By Lauren Mahakian Contributing writer. Originally published in Santa Ynez Velley News on 10/28/2021
As we age and our activity levels and muscle mass decrease, so do our dietary and calorie intake requirements; however, even with lower calorie counts, the value of nutrients consumed should not change — if anything, some nutrients need to increase.
This is a challenging balancing act that can become even worsened when caring for a loved one with dementia.
Generally, between the ages of 60 and 70, our calorie intake needs reduce by approximately 200 a day. Daily calorie needs vary according to gender, age, height, weight, muscle mass, activity level and several other factors.
General guidelines indicate that females over the age of 50 require approximately 1,600 daily calories if sedentary, 1,800 if moderately active, and 2,000 to 2,200 with regular physical activity of walking over 3 miles daily at 3 to 4 mph.
For males, those same numbers increase to 2,000 to 2,200 calories daily if sedentary, 2,200 to 2,400 for moderate, and 2,400 to 2,800 for more active individuals.
To get the right amount and type of nutrients, however, it is very important for older adults to eat a variety of whole foods such as fruits, vegetables, fish and lean meats. Nutrients that become especially important as we age include protein, vitamin D, calcium and vitamin B12. Fiber also is necessary to fight constipation.
Eating challenges for people with dementia:
A person with dementia may lose interest in food. They may refuse to eat to the point of even spitting it out and become angry or agitated during mealtimes. This can certainly be difficult for any caregiver who is rightfully trying to ensure good nutrition.
If a person is not eating enough, it can lead to weight and muscle loss. They may also feel tired and weak. This can make them frail, lightheaded, more prone to falls, cause skin breakdowns and to make matters worse, any recovery from disease or infections, viruses or injury is more difficult.
Causes for poor appetite:
- Difficulties chewing are prominent among older adults;
- Pain caused by problems with their dentures, sore gums or teeth. Oral hygiene and regular mouth checks are important. Generally, those with poorly fitting dentures chew 75% to 85% less efficiently than those with natural teeth. Dentures should be adjusted for a proper fit. Softer foods are easier to chew;
- Problems swallowing;
- As the ability to smell and taste becomes dulled, food may be less appetizing;
- Medications and/or dry mouth may leave a bitter taste;
- Depression and feelings of isolation, prevalent with dementia, can reduce appetite. (If you suspect that the person you are caring for has depression, consult the general practitioner);
- Inability to communicate when hungry or if food is disagreeable, too hot or cold;
- Insecurity or inability in handling food;
- Tiredness which can cause people with dementia to not eat or give up partway through a meal. Offer food when they are most alert;
- Medications or dosages that can result in appetite changes. Check with pharmacist or general practitioner;
- Constipation caused by insufficient fiber or fluids and by physical inactivity. It is important to incorporate whole grain breads and cereals, legumes, vegetables and fruit;
- Inactivity and lack of stimulation which reduces appetite. Remember that activity is overall beneficial;
How to encourage someone with dementia to eat:
- Smaller and less overwhelming plates may be helpful;
- While focused on nutrition, don’t ignore personal preferences for taste or texture;
- Allow dessert even if they haven’t eaten their meal;
- Give gentle reminders to eat, and remind of the pleasures;
- If agitated or distressed, wait until they are calm and are less anxious before offering food or drink. Remember that these reactions are not a deliberate attempt to be “difficult” or a personal attack;
- Use eating and drinking as an opportunity for activity, social stimulation and conversation about memories;
- Prepare finger foods, such as sandwiches, slices of fruit and vegetables so they can snack on these easily. Consider including baby carrots, prewashed and cut salad ingredients in a bag, cheese and low-fat yogurt or pudding;
- Be mindful and observant. If lack of appetite and nutrition is a concern, speak to a general practitioner;
- Plan meals in advance. Not only does this allow for easy availability but also for conversation about the meal. Prepare stews, soups, casseroles or roasts in large quantities. Package in small containers and freeze the leftovers for reheating. Include instructions for reheating for other caregivers;
- Cereals and instant oatmeal are a good quick breakfast. Eggs and yogurt may be even better;
- Be mindful and observant. If lack of appetite and nutrition is a concern, speak to a general practitioner.
As you are taking care of a loved one with dementia, mealtime and their lack of appetite can be among one of the most frustrating efforts. With this in mind, employ as many techniques as possible to minimize the conflicts. Focus on health, optimum nutrition, and stay in touch with their physician and pharmacist to ensure enough calories and nutrition are being consumed.