Dementia diet: what and how you feed someone with memory problems

mmoran
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Posted: Oct 18, 2017 5:07 PM
For caregivers, dementia is a demanding disorder. It means understanding the dementia sufferer’s physical and emotional needs—with little help from the sufferer, who often can’t communicate their needs, especially around diet and mealtimes. As with every other disease, food can be helpful or harmful, a restorative blessing or a crippling curse. But even the most carefully prepared, health-supporting meal can become irrelevant if the dementia patient rejects it. I can’t tell you how many times caregivers have come to me in anguish. “My dad won’t eat.”

Dementia and diet

The most important thing I want to get across to caregivers is that we must never assume a dementia sufferer refuses food because he or she doesn’t want or need it. That’s because there are many reasons why someone with dementia may refuse to eat. The contributing factors, and the common solutions I see and hear about, include all of the following: Depression and loss of interest in food go hand in hand. What once was a time of enjoyment and pleasure seems, through the joyless fog of depression, like a dreary burden. There are many effective treatments for depression, including medication and other therapies, but it’s important to first get confirmation that depression is the true diagnosis. Symptoms can be contained or even eliminated with natural lifestyle and diet changes. The un-natural solutions offered by Big Pharma are to be avoided except as a last resort. Difficulty communicating. Dementia turns the brain into a scrambled, disorderly mess. It leads inevitably to problems such as letting a caretaker know the person is unhappy with the food being served and can manifest as refusing to eat, refusing to swallow chewed food, spitting food out, and other ways to send a signal. Letting the person choose from a selection of foods, or showing them pictures may help.
Pain. Someone with dementia may be experiencing tooth or gum pain that makes eating an ordeal. He or she often can’t express that they’re having, for example, denture or other painful problems, so regular oral hygiene and mouth checks are extra important. Fatigue. This can cause people with dementia to become tired of eating before finishing their meal. Fatigue can also lead to other difficulties at the table, such as problems with concentration or impaired ability to use common utensils—their knife, fork, or spoon. Caregivers must try to discern when the person they’re caring for is likely to be tired and try to schedule meals at times when he or she is most likely to be awake and alert. Medication. It’s no surprise that a new medication or a change in medication dosage can lead to loss of appetite. This is most likely for patients on a powerful Big Pharma meds instead of natural, gentler interventions. Caretakers must be sure to notify the patient’s doctor if this is the case. Physical activity. Even healthy people stay still for too long. An older dementia patient is even more likely to have too little physical activity of even the simplest kind, like walking. The result, of course, is lack of appetite—activity helps burn calories, which helps create the sensation of hunger. So encouraging activity is a vital step forward toward better health in general, and heartier appetite specifically.
Constipation. There’s nothing like a bout of constipation to depress the appetite. This is a common problem with dementia sufferers. Who wants to eat when you’re bloated or nauseous? Lack of physical activity is a major cause of constipation, so caretakers have yet another reason to encourage exercise. Enriching the diet with extra fiber-rich foods and plenty of fluids is often all that needs to be done. But if constipation becomes a persistent problem, it’s time to alert the medical team. Concentration. As with communication issues, people with dementia often have a short attention span and are easily distracted. This can lead to their forgetting that eating and drinking are underway—and wandering away from the table. Again, it’s essential that caregivers do not take this as a sign that the person is full and satisfied. It’s imperative that they recognize when sufficient nutrients have been consumed, and if they haven’t, their job is to bring the dementia sufferer back to the table. Coordination. What we do unconsciously every day—use a knife, fork, and spoon—can become extremely difficult, stressful, and depressing for people with dementia. I agree with the experts on elder care who recommend replacing the typical utensils with “finger food.” The benefits are many—mealtime is far less stressful, no utensils are needed, so the likelihood of dropped food is greatly reduced, and the dementia sufferer can retain his or her sense of independence and dignity. Many cultures include finger food as common at mealtime—antipasto from Italy, with its range of meat and vegetable finger foods—Chinese dim sum, Japanese sushi, all sorts of cheeses, bite-sized meats, mezze from the Mediterranean region. There’s no reason for finger food to get stuck into the chicken nuggets category.

Foods for dementia

There’s strong evidence that our bodies are not set up to effectively digest the mainstays of the Standard American Diet—grains, sugars, legumes, dairy products, processed oils, salt, alcohol, and coffee. Instead we should eat what our ancestors ate—fresh fruits and vegetables, nuts, roots, and meat. This is known as a Paleo or Keto diet, and I’m totally for it. The key? It’s all about keeping carbs away—replacing carbs with more nutrient-dense foods delivers health benefits across every part of our bodies—including our brains. Studies show strong indications that dementia can be slowed, halted, and even reversed when people observe this natural regimen. It means a radical change for some people, so anyone considering that change should get it cleared with their doctors.

B-12 deficiency

Almost every patient I see lacks vitamin B-12, which plays an essential role in helping the brain build new neural pathways—one of the key processes involved in creating and maintaining memory. As we age, we’re less able to fully absorb B-12, and on every kind of memory test, people with high levels far outperform those with low levels. Our bodies can’t manufacture the B-12 we need, so I recommend these delicious and healthy providers:
  • Cooked clams and oysters deliver more than 1,000 percent of the recommended daily intake (RDI)
  • Organ and muscle meats—a six-ounce serving of beef steak hits 150 percent of the RDI
  • Each whole egg provides about 6 percent of the RDI
  • One cup of whole milk provides about 18 percent of the RDI
To ensure adequate B-12, I recommend a supplement providing 6 mcg daily. The methylated form of B-12 is best. It’s not always easy to find in your average grocery store—visit your local health food store or find a good online supplement source. I hope my suggestions improve the lives of those with dementia and their caregivers. Take good care.

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