I cook regularly for a family that includes a father with dementia; he is still “with it” sometimes but it is getting worse. Today his daughter mentioned that “he doesn’t care very much what he eats,” but she has also reported on dishes he absolutely adores, and on foods he was suspicious of because he didn’t know what they were. So of course, I will continue to prepare what I know he likes, and avoid foods he doesn’t recognize, to the extent I can.
But I wonder if there are any guidelines on what Alzheimer’s patients tend to agree on, food-wise?
This isn’t FQ, and if you have experience with caring for a relative, friend, or patient with dementia, I’d be happy to hear what worked for you and the individual(s) you were feeding, regardless of whether there is any conventional wisdom or scientific studies to support your observations.
When my grandfather was sliding into dementia, the foods he liked best were both familiar to him and easy to eat. It became difficult for him to use a knife and fork neatly, so he did best with food that could be eaten with just a spoon or fork. My aunt mostly cooked him various casseroles before he went to The Home.
IANAD. My mother had Alzheimer’s. She died some years ago so this is from a vague memory of what we were told when getting meals for her (she eventually ended up in a nursing facility).
In no particular order:
The diet needs to be similar to a healthy diet you would make for anyone. It’s fine to make something they like. At this point their diet is probably not what will be a problem but still, lean towards healthy food. (Assuming they have no dietary restrictions…if so then of course that needs to be accounted for.)
Watch the temperature. They may not be able to tell something is hot.
Eat with them. Try not to let them eat alone.
Try not to clutter the plate with too much stuff. Separate main items or serve them separately.
They may eat slowly. Allow enough time for them.
They may decide they do not like something they used to like. Gotta roll with it.
I am sure there is more. People suffering from Alzheimer’s can be very different from one to the next. Maybe call a nursing home specializing in caring for Alzheimer’s patients. I’d think they would be willing to offer advice (and may even have literature or resources they can give you).
Certainly no expert knowledge here, just some things we found worked while caring for my mother:
Familiarity was very important for her. And I mean 'going all the way back to her childhood/young adult days. This was not the time to expand her range of foods she was comfortable with – let’s face it, that involves learning new things, and that wasn’t happening any more. She grew up eating a normal, meat and potatoes typical mid-west diet, so that’s what we mostly made for her.
It’s likely that eating food he likes is one of the biggest pleasures in his increasingly small world. So give them to him often, he won’t remember that he had baked hash two days ago, and three days before that, or whatever. It will simply be, “Oh, hash! I love hash!” for him. Since you’re feeding an entire family this might not work as well, for the sake of the others in the family. Perhaps make the repeated favorites a dessert or some sort of side dish, so the others can eat or skip it if they are getting tired of it.
This one is probably controversial, but we threw out all consideration about any dietary restrictions that the doctor had previously suggested due to other health concerns. Well, I mean long term stuff. If cucumbers give him heart burn, don’t feed him cucumbers. But if he had been told to cut down on eggs or something due to high cholesterol, or he loves cheese but it was restricted due to its fat, or no high sugar desserts and he has a sweet tooth… well, my view (and I repeat that this is just what I feel) is that long term health stops being a big concern for dementia patients. Short term pleasures are all they can really have: they enjoy the taste of what they are eating NOW even though they won’t remember a half hour later. And if indulging in those things means they might die a few days or weeks or even months sooner than if you keep them on a strictly ‘healthy’ die, well, it’s an acceptable tradeoff in the circumstances. (Again, IMHO)
I don’t know if this person has any other conditions that affect his eating, such as tremors or restrictions in movements or clumsiness in dealing with utensils, any such thing that means that getting food into his mouth becomes hard/creates a mess/requires someone to actually feed him mouthful by mouthful. If so, try to make the foods as simple to consume as possible. Like, a scoop of pulled pork is easier to eat than bone-in spare ribs, and tater tots are easier to master than a loaded baked potato. Probably not so much corn on the cob. Cut up fruit cup rather than a whole peach with a pit to deal with. A mug of soup is way safer than a bowl of it.
Hope some of this helps you. I’m sure the patient’s family is immensely grateful for your help.
My Mil would forget to chew properly and choke sometimes and gag a lot. Watch for that.
Before she had to be on only liquids she was eating baby food and mashed foods.
