Living with dementia: a dietitian’s perspective

Dementia is the second leading cause of death among older Australians. Most people think it is an age related condition that only causes memory loss and inability to think clearly. But it can have a severe impact on physical health including changing eating habits which concerns many families. We caught up with Kay Holmes, Chief Dietitian at Goodwin House, Ainslie, to understand more.

Kay, there is a common misconception that dementia only affects mental health. Can you tell us how it has a direct impact on a person’s eating and nutrition?

Because dementia causes progressive memory loss, people with dementia can forget how to eat, chew and swallow. They may also forget how to use cutlery. This causes them, over time, to lose interest in eating and drinking. When they don’t eat, they lose weight and become malnourished, and that is when it starts taking toll on their health. Consequently, their immunity goes down, and they are more likely to get sick and take longer to recover, leading to a constant deterioration in physical health.

So what can families do when they notice a loved one refusing food, if they live with dementia?

If your loved one is living with dementia, you need to relax and be very patient, especially during meal times. Make meals simple, relaxed and calm, and allow time for their memory to respond. Helping to maintain independence and dignity with eating and drinking has a positive effect on people living with dementia, and improves their quality of life.

Kay’s 6 magic tips

1. Set reminders for meal and snack times through an alarm clock, or making phone calls
2. Eat together as much as possible. It helps your loved one to copy you if they forget how to eat.
3. Offer finger food that’s easy to munch, and doesn’t require cutlery.
4. Replace low calorie foods and drinks with high protein, high energy options, such as milkshakes, yoghurt, and smoothies.
5. Spread out meals across the day. Often three big meals a day can become hard to manage.
6. If your loved one shows a tendency to eat more at a certain time of the day, plan larger meals at these times.

How do you incorporate these methods at Goodwin to ensure the wellbeing of your residents?

Goodwin residential care facilities are striving for a food-first approach before considering supplements, which can have a high refusal rate over time. I am currently working with our head chef, Sandeep Vaid, to create a “grazing menu”. Essentially, it means a menu of nutritious and easier-to-eat finger food that people can munch, on-the-go. It will be particularly useful for residents who find it difficult to use cutlery and it will also cater to those who like to eat throughout the day or have smaller appetites. We are also looking into news ways of presenting puree food that is more visually appealing and recognisable to residents, which will hopefully reduce food refusal.