Alzheimer's is a progressive disease of the brain that affects memory, thinking and comprehension, language and judgment. The progression of the disease begins to interfere with daily functioning, including the ability to prepare meals or even realize the need to eat.
Significance
As noted in a March 2010 article in "Nursing & Residential Care," Alzheimer's's disease is the most prevalent dementing disease. As the disease progresses, changes occur in the individual's nutritional status. The patient may forget the steps involved in preparing a meal and forget to shop for food. Safety concerns arise, as the individual may forget how to work the stove, may not recognize when food has spoiled and may not be able to pay attention throughout a meal.
Appetite Changes
In addition to the changes caused by the progression of the disease, there are other reasons a person with Alzheimer's may be uninterested in eating. The coexistence of depression, ill-fitting dentures, sore gums and reduced energy are factors that contribute to nutritional changes. People with Alzheimer's may not understand that the food in front of them is there to be eaten. Chewing and swallowing also becomes difficult as the disease progresses, creating a risk of aspiration.
Feeding Difficulties
The process of Alzheimer's creates some physical difficulties at mealtimes. The individual will have a a gradual loss of motor skills and may no longer know how to use a knife and fork. Apraxia is a condition in which the person may intend to open his mouth to eat but is unable to do so. This may cause family and caregivers to think the person is refusing to eat. Restlessness and agitation associated with Alzheimer's causes the individual to be unable to sit for prolonged periods, and she may throw or spit her food.
Dietary Recommendations
Interventions to help improve diet and nutrition with Alzheimer's should include offering frequent feedings with small portions. Control noise and distractions, use cups and utensils that are easy to grasp, serve one item at a time and supervise the meal encouraging eating. Encourage independence by providing finger foods such as toast, sandwiches, hamburgers and fruit. Cut meats into small pieces, and allow plenty of time for eating. Individuals with Alzheimer's may lose the ability to judge temperature, so make sure foods are not too hot. For those with low body weight, including energy-dense snacks such as milkshakes, cheese or puddings can be beneficial.
References
- Mayo Clinic: Alzheimer's disease
- "Nursing & Residential Care"; Nutrition and dementia; A. Dunne; March 2010
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