Understand and meet the nutritional requirements of individuals with Dementia

1.1-.Cognitive means the affect that dementia has on thinking skills e.g. memory, understanding etc. Functional is about the ability to perform actions such as feeding themselves. Emotional is about how they feel and react e.g. confusion can cause distress and aggression. As dementia progresses, eating and drinking can become difficult for some people. This factsheet looks at some of the difficulties that people with dementia may have with eating and drinking, and suggests ways to help.
A person with dementia may no longer recognise the food in front of them. They may struggle to use a knife and fork as co-ordination becomes difficult. The person may not open their mouths as food approaches and may need reminding to do so. Food may be difficult to chew or swallow or they may not want to accept assistance with eating.

1.2.- Dementia can greatly affect a person's relationship to food and eating. The behavioural, emotional and physical changes that take place as dementia progresses can all have an impact upon a person's eating habits and on their intake of food and drink.
It is important to do what you can to make sure that the person you are caring for enjoys their food and eats a healthy, balanced diet. As dementia progresses eating can become difficult for some people. However, by making a few changes you can help keep mealtimes as enjoyable and stress free as possible.

1-3-. Physical discomfort - The person may be having problems with badly fitting dentures, sore gums or painful teeth, all of which will make eating uncomfortable.
Lack of exercise - If the person is not very active during the day, they may not feel hungry. Try to encourage them to move around during the day and take part in physical activities or exercise.
1.4- culture, Identify and respect personal, cultural, and religious food preferences, such as eating tortillas instead of bread, avoiding pork or milk products, and not liking certain kinds of vegetables. Many caregivers have found that maintaining a sense of normality adds to mealtime pleasure, provides reassurance, helps maintain the person’s dignity, increases food consumption, and eases the tension that often arises during mealtimes
1.5- The importance of adding a variety of food and drink – To maintain the individuals choice and Help the person drink plenty of fluids throughout the day—dehydration can lead to problems such as increased constipation, confusion, and dizziness.
2.1- Mealtime cultures such as having strict meal times and sizes, a certain number of courses and in a certain order may not adhere to the needs of a person with dementia, their tastes may of changes and they may not wish to eat meals set out in a traditional fashion, they may not want to eat at the same time as everyone else or they may want to eat small amounts more often
2.2- Assessing the mealtime situation can help caregivers identify and resolve problems and understand what is happening from the care recipient’s perspective. the visual aspects of the environment—for example, whether there is poor room lighting, too much glare or too many shadows in the room or on the table, unneeded items or too many food choices on the table, distracting patterns in the place setting, or too little colour contrast between the food and the dishes, how the food smells, tastes, and feels, If the care recipient has difficulty using utensils, replace some foods with finger foods such as small sandwiches, cheese, hard-boiled eggs, and fresh fruits and vegetables. Simple adaptive eating tools also can help some people remain independent and maintain a sense of personal control while dining. These include items such as plates with large rims, cups with lids and wide bases, flexible straws, utensils with large or built-up handles, and non-slip placemats or suction cups to keep dishes from moving on the table.
2.3-Person centred approach -As dementia progresses, eating and drinking can become difficult for some people.
A person with dementia may no longer recognise the food in front of them. They may
Struggle to use a knife and fork as co-ordination becomes difficult. The person may not open
Their mouths as food approaches and may need reminding to do so. Food may be difficult to
Chew or swallow or they may not want to accept assistance with eating. If you are supporting a person with dementia at mealtimes it is important to remember that these reactions are not a deliberate attempt to be ‘difficult’, or a personal attack. The difficulties are likely to be related to changes caused by the person’s dementia. When supporting a person at mealtimes it can be a challenge to identify what the problem is, particularly if the person themselves is finding it difficult to find the words to explain, Meals should be relaxed and unhurried. Allow plenty of time and make sure that there are no distractions such as a television or excess noise in the background, do not feel you need to prepare elaborate meals – it is probably better to devote your energy to ensuring that the person eats and enjoys their food. Preferences and styles of eating may change, try to be flexible. If you have to assist a person to eat and drink, talk about what you are offering them to help remind them of tastes and flavours