Ask Miriam – April 2022
Dear Miriam,
My partner has Alzheimer’s and I’ve had to take over all the household tasks, which I admit has not been easy since she was the one who always shopped, cooked, and cleaned. But I am doing my best. I try to make appetizing meals every day for her. My problem is that she never wants to eat, and she has been losing weight. The doctor said he is going to have to start her on an appetite stimulant if she doesn’t start to take in more calories. I have no idea what to do to try to get her to eat more, but I would rather she didn’t take a medication if she doesn’t have to. When I ask her if she is hungry, she always says no. And if I set the food in front of her, she just takes a few bites, and then says she doesn’t want any more. Why won’t she eat?
—Need to Feed
Dear Need to Feed,
I’m so glad you reached out, and it sounds like you are doing a good job of preparing some nutritious foods, but it is common for people with Alzheimer’s disease to have trouble with eating. Sometimes they eat more frequently or overeat (which may be due to forgetting that they already ate), and sometimes, like your partner, their brain does not interpret the signals of hunger correctly and they may forget that they haven’t eaten recently.
Try to provide something to eat and drink every hour or two during the day, especially if she does not eat much at one time. You do not have to ask, “Are you hungry?” or “Can I get you something to eat?” When someone has dementia, they are less able to cope with making decisions, and sometimes the easiest thing to say is, “No!” In addition, there are ways you can add to the calories of the food that your partner does eat. For example, try adding high-protein powder to a shake, and use healthy fats and oils, such as full-fat milk, yogurt, and cheese, as well as nut butters, and drizzling olive oil onto vegetables.
Another thing to be aware of is the physical effort involved in eating. Make sure to provide finger foods if she is having difficulties with managing forks and spoons. Cut the food into bite size pieces so she does not have to use a knife. In addition, swallowing can sometimes be a concern for the person with dementia. While this is usually associated with the late stages of the disease, it can happen earlier on, too. Ask your partner’s primary care physician for a referral to a dietitian, who can assess her ability to swallow different kinds of foods, or an occupational therapist, who can give you ideas for adaptive tools that might help. A dietitian can also recommend high-calorie foods that she might like.
For more information about caregiving, eating, and other challenges in caring for someone with dementia, please call our Helpline at 844-435-7259. You can also read our Eating & Drinking tip sheet.
If you have a question for Miriam, e-mail askmiriam@alzla.org.
Best,
Miriam
Questions for Miriam can be sent to askmiriam@alzla.org.