According to the Alzheimer’s Association facts and figures, 5.8 million Americans are living with Alzheimer’s disease. By the year 2050, this number is projected to increase to nearly 14 million individuals. Alzheimer’s is the most common cause of dementia in older adults. Proper nutrition is important to help keep the body strong and healthy. In all healthcare settings, the care of older adults must meet two goals: health maintenance and quality of life. Foods must meet health and nutritional needs but should also enhance quality of life.
Regular nutritious meals may be a challenge for people with Alzheimer’s disease and dementia. These individuals may have appetite changes or problems with chewing or swallowing. Unintended weight loss is common in individuals with Alzheimer’s disease. Meal intake is often poor – reasons may include not recognizing the food on the plate, poor dentition, or decreased sense of taste or smell. A medication may also have a side effect of decreasing appetite. Lack of physical activity can also affect appetite. It is important to purchase healthy foods such as fruits and vegetables and whole grain products for individuals with Alzheimer’s disease. Serving favorite foods can make mealtimes more pleasant. It is also important to maintain familiar routines. It is helpful to serve one dish at a time – for example meat followed by mashed potatoes. A caretaker or healthcare facility employee may need to check food temperatures – a person with Alzheimer’s disease might not be able to tell if something is too hot to eat or drink. The consistency of the diet may need to be altered because of problems with chewing or swallowing. This could result in a diet change to a mechanical soft or pureed diet. Incorporating some walking or other activity into the day can be of benefit to the person with Alzheimer’s.
It is helpful to plan for several small meals rather than three large ones. If the person’s appetite does not increase and he or she is losing weight, a supplemental drink such as Ensure or Boost may be needed. Some residents may need an appetite stimulant. Cognitive impairments such as moderate to severe Alzheimer’s disease and other dementias affect approximately 65 percent of long-term care residents. Individuals living at home with Alzheimer’s disease can benefit from a home-delivered meal service such as Meals on Wheels as they may not be able to cook meals. He or she may forget to turn the stove burner or oven off – cooking and preparing food becomes a safety issue. It is also a good idea to offer finger foods – bite-sized pieces that are easy to pick up such as a sandwich, steamed broccoli, or orange segments. Most importantly, it is imperative that the person have plenty of fluids such as water, soup, milk, hot or iced tea to prevent dehydration.
Individualizing diets, providing the least restrictive diet, and allowing the person to have choice in food selection can increase the desire to eat. The goal of the caretaker or healthcare facility should be to maintain proper nutrition and hydration. This may slow down or delay the progression of the disease and improve quality of life.
Alzheimer’s Association website www.alz.org
Journal of the Academy of Nutrition and Dietetics, Position of the Academy of Nutrition and Dietetics: Individualized Nutrition Approaches for Older Adults: Long-term Care, Post-Acute Care, and Other Settings, April 2018, Volume 118, Number 4
National Institute on Aging website www.nia.nih.gov