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Encouraging Eating: Advice for
At-Home Dementia Caregivers


(Page 5 of 7)

In addition, visual, verbal, sensory, and physical cueing can promote independence, especially when the cues are based on lifelong habits. Coppola recommends starting with visual cueing, which can be as simple as eating with the person as a reminder that it is mealtime. Place utensils in the positions in which they will be used. Dishes that are different colors from the food help the person distinguish the food.

Clear, easy-to-understand verbal prompting may also be needed. Depending on the person’s language ability, this may mean giving very specific, step-by-step directions, or it may mean offering simple choices, such as “Do you want peaches or apples?” or “Would you like cream in your coffee?” Verbal prompts such as “Do you think the beans have enough salt?” can focus the person’s attention on the food.

Sensory cues, especially those involving smell, can let the person know it is time to eat. Sifton notes that nothing “says” mealtime and triggers the appetite more than aroma of soup or stew simmering on the stove or something baking in the oven. Even the smell of toast can help.

People with more advanced dementia may also need physical prompting to initiate the process of eating or to continue eating. For example, the caregiver might place a finger or hand under the person’s grasped hand on the fork and guide it to the mouth. After getting help with initiating eating, the person may then take over.
However, Sifton notes, while physical cueing often can help, caregivers should not step in too soon. Doing so can diminish the care recipient’s sense of personal control and independence. “When the person starts to have difficulty doing things, it’s often too easy for the caregiver to take over, rather than finding ways to involve the person,” she says.

Maintain Familiar Routines

Change can be difficult for a person with AD, so preserving familiar routines and rituals, and respecting lifelong preferences and eating habits can make mealtimes easier. Many caregivers have found that maintaining a sense of normality adds to mealtime pleasure, provides reassurance, helps maintain the person’s dignity, increases food consumption, and eases the tension that often arises during mealtimes. “Follow the person’s normal routine to the extent that you can,” suggests Epstein. “That makes the person more relaxed and, because it’s predictable, he or she will feel more in control knowing what’s going on.”

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