Meeting the nutritional needs of individuals living with dementia

This week is Dementia Action Week – an awareness campaign that holds deep significance for us at White Oaks. As a well renowned catering service provider to the senior living sector, we are committed to supporting those living with dementia and the communities that care for them. To show our support during this important week, we’d like to share some of our food and drink strategies designed to enhance the wellbeing of individuals living with dementia.

Dementia is a group of symptoms caused by different diseases that damage the brain. The symptoms include memory loss, confusion and needing help with daily tasks, problems with language and understanding, and changes in behaviour. Dementia is progressive, which means symptoms may be relatively mild at first but they get worse over time. There are many types of dementia, but Alzheimer’s disease is the most common, followed by vascular dementia.

There are currently 900,000 people in the UK living with dementia, but this is expected to rise to 1.4 million by 2040. Whilst it mainly affects people over the age of 65, some younger adults can also develop the condition, and it is estimated that 1 in 3 people born today will develop dementia during their lifetime.

Many people living with dementia will experience some difficulties with eating and drinking, which puts them at a higher risk of becoming malnourished. They may experience a poor appetite, forget to eat or, conversely, forget that they have already eaten. They may not recognise the food on their plate and can experience difficulties with chewing or swallowing. Sometimes, they may refuse food or can become very particular about what they will or won’t eat and may also start eating food that they have never eaten before. Sometimes, individuals walk a lot and find it difficult to sit down and eat a meal, and background noise can be very distracting.

The eating and drinking difficulties that any individual experiences are unique to them, so any support and advice offered needs to be tailored to support each individual differently, as the strategies that work for one person may not work for someone else. It is crucial that all individuals living with dementia are provided with food and drink that they will enjoy and that will meet their nutritional needs. It is essential that we understand the mealtime preferences of each individual and what is important to them. This goes beyond just ‘likes and dislikes’, but an understanding of how they like their meals served, where they prefer to eat, and what assistance they require to eat safely. In some cases, a relative or carer can be really helpful with providing this information if an individual isn’t able to articulate their own ‘food story’.

Some of the food and drink strategies we suggest can include:

• If an individual refuses food, adapt the timings of meals and snacks to a time when they might be more receptive to eating and drinking.
• Provide smaller portions of food to prevent individuals from becoming overwhelmed with large portions on their plate. They can always have seconds if they are hungry, or their plate can be topped up with more food if they are eating well.
• Provide small meals with a nutrient dense snack in between every meal, and nourishing drinks where appropriate, if someone is at risk of not eating enough to meet their nutritional needs and/or is at risk of malnutrition.
• Support independence by using adapted cutlery and crockery where possible. Also, ensure that any support that is required is provided at the right level and right time during mealtimes.
• Consider providing finger foods for individuals who struggle to use cutlery. They can also be useful for individuals if they struggle to sit down for a meal and prefer to eat on the go. Where finger foods are offered, it is important to ensure these create a balanced meal and that people aren’t only offered standard buffet food.
• Keep the mealtime service calm and quiet, avoiding excess noise, which can be distracting for individuals with dementia.

Strategies that are used often need to be reviewed and changed over time as the dementia progresses. Outlined here are just a few of the strategies we can suggest, but there is a wealth of further information available for individuals and carers of individuals living with dementia, including the Alzheimer’s Society, NHS and Dementia UK. The BDA Care Home Digest also provides guidance on food service and menu planning for older adults in care homes and has a section about dementia.

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