Dementia is a condition that affects the brain and changes the way a person thinks, remembers, and behaves. One of the things that can happen as dementia gets worse is that people may forget to eat or drink. This is not something they choose to do on purpose. It is because the disease changes the way their brain works, making it harder for them to remember basic things like when they last ate or what food is for [1].
When someone has dementia, their brain struggles to process information. This means they might not feel hungry or thirsty the way they used to. The parts of the brain that control appetite and thirst can be damaged by dementia, so the signals that tell a person they need food or water do not work as well [4]. Sometimes, a person with dementia might not even recognize food when they see it. They might look at a plate and not know what it is or how to use a fork or spoon. This can make mealtimes confusing and frustrating for both the person with dementia and the people caring for them [1].
Memory loss is a big part of dementia. Someone might forget that they have already eaten, or they might forget that they need to eat at all. They could sit down to a meal and then walk away before finishing, or they might not remember to prepare food for themselves. This can lead to missed meals and not getting enough nutrition [1]. Sometimes, people with dementia will eat the same thing over and over because they do not remember what they had before. Other times, they might eat too much if their sense of fullness is affected, especially in certain types of dementia like frontotemporal dementia [2].
Swallowing can also become a problem. Many people with dementia develop something called dysphagia, which means they have trouble swallowing food or drink. This can make eating uncomfortable or even dangerous. Signs of swallowing problems include coughing or choking while eating, or having a wet, gurgly voice after swallowing. When food or liquid goes into the lungs instead of the stomach, it can cause pneumonia, which is a serious infection that can be life-threatening, especially in the later stages of dementia [1].
As dementia progresses, a person may lose the ability to recognize food or drink. They might not know what a glass of water is for or how to use a cup. They might forget how to chew or swallow, or they might not understand that food is meant to be eaten. In the later stages, some people need help with every part of eating, from sitting up to chewing and swallowing. Food may need to be made into a thick purée so it is easier to swallow [2].
Mood changes can also play a role. People with dementia often feel depressed, anxious, or apathetic. These feelings can make them lose interest in food and drink. They might not want to eat because they do not feel like doing anything, or they might not care about what they eat. Sometimes, medications used to treat dementia or other conditions can also affect appetite and make someone feel less hungry [1].
Sensory changes are another factor. Dementia can dull the senses of smell and taste, so food might not seem as appealing as it used to. This can make someone less likely to want to eat, even if they are hungry. They might not notice the smell of food cooking or the taste of their favorite meal, which can make eating less enjoyable [1].
Weight loss is a common sign of eating problems in dementia. Most people with dementia lose weight because they are not eating enough. This can happen slowly over time, and it might not be noticed right away. Offering calorie-dense foods in small portions, like porridge, soups, or smoothies, can help make sure a person gets enough nutrition. Sometimes, light exercise like short walks or chair-based movement can help stimulate appetite and support healthy digestion [1].
In some cases, people with dementia may eat or drink too much. This is more common in certain types of dementia, like behavioral variant frontotemporal dementia, where a person might have a drastic increase in appetite. They might eat large amounts of food or drink, sometimes even eating things that are not meant to be eaten. This can lead to weight gain and other health problems [2].
It is important to watch for signs that someone with dementia is not eating or drinking enough. These signs include losing weight, seeming tired or weak, not finishing meals, or not asking for food or drink. If someone is having trouble swallowing, coughing or choking while eating, or seems confused about food, it is important to talk to a doctor or healthcare professional. They can help figure out what is going on and suggest ways to make eating and drinking safer and easier [1].
Caregivers can help by making mealtimes simple and calm. Offering small, frequent meals instead of large ones can make it easier for someone with dementia to eat. Using familiar foods and drinks, making sure the person is sitting up straight, and giving gentle reminders can also help. Sometimes, using adaptive utensils or plates with high edges can make it easier for someone to feed themselves [1].
Pain can also affect eating and drinking in dementia, but it can be hard to know if someone is in pain because they might not be able to tell you. Pain might show up as changes in behavior, like being more irritable or withdrawn. If someone seems to be having trouble eating or drinking, it is important to check if they might be in pain and talk to a healthcare professional about it [2].
In the later stages of dementia, a person might forget how to eat or drink altogether. They might not recognize food or drink, or they might not be able to swallow. At this point, they will need help with every part of eating and drinking. It is important to keep offering food and drink, even if the person does not seem interested, and to make sure they are getting enough nutrition and hydration [5].
Dementia can make people forget to eat or drink because it changes the way their brain works. It can affect their memory, their ability to recognize food, their appetite, their mood, and their ability to swallow. Caregivers and healthcare professionals can help by making mealtimes easier, watching for signs of problems, and getting help when needed. Eating and drinking are important for health and well-being, and finding ways to support someone with dementia at mealtimes can make a big difference in their quality of life [1].
Sources
[1] https://myhometouch.com/articles/dementia-and-eating-problems
[2] https://en.wikipedia.org/wiki/Dementia
[4] https://smart.dhgate.com/alzheimers-eating-problems-why-patients-stop-eating/
[5] https://www.dementia.org.au/living-dementia/later-stages-and-end-life
