Nutritional care of patients
with Dementia
Sarah Herbert – Dietitian (BSc, RD) Mental Health
Services
Lynn Mockridge - Advanced Mental Health worker and
Nutrition Advisor
Contents
 Introduction
 Dementia
 Effects of dementia on nutritional status
 Practical advice – support with eating and
drinking
 Nutritional therapy in Dementia
 Quiz
 Questions
Introduction
 Based at Callington Road Psychiatric Hospital
 Long, enduring mental health conditions
 Intensive care, acute, rehabilitation and elderly
(one organic, one functional) units
 Team of four; three Dietitians, one Nutrition
Advisor/Advanced MH worker
Dementia
 Dementia describes a number of conditions in
which there is a progressive loss of brain function.
 About 750,000 people in the UK have dementia
and this number is expected to double in the next
thirty years (DoH, 2012)
 As Dementia progresses, so does an individual’s
ability to eat and drink resulting in a decline in
nutritional status.
Effects of Dementia on nutritional
status
 Early stages – weight gain?
 Poor appetite and dehydration
 Weight loss
 Re-feeding syndrome
 Increased nutritional requirements
 Vitamin and mineral deficiencies
 G.I disturbances from medication may affect appetite
What are the common difficulties with
eating and drinking?
Decreased ability
to recognise
hunger and satiety
Lack of
recognition
Food
preferences
may change
Challenge to
communicate
likes and
dislikes.
Cutlery may
become difficult
to use or
forgotten how to
be used
Motivation
Concentration
Preparing/cooking
food may become
difficult
Environmental
issues:
inpatient
facilities.
Dexterity
issues
(manual and
mental)
Preparing for a meal
 Encourage the person to go to the toilet before
meals if needed
 Making sure glasses or dentures are in place for
the meal
 Consider using adapted cutlery
 Use plate warmers to help keep food warm
 Use contrasting coloured plates
 Avoid distracting items on the meal table
 Ensure good oral hygiene after eating
Taste changes
 Try naturally sweet vegetables
 Use sweet and sour sauces
 Add honey to vegetables
 Add a little sugar to mince, stew or potatoes
 Encourage milk-based puddings such as:
Refusal of food previously accepted
 Strong flavoured foods, spicy foods or previously
disliked foods may now be enjoyed
 Keep an open mind, don’t exclude any foods
 Keep a list of current preferences
 Try adding additional spices, herbs, onion, garlic,
chilli
 Avoid adding extra salt
 Offer table sauces – chutney, pickle, relishes,
vinegar, mustard
What if someone struggles to finish a
meal?
 Allow extra time for meals as needed
 Serve one course at a time to keep food warm
 Prompting/Reassuring
 Dish up a small amount of food at any one time
 Consider offering 5-6 small snacks during the day
rather than 3 main meals
 Avoid removing plate early in an inpatient/care
home setting
Wandering/distraction at mealtimes
 Leave out snacks along the route the person walk
or place foods in their hand to prompt
 Try a variety of finger foods
 Encourage high energy foods where possible
 Change the environment
 Change mealtimes to suit the person
Food fortification
 Don’t add extra foods but concentrate with
energy and protein
 5-6 small meals/snacks instead of 3 larger meals
per day
 Avoid low calorie/reduced fat foods
 Add extra butter, cheese, cream, sugar to foods
 Spread jam/honey thickly onto toast/crumpets
 Fortify full cream milk by adding 2tbps of milk
powder
Quiz!
Thanks for listening!
We hope you enjoyed it and found it
helpful