Appetite & Dementia

Common New Year's resolutions are to lose weight, change your diet, and curb your appetite. The opposite resolution goes for many caregivers caring for someone with dementia. Losing your appetite can be a symptom of dementia. It is a concerning symptom for caregivers, because their family member with the disease loses weight and muscle mass. This means they become more of a fall risk and lose the strength to help you help them. When they eat less and lose muscle, it becomes more of a challenge to help them get out of a chair, in and out of a car, or off the toilet.

As you might imagine, a common question for caregivers is what to do to get their family member with dementia to eat so they do not lose weight. Often in the later stages of the disease, caregivers become desperate to simply get calories into their family member. 

So, how do we get people with dementia to eat? First, asking people with dementia if they are hungry will not often result in an answer of "no." And, asking them what they want to eat is often not effective, either. Asking people who may have difficulty deciding what they would like or even understanding your question is very challenging for them to decode and comprehend; so, getting their cooperation can be difficult.

At the same time, two other important physical cues diminish. The cues for hunger and thirst are lost as part of the progression of dementia. The hypothalamus becomes compromised, and hunger recognition diminishes so they don't feel hungry. Thirst is very complex and involves the entire body, including the ventricles of the brain, circulatory system, and kidneys. As a whole, the cues that tell them they are thirsty are lost. Since our bodies are 70 percent water and our brains are a 25-watt, glucose-burning, water-based computer, the loss of water is loss of conductivity and thinking ability.

So, how do we get our family member with dementia to eat more?

1. If they are able to make small decisions, ask if they would like x or y to eat. Stop asking if they are hungry.
2. If decisions are more challenging, invite them (with a hint of excitement) to eat x with you. "Mom, I cooked your favorite, join me!"
3. Leave out easy-to-reach and easy-to-eat food, such as cut-up fruit, cheese, and nuts on a plate.
4. Cook bacon. Brew coffee. Bake cookies. Bake bread. Familiar and pleasant smells can engage long- term recall and associative memories and may stimulate appetite.
5. Ask for help from other caregivers, a dietitian, or a dementia expert to help your family member get more nutrition and hydration to make them more comfortable.

This article is a service of the Family Caregiver Support Program at the Lewis-Mason-Thurston Area Agency on Aging.