Helping Someone With Dementia Eat and Drink

By Silver Sitters

Appetite and mealtime habits can change when someone has dementia. Changes in taste, smell or medication effects may play a part. Difficulty chewing or swallowing also needs attention. New or persistent eating problems should be discussed with the person’s healthcare professional rather than assumed to be an unavoidable part of dementia.

Make meals familiar and unhurried

Offer preferred foods that fit the person’s dietary and swallowing needs. Keep a familiar routine and reduce distractions such as a loud television. A calm meal can still include friendly conversation; allow time for each mouthful and avoid talking while food is in the mouth.

• Present one item at a time if a full plate feels overwhelming.
• Encourage the person to do what they can independently and offer gentle assistance when needed.
• Try smaller, more frequent meals if large portions are discouraging. There is no fixed number of meals that is right for everyone.
• Do not rush, pressure or force-feed the person.

Get help for swallowing difficulties

Coughing during meals, a wet or gurgly voice after drinking, food feeling stuck, unexplained weight loss or repeated chest infections can signal a swallowing problem. Seek prompt medical assessment. A speech-language pathologist can assess swallowing, and a dietitian can help with nutrition needs.

Food texture, bite size, drinks and any thickener should follow the person’s individual swallowing plan. Do not assume that finger foods or food cut into smaller pieces are safe for everyone. Avoid experimenting with textures when swallowing is difficult; ask the care team for specific instructions. Modified textures and thickened drinks do not remove every aspiration risk.

If someone is choking and cannot breathe, speak or cough effectively, call 911 and begin appropriate choking first aid. Follow the emergency dispatcher’s instructions.

Review nutrition and hydration together

Tell the care team about reduced intake, weight changes and trouble taking medicines. Follow any prescribed fluid limits and swallowing instructions when offering drinks. Ask the clinician or dietitian about practical ways to meet the person’s needs, including whether supplements are appropriate. Do not crush medicines or add them to food without checking with a pharmacist.

Care preferences and goals may change in advanced dementia. Discuss comfort, nutrition and available support with the person’s healthcare team and involve the person in decisions as much as possible.

Support at home

Silver Sitters can discuss help with meal preparation, companionship and daily routines. Share the healthcare team’s written instructions and clarify the assistance needed. Caregiver support complements professional swallowing and nutrition assessment.