful and attentive. If hunger and lack of nutrition are a concern, talk to a doctor.
As you are caring for a loved one with dementia, meal timing and their loss of appetite can be one of the most frustrating endeavors.
Focus on health, optimum nutrition, but also keeping in mind that they have taste preferences.
Keep in touch with your loved one’s doctor and pharmacist to make sure that adequate calories and nutrition are being consumed and that medications are not affecting their appetite.
Hope good health and may meal time turn into a joyous event!