What To Do When A Person Living With Dementia Refuses To Eat

Why do people with dementia refuse to eat?

I had a recent Zoom call with a lady, who is caring for her partner with dementia, looking for advice and tips on how best to support him when he refuses to eat. And based on that conversation, I thought I would share some top tips. 

It also feels appropriate to talk about this, as it was #Nutrition and Hydration last week, and a topic which is very close to my heart and, I believe, much misunderstood.

I get very concerned when I’m completing my dementia mealtime audits in care homes when I see untouched plates of food being returned to the kitchen and I hear a carer say, ‘he/she refused to eat.

One of the most significant challenges carers can face when supporting a person living with dementia, is ensuring that a person gets the nutrition they need,  particularly when they refuse to eat.

You may also be interested to read my previous article, ‘How to Encourage People Living with Dementia to Eat’ 

And it makes me question how well carers are receiving the appropriate training to help them understand mealtime behaviours in people who live with dementia. 

How are your staff responding when the people you support living with dementia refuse to eat? 

 Are they probing deeper into other potential reasons why someone might not choose to eat? 

When they encounter challenging behaviours at mealtimes, do they see it as their problem for not getting the mealtime experience right for the people you’re supporting? 

To learn more ways of overcoming eating challenges with people living with dementia , why not download my FREE Dignified Dining Solutions guide here?

I remember well having this same challenge with my Mum, when she wouldn’t even pick up a knife or fork to eat, and would literally turn her head away from me when I attempted to assist her with her meal. 

You cant make someone eat, but you can help them want to eat again. 

I needed to learn why she was choosing NOT to eat. 

Through careful observation, changes to her environment, giving her choice, introducing adapted cutlery and crockery which meant she could retain her independence, and sitting and eating with her, gradually Mum began to eat for herself again.

And, after being told she would die in December 2016, Mum went on to enjoy 4 more Christmas dinners and blow out 396 more birthday candles before leaving us on Mother’s Day 2020. 

Dementia can affect a person's ability to recognize food, understand hunger and thirst, and remember how to eat.

 It can also cause changes in taste and smell, which may make food less appealing. As a result, people with dementia may refuse to eat, even if they are hungry or thirsty. 

Other factors, such as depression, medication side effects, dental problems, or difficulty swallowing, may also contribute to a person's refusal to eat.

I have a list of over 30 reasons, which can largely be broken down into 5 key areas. 

• Health
• Choice
• Meal Presentation
• Environment
• Care Delivery

I will be delving deeper into each of these topics individually in a series of 5 articles over the coming months, so keep an eye out if you’re interested! 

If you're struggling to understand why someone is refusing to eat, here are our top tips to help you encourage them:

1.Rule out any underlying medical issues: Before assuming that the refusal to eat is due to dementia, it's essential to rule out any underlying medical issues that may be causing the problem. For instance, the person may be experiencing pain or discomfort while eating, which is causing them to refuse food.

2. Assess their food preferences: Sometimes, people with dementia refuse to eat because the food doesn't appeal to them. Carers need to find out what types of food the person likes and dislikes, and prepare meals that are more likely to be appealing.

3. Create a calm environment: People with dementia can become agitated or confused by noisy and ‘busy’ dining rooms, making it difficult for them to eat. Creating a calm and peaceful environment can help to reduce stress and encourage them to eat.

4. Introduce adaptive crockery and cutlery:  If a person is struggling with traditional eating utensils, consider using adapted versions, such as large-handled spoons or forks, and lipped plates, to make eating easier and help retain their independence

5. Offer small, frequent meals: For some people, large food portions can be over facing, try offering smaller, more frequent meals throughout the day. This can help to increase  appetite and make it easier  to eat.

6. Consider texture modified foods: If a person is having difficulty chewing or swallowing, they may need a soft or pureed diet to make eating easier. Seek professional advice from a Speech and Language Therapist.

7. Seek medical advice: If a person with dementia continues to refuse food, it's important to seek medical advice from a healthcare professional. They can assess the person's nutritional needs and recommend a course of action, which may include nutritional supplements or other interventions.

Remember that it's important to approach mealtimes with patience and compassion. If a person is refusing to eat, it's likely that they’re experiencing some level of distress, and carers should try to address their needs in a gentle and understanding manner. With the right approach, you can help a person maintain their health and well-being.

To learn more ways of overcoming eating challenges with people living with dementia, why not download my FREE Dignified Dining Solutions guide here?