There are many causes of decreased appetite in the elderly and/or memory impaired. Many times it is related to medication, trauma, or infection. Lack of appetite or poor nutrition due to memory impairment or failure to thrive is not easy to overcome. Frequently the caregiver grows frustrated and overwhelmed. Here are some strategies that may help.
- Get to the bottom of it: A medical professional should try to determine the reason for the appetite loss. It could something fixable and transient, or it could be a long term issue.
- You need guidelines. You need to know dietary restrictions and caloric goals. Talk to your physician or a registered dietician. This isn’t guesswork, it’s science.
- There are some medications that can stimulate appetite- ask about them.
- There are some medications that decrease appetite-a medication or dosage change could be the answer
- Don’t present a bountiful, three course meal: When a person isn’t hungry, and they already feel full and satiated, eating an entire meal is next to impossible. In fact, because the meal presented is so “balanced” and comprehensive, the inherent message is that it all must be consumed. Saying “just eat what you can” implies failure. The appetite center simply shuts down and says, “No thank you”.
- A banana will do: And an hour or two later, a few crackers with cheese, and an hour or two later, an ensure milk shake, and after that, a bowl of ice cream, and after that, a half of a sandwich. Small treats spaced evenly apart will be more manageable than an “all at once approach”. It doesn’t matter when they get the calories, so long as they go in.
- Fortify their favorites: If you find that ice cream is rarely refused, then go with that. Stir in some fruit pieces, protein powder, or a nutritional supplement. Make a milk shake using Ensure and ice cream. You can even pour the ensure into a bowl and freeze it… looks like a bowl of ice cream when its frozen.
- Keep a log, use an online calorie counter, or download an app… find some way to track the calorie consumption so that you have some objective feedback about your efforts.
- Create a routine… dementia behaviors tend to be repetitive. Use that to your advantage. Same thing, same presentation. It sometimes works.
- They don’t remember anyway: present an item several times, especially if it was well received. Frequently, a person with dementia doesn’t remember eating just an hour before. Use that to your advantage.
If the person lives alone…
- Prepare and package snacks and small meals
- Label each item with a day and time it should be eaten (all “Wednesday” food should be eaten in one day)
- Throw out unused food at least weekly
Remember that adequate nutrition is vital to good brain health. Poor appetite and failure to thrive are common phenomena in dementia. Poor appetite is not something you attack, it’s something you work with. Be patient, creative and unconventional- and let us know if you have any other tips!