Dementia and Eating Issues
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Nutrition and meal support for a loved one with dementia

a woman with shoulder length grey hair and a red shirt eats a boal of soup with some fruit on the side

Dementia and eating issues are very common.  Do you have a loved one with dementia that is not eating or experiencing swallowing issues?  For people living with dementia and their relatives and care givers everyday living can become a challenge. Dementia can make it harder to do simple daily activities such as using the bathroom, socializing, cooking and self-feeding.  


You might be asking yourself  


  • How can I make sure my loved one stays healthy? 
  • How does dementia affect nutrition? 
  • What can I do to support dementia and eating issues that may show up for my loved one? 


Depending on the stage of the disease and the eating behavior the risk of malnutrition may be high. However, how dementia is expressed is individual and the recommendations are as well. According to Gail Elliot, gerontologist and founder of the DementiAbility Program, “if you know one person with dementia… you know one person with dementia”. This powerful statement expresses, in only a few words, the diversity of behavioral responses to dementia.  


The 7 stages of dementia


Dementia is divided in seven stages. Risks of dehydration and malnutrition increase as the disease progresses.  


Stage one: The person has no cognitive decline. People without dementia belong to this stage.  

Stage two: The person forgets certain things, such as where their keys are.  This is usually forgetfulness associated with aging. 

Stage three: Forgetting becomes more regular, but it usually doesn’t have a major impact on daily activities.  

Stage four: Considered early stage of dementia. The person will show difficulty in problem solving, remembering recent events and managing their own financial affairs. Some people might have difficulty remembering mealtimes, their level of appetite or their food preferences. However, for some dementia and eating issues don’t present as a problem and there may be no nutrition concerns while cooking and eating meals continues normally. 

Stage five: The person has major cognitive decline; they are more confused and may not remember the time/date/year or where they are. At this stage, the person may need support in toileting and getting dressed. Generally, the person is unsafe to prepare meals on his/her own and may need support or cuing in feeding.  They may also show difficulty swallowing and/or have a decreased appetite.  


an older couple prepare a meal together in the kitchen. The woman stirs a pot and the man slices tomatoes


Stage six: The person has severe cognitive decline; they generally do not remember the time/date/year, where they are, some relatives, may not remember their life and their personality may change. At this stage, the person is generally incontinent, has difficulty communicating and needs support in every aspect of the daily activities.  They may show worsening difficulty swallowing and feeding. Weight loss is often a major concern.  

Stage seven: Called end of life stage.  The person is not able to communicate anymore or perform any daily activities and unable to feed themselves.  


Nutrition and dementia


While it is impossible to generalize and predict the nutrition and eating problems associated with the disease because every individual responds differently, some challenges are more common and well known:  


Taste and smell change

An older woman with short white hair and a green floral shirt eats ice cream from a glass cup

Many families would testify that they do not know what their loved one likes anymore. As dementia advances, new food preferences appear and some might dislike a food item that has forever been appreciated. This can even be more challenging when the person is no longer able to communicate. It is recommended to describe the food with positivity (example: “I made you a great butternut squash soup and I added some cream in it, just the way you like”).  Try different foods regularly or try foods the person used to dislike and keep a record of the new preferences for quick reference.  



Forgetting can affect a person’s nutritional intake in many different ways. Some people will forget the time to eat, others will not recognize the food in front of them and some don’t make a good connection to swallow when the food is in the mouth. Extra support, cuing, and patience is the key.  


Loss of self feeding ability

As the disease progresses, it is common to see the person not remembering how to use their utensils or having more rigidity in the movement of feeding themselves. The best practice recommends to maintain their autonomy as much as possible. Cuing or using the hand-over-hand or hand-under-hand techniques would usually be recommended first while total assistance may be recommended as the disease progresses.   Here is a helpful video on Handfeeding Assistance for Dementia and Alzheimers. 


Difficulty swallowing (dysphagia)

Difficulty eating and swallowing may cause severe risks of harm. The cognitive decline and muscle loss may change the ability to eat and swallow normal food. When it is suspected that a person has difficulty swallowing, a referral to a Registered Dietitian specialising in dysphagia should be made to assess the safety on normal food and fluids. Recommendation for altered food texture or fluid consistency may be made for safety and to increase the food intake. 


Assistance by a Dietitian specializing in dementia and eating issues

A woman feeds oatmal to an elderly man

A Registered Dietitian specializing in dysphagia can help by:   


  • Conducting dysphagia assessment to identify the most appropriate food texture and fluid consistency for safety and to prevent choking. 
  • Preventing malnutrition and weight loss by offering suggestions on how to increase the protein and calories of the food choices provided.
  • Ensuring a good food intake by helping brainstorm new ideas to accommodate preferences, supporting healthy mealtime behaviors and reducing distractions 


Ask for support from a Dysphagia Dietitian – don’t go through the journey alone. Having adequate support will help increase your, and your loved one, quality of life to keep sharing positive memories.  


