Ask a Dietitian > Q&A: How to reduce weight loss in people with dementia

Q&A: How to reduce weight loss in people with dementia

November 27, 2018

In this Q&A, our expert dietitian, Kaye Dennison (NZRD), answers an important question about reducing weight loss in those living with dementia.

“I am caring for my wife who has dementia, occasionally some swallowing problems and is losing weight. What are some easy ideas to help stop her losing more weight?”

Here is Kaye’s response:

I’m sorry to hear you’ve been having problems with your wife’s nutrition.

Unfortunately, it’s not uncommon to face challenges around eating and drinking if you are caring for someone with dementia.

Some reasons for your wife’s weight loss may include:       

  • Changes in food preferences
  • Forgetting to eat and drink
  • Taste changes or even difficulties with swallowing or recognising food.

If swallowing is causing your wife a lot of problems and she is coughing after eating, the priority would be organising, through your family doctor, for a swallowing assessment by a speech language therapist.

There are also some practical strategies that you could try to help prevent your wife losing more weight and make mealtimes less stressful, for both of you.

If your wife is struggling to finish meals, fortifying them can be a great way to get more “bang for your buck”.

Adding high energy and high protein food to her normal meals can be a good way to get extra energy and protein into meals and snacks, without making her feel too full.

Some simple ideas include:

  • Adding cream, honey or sugar of any description to porridge. For example, adding 1 tablespoon of brown sugar provides an extra 250kj of energy to a standard 180g serve of porridge.
  • Drizzle a teaspoon of canola oil over cooked vegetables. For example, 1 tsp of canola oil provides an extra 180kj energy to a 100g serving of roast potatoes.
  • Using commercially prepared fortified, modified texture meals and desserts that will help to add protein and energy – aiming for 3 – 4 portions at a main meal (e.g. 1 serve of meat, 2-3 serves of vegetables). In addition, offering desserts between meals. For example, substituting your 100g serve of beef bolognese mince with a Pure Food meal provides 10g more protein and 205 kj more energy than it’s non-fortified equivalent.

If her appetite or interest in food has decreased, including small meals more frequently can be a good way to give her additional nutrition. Using a 3+3 approach with three small meals and three snacks spread over the day can make meals feel less overwhelming.

Some people with dementia forget how to use cutlery and prefer to eat with their fingers. You may like to try offering finger food style snacks that are higher in energy and protein.

These could include:

  • Small crackers with cream cheese, hummus or other soft toppings,
  • Sandwiches with soft fillings, cut into bite-sized pieces,
  • Mini quiches and sticks of cheese,
  • Cake or sweet squares cut into mouthful size portions  

Using coloured plates or having a difference in colour between the table and plate when serving main and snack meals, will help your wife to see the outline of each food more clearly and this technique has been known to increase the intake of people with dementia.

Lipped plates and easy-to-hold cutlery and cups will also enable as much independence as possible when she is eating, and can help maintain food intake.

Prioritise nutritious fluids, making every mouthful count, by offering juices, hot chocolate and full cream milk.

Smoothies and milkshakes are also a great way to increase the amount of energy she is getting and can help to reduce weight loss.

Some of the Pure Food dessert products can be used as a smoothie base, check out the new high energy recipes on our website.

If your wife enjoys hot drinks such as tea, try swapping one or two cups of tea with a small glass of smoothie or milkshake.

For further nutrition advice, or if you find your wife is continuing to lose weight, please consider speaking with a New Zealand registered dietitian, your family doctor or your local alzheimer organisation.

All the best,

Kaye

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