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Alzheimer’s
Alzheimer's disease is a progressive disorder of the brain that causes the brain cells to shrink and eventually die.
Alzheimer's disease is a progressive disorder of the brain that causes the brain cells to shrink and eventually die. It is the most common cause of dementia (loss of memory and cognitive skills) in the elderly. This condition presents with a gradual decline in thinking, emotive capability, behavioral, and social skills.
The earliest sign of Alzheimer’s disease is often loss of smell, followed by lapses in memory. The person may forget the recent events or conversations. As the disease progresses over the months and years, the patient will develop severe impairment of memory and speech; they may not be able to take care of their daily routine, such as bathing, using the washroom, brushing the teeth.
A caregiver (which could be a friend, family member, or professional) of an Alzheimer’s patient must be attentive and aware of various issues faced by the patient. They must ensure the patient is properly eating, drinking, and grooming. Being a caregiver for a patient with advanced Alzheimer’s can be tough because the patient cannot always express their needs. They may not realize when they are hungry and/or thirsty. Also, they may sometimes forget to swallow and chew the food. Though it is distressing for a caregiver when patients stop eating or talking, they need to be patient while taking care and step up if needed.
Table. Potential reasons for an Alzheimer’s patient to stop eating
Cause
Explanation
Management and tips
A stomach or a gut infection
Stomach pain, loss of appetite, or nausea triggered by an infection may reduce appetite
Soft bland diet
Medications
Giving fluids, such as soups, juices
Bloating or gases due to constipation may lead to reduced food intake
Soft bland diet
Medications
Adding fiber or bran (prunes, raisins) to the diet
Increase the water intake
Oral issues
Sores inside the mouth
Gum swelling
Dental caries
Inability to open mouth to eat (trismus)
Fix an appointment with a dentist
Local gels for mouth ulcers
Vitamin B12 supplements
Helping them brush the teeth
Side effects of medications
Schedule a visit with the physician
Difficulty chewing and swallowing
Weakened jaw muscles
Inability to swallow due to poor tone of throat muscles
See an occupational therapist
Serve foods that are easy to swallow, such as applesauce, pudding, yogurt, or pureed food
Cut solid food into small pieces
Never serve very hot or cold foods
Accompany the old age and the disease progression
Spend time with them
Help them visit other people of their age
Listening to music or painting may help as well
Advanced memory loss
They may not realize the food must be eaten
Forget to swallow
Let them smell or feel the food
Eat with them or direct the food to their mouths
Serve food on dishes that are of a different color from the food
Maintain fixed eating times
Reduced activity
Lying in bed all-day
Lethargy
They are not motivated to move
Take them for a walk
They can do minor stretching exercises under the supervision
Denture problems
Loose dentures or dentures with bumps or cracks may cause pain while chewing, making it hard to eat
Get dentures that fit
Comorbid conditions
Uncontrolled sugars
Liver problems
Kidney disorders
Tumors
Schedule regular visits to the physician
Feeding tips for caregivers of Alzheimer’s patients:
- Get the patient to sit up straight when they eat. Keep the person upright for 30 minutes after eating.
- Choose soft foods that can be easily chewed and swallowed. Thicken liquids with corn-starch before consumption or give them pudding.
- Serve their largest meal at the time they are most hungry.
- Offer them just one food at a time (e.g., a bread sandwich) instead of filling the plate with too many things.
- Sometimes a person needs cues to get started. Put the food on a spoon and try guiding it to the person's mouth.
- Consider a high-calorie drink, such as protein milkshakes, if they refuse to take proper meals.
- Be patient and allow them time to eat, chew, and swallow.
- If the person has trouble swallowing solid foods, try fruit juice, custards, or soups.
- Consider giving a multivitamin supplement as a complement to the person’s diet. Talk to the doctor before initiating any supplement.