If you are looking for support from a private practice Dysphagia Dietitian and to help support dementia and eating issues contact us to see if we can assist.  For more information on our personal nutrition counseling support programs visit:  Personal Nutrition Counseling for Dementia and Dysphagia (Swallowing Issues) 



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Success stories

"I am a psychologist in private practice and it is very important to me that my clients have the best care with other health care professionals. For that reason Health Stand Nutrition is my only source for exceptional Dietitians. Andrea and her team provide highly knowledgeable, compassionate, and real world support to my clients who require assistance with food lifestyle. I trust my clients to them and you would be in excellent hands making them part of your health care team."
Adele Fox, Psychologist
“This is the first time I feel satisfied; my cravings have diminished dramatically and I have a whole new relationship with food. I am eating guilt-free for the first time in my life. My energy has also dramatically increased and I feel great!
Rhonda Jenkins, Nutrition Counseling Client
“The Dieticians at Health Stand Nutrition help you to take action on the science behind eating well by making it practical, understandable, and fun. Their office is cozy and not at all clinical or intimidating. I felt like I was sitting down with a really smart, caring friend who wanted to help me make the best choices for my lifestyle and food preferences. They really are the best in the business.”
Marty Avery, Nutrition Counseling Client
“I have come to think of the program as a one stop shopping excursion for everything one needs to know about creating a joyous relationship with food and our bodies. In a single word, the course has gifted me with freedom from the punishing rigidity of disordered eating, old stories that never were true, and body dysmorphia that did nothing but make me lose sight of a body that has done everything I've asked, despite my careless dismissal of her needs. Now when I look in the mirror I find myself shifting from harsh criticism to gentle gratitude.”
Lynn Haley, Pursuit of Healthiness Online Course Participant
“I spent 3 hours when first diagnosed with type 2 diabetes. I learned more from my Dietitian about food in those 3 hours than I had learned in all the years of my life. I also love the newsletter, there is always something to learn.”
Peter Whitehead, Nutrition Counseling Client
“I didn’t realize how strong my “diet mentality” was, and all the rules I had in my head about food. I was in a cycle of reward/punish/binge/cringe. I booked with your business very reluctantly, on the repeated advice of my doctor, to get my slowly rising cholesterol levels in check. I thought I knew everything about food, and my behaviour with food, but I was definitely re-schooled. My weight is creeping down, I feel good about my diet, exercise, body image, and lifestyle.”
Amy Floyd, Nutrition Counseling Client
“Thanks Andrea for an amazing presentation, I have heard all positive remarks from attendees and the evaluations show the same sentiment. It is really gratifying when a speaker does their “homework” and weaves in our profession’s day to day challenges within their content, you did an awesome job of this! You truly took the “die” out of Dietician! Your information on healthy eating and simplifying how we can work towards this as we are all so busy really hit the mark. Andrea connects very well with her audience; she is energetic, funny, and very approachable.”
Carole Ann LaGrange, Transfusion Medicine Safety Officer

Event Planner for Laboratory Diagnostic Imaging Annual Event

I am a family physician who sees patients with a myriad of eating concerns – from wanting to know how to plan healthy meals for active families, to weight loss, to eating disorders, and so on. I cannot recommend the Health Stand team highly enough. I have worked with (and been to!) other Dieticians in the past and too often find that they just ask for food logs and make suggestions that are easily obtained online or in books. The Dieticians at Health Stand offer much more than just telling clients what they “should be eating.” In contrast, the team really does more of a counselling practice, and they work hard to help their clients learn more about why their eating habits may be off track and not optimal for them, as well as helping people to effect change at a deep level that, most importantly, is sustainable for lifetime health.”
Dr. Deb Putnam, Family Physician

Nutrition Counseling Client & Referring Physician

“I am a busy mom, with kids in high level sports, working full-time downtown, and running our home acreage outside the City. I now have the knowledge and tools I need to plan for and manage the chaos of meal planning.”
Gillian Gray, Pursuit of Healthiness Online Course Participant
“As a construction company, we select speakers who can relate to our industry and its employees. Andrea’s message was delivered with humor and empathy. She makes people feel as though they can make changes without leaving behind every favorite food. Andrea focused her presentation on healthy eating as a way to keep energy high throughout the day. This message and the way it was delivered resonated with our predominantly male, blue collar culture. I would highly recommend Andrea as a speaker for groups such as ours. She will get your message across without alienating anyone in your audience – which is a huge hurdle when trying to introduce a wellness program in the workplace!”
Stephanie Wood, HR and Safety Manager

Fisher Construction Group, Burlington, WA

I found my Dietitian warm, funny, and skilled at teaching nutrition concepts without the overwhelm. The general approach of each session was to mix science with emotion, which was exceedingly effective in helping me shift my perspective on food from one of anxiety to one of joy and curiosity.”
Erin Kronstedt, Nutrition Counseling Client
“Excellent presentation! What a refreshing change to have a speaker inspire rather than “lecture” about nutrition. Your captivating stories, tips and overall approach to healthy eating uplifts and puts people at ease. It was great to hear we don’t need to strive to be perfect eaters, and that small changes really can make a difference in how we feel and in our health. Thanks to Andrea, we have solutions to our everyday nutrition challenges that can actually work in real life!”
Tina Tamagi, Human Resources

ARC Resources Ltd.

“Had I not joined this course I would have struggled with no focus, low energy, and mindless eating. Excellent teaching and motivation. This is not just a course, it is a nutrition club with mentorship, support, and connections with other people with similar situations.”
Lorri Lawrence, Pursuit of Healthiness online course participant

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