4.3 Eat well

Carers’ lives are busy. It can be challenging to plan, shop for, and prepare nutritious, healthy meals. Dementia can bring additional challenges to meal preparation.

Some people with dementia are known to have sensory changes of taste and smell which may reduce their appetite and people with frontotemporal dementia often develop a hankering for sweet things. Others may find their sense of smell and taste have become dull and want to eat spicy or highly flavoured food or alternately show little interest in food. Some medications can also dull the sense of taste. The presentation of food can be important to encourage people to eat.

Maintaining good nutrition can feel like an added challenge! Some tips to help you include:

• If shopping is difficult, consider using online shopping with home delivery. This is offered by the larger supermarkets, but many shops in small towns will offer this service.
• Make shopping a social activity and go with a friend or neighbour.
• Consider getting a meal service. You can order a couple of meals a week from a provider like Hello Fresh or Marley Spoon who will deliver all ingredients with a recipe for a meal of your choice. This can be a good way to try new meals and add variety to the weekly diet.
• Supermarkets often sell pre-prepared vegetables for salads, soups and stews. This can cut down on preparation time.
• Cook in bulk. When you cook, make double quantities and freeze portions for later.
• Ask others to help. Often family members or neighbours are happy to cook extra meals to freeze.
• Involve the person with dementia in cooking. Even if they haven’t been interested in cooking previously, get them involved particularly in meal preparation. Preparation can sometimes stimulate the appetite.
• Keep nutritious snacks like nuts, unsweetened yoghurt and fresh fruit on hand.
• If you need to change your diet or your person’s diet, do it gradually.

Research indicates that a Mediterranean diet might help lower the risk of dementia, but there is no proof this diet helps people who already have dementia.

A Mediterranean diet includes:

• lots of vegetables and fruits,
• pulses and nuts,
• whole grains,
• fish and seafood,
• olive oil, and
• some dairy.

The Mediterranean diet has less sugar, red meats and processed foods. You don’t need to cook Mediterranean recipes, just eat foods commonly found in Mediterranean diets, and avoid foods not in the diet. It is a healthy, colourful, and tasty diet which is rich in nutrients.

Nutrition levels

There are nutritional drinks under investigation to reduce symptoms of dementia. Marketed as Souvenaid in Australia, and available in pharmacies, there is some evidence they may help slow progression in early Alzheimer’s disease. Current Australian Dementia Guidelines recommend that Souvenaid not be used for people with moderate or severe dementia.

If you are at all concerned about your nutrition – or the nutrition of the person you support, ask your GP to check levels of key vitamins and various blood markers for nutrition. If required, your GP can refer you to a dietitian for specific advice. Dietitians can also advise on particular issues that may affect eating, including poor teeth or dry mouth, as well as a healthy diet if people have other chronic health conditions.

Drink less alcohol

Drinking alcohol, especially heavy drinking may accelerate deterioration in people with dementia. Heavy drinking is defined as more than seven standard drinks a week for women, or more than 14 drinks a week for men. Do not have more than two standard drinks per day and aim for at least two alcohol-free days each week. Consider trying non-or low-alcoholic beverages or substituting with juices like cranberry juice. Again, a dietitian can help provide advice for your situation.

Drink more water

It’s easy to forget to drink, and the ability to sense thirst decreases with age. What’s more, research suggests that peoples’ ability to think clearly decreases when they are dehydrated. Stay hydrated by drinking sufficient water every day and drink more water on hot days.

Make it part of your routine to have a glass of water with every meal, and in between meals too. To prompt drinking more water, some people fill a jug each morning and leave on the kitchen bench to prompt them to drink water during the day. Water is the healthiest choice, but tea, milk, juice or soup can also help you stay hydrated.