Thank you for that (also thanks to @Whack-a-Mole and @InternetLegend). I tend to emphasize healthy food, and try to cook for the family with generous amounts of veggies while going easier on fat, salt, and meat.
But in talking to the daughter (the caretaker for mom - who is not demented, but she is physically disabled and rather cranky - and the dad who is experiencing dementia), I’ve learned that the parents are both in their mid-80s. And they both LOVE cookies and cakes. And they both are normal weight and have good blood pressure.
Thinking about that has changed my perspective a bit. When I started doing the cooking, I felt under pressure to severely limit sweets (which they both, especially mom, really like) and maximize vegetables. But now … well, yeah, I still try to cook nourishing food. But when I am 85, dammit, I hope I get to eat food I like, and if that means I eat cake pretty often, well … lucky me.
With that attitude in mind, I’ve loosened up a bit, and now tend to provide more cake and pudding than I used to. Of course, the cake is made with whole wheat flour and pureed squash, and the pudding is made with yogurt and fruit, so everything has nutritional value.
But if there is some salt and sugar and fat involved (given that neither parent is overweight or diabetic), I’m now gonna go for it.
Great idea - maybe something I could arrange as a special treat (since the transport would have to be carefully planned or the froyo would melt in transit).
But that suggests something else I should note - foods also need to be transportable by amateurs and should withstand a while in the car. I’ve been doing lots of “mushy” foods like soups and stews because they will withstand being refrigerated in a plastic container for a few hours/overnight, and then I can throw them into the trunk of my car and take them to the class where I meet with the daughter, who then takes them back to her parents.
For example, today I delivered: turkey chili, mac-n-cheese, a sweet potato pound cake, pureed peas, and pesto rounds (baguette slices slathered with pesto and toasted). All those foods could be made in advance and chilled as needed, and then could withstand a couple of hours sitting wrapped up at room temp.
Yikes, good point! The chili I made today was cooked with two bay leaves. I was careful to remove them before packing up the food, kinda sorta thinking, “Dad might not recognize and remove a stray bay leaf, he might just swallow it.” But TBH, I didn’t really take it all that seriously. You have reminded me that yes, I do need to be serious about stuff like that. Thanks.
Adding to what others have said: They’re probably not eating enough. Put more on the plate than they ask for – not a huge amount, but a normal sort of portion; and tell them when they say it’s too much ‘don’t worry about it, just eat what you feel like and I’ll do something else with the rest of it later’. They’ll probably eat more than they would have otherwise, and may even
finish it off. Don’t bug them if they don’t.
Agreeing with this, but also adding: they may have gotten it into their heads that they mustn’t eat X. I wouldn’t argue with them about that, either; unless X is something absolutely essential for their short term comfort.
I would say, even if they are. When they were 40 they could eat cake even if they were overweight or diabetic. Why should they be forbidden to do so when they’re 80?
Do your best to offer healthy foods, of course; and try to adjust the cake ingredients to make that relatively healthy also. But ‘you couldn’t lose weight for 40 years so now that we’ve got control of the plate we’re going to force you onto a starvation diet’ is going to make the person utterly miserable, and may not even gain them more time in which to be so.
I don’t have much to add except that my father in his prime was always a very disciplined eater. But in his last years with dementia, when it came to something soft that he liked (he had dentures) he just let himself go. One morning my mom came down to find that he’d eaten almost all of a 9" pumpkin pie–they’d had 2 small slices after dinner, but he came down overnight and ate all the filling, leaving the crust.
At least the pie was relatively healthy. Another time he got hold of a jar of mayo and ate half a cup before anyone saw him. And he ate several mouthfuls of the kids’ white Play-Doh that they left near him on the table.
It sounds like the dad you’re cooking for isn’t at that stage yet, but this was unexpected for us.
Wow! No, he is much earlier along - until last week he has always remembered who I am. But of course, things will only get worse. I feel great sympathy for his daughter, and for all who take care of dementia patients.
Feeding mayo by the spoonful until a cup or more is eaten is a pretty standard feeding technique for late stage cancer folks wasting away. It’s soft, easy to digest, and very calorie dense. And the flavor is innocuous enough that even if their sense of taste is all wacked out, it’s unlikely to be (very) offensive to them.