Malnutrition awareness week takes place from 10^th – 16^th October in the UK. This year, the Malnutrition Task Force and BAPEN have one simple request – to Ask, Look and Listen, and recognise that we are ALL in this together. More than three million people across the UK are either malnourished or at risk of becoming malnourished, with an estimated one million of these people over the age of 65. This coincides with a higher likelihood of someone living with dementia to forget or neglect to eat or drink, as a result of their diagnosis, therefore experiencing an increased likelihood of malnutrition or dehydration.

If you know someone who may be at a higher risk, because they are older, or living with dementia (even more so if they are living alone), do not be afraid to ask them if they are eating and drinking properly. You should feel comfortable asking them about their appetite or ability to prepare their own food or drink, as malnutrition and dehydration are gradual processes that are not always easy to recognise at first. To combat this, you should always be on the lookout for tell-tale signs of unplanned weight loss such as loose clothes, jewellery, or dentures. You can also check to see if someone’s fridge or cupboards are unusually bare or empty, as this may also be a sign that they are not eating sufficiently. It may not always be obvious that someone is not eating or drinking enough, so by listening for subtle hints that someone is suffering from malnutrition during conversation can help you to spot these signs sooner. These signs may not be about eating and drinking directly, rather about feeling lonely, symptoms of apathy (disinterest for things that were once exciting or enjoyable), or fatigue. Active listening can help you decide how capable someone is of looking after themselves.

It is easy to overlook the detrimental effects of dementia on someone’s eating and drinking habits; however, these effects have the potential to be far more damaging to an individual than you may think. Naturally, if someone is not eating or drinking sufficiently, the long-term effects can be fatal. A dementia diagnosis can make eating and drinking far more challenging/ complex for someone, particularly if they live alone, or do not receive regular care.

So how might dementia affect someone’s eating and drinking habits?

People with dementia face a number of difficulties when it comes to eating and drinking, on a daily basis. For example, somebody living with dementia may lose the ability to distinguish between day and night, and therefore breakfast and dinner. They may not be able to acknowledge the feeling of thirst, or the ability to communicate this feeling to others, such as carers. People with dementia, particularly those with the frontotemporal type, often over or undereat as a result of change in behaviour. Not only this, but it is common for those living with dementia to throw food away, unplug or use kitchen appliances incorrectly, ignore best before dates and lack attentiveness to their own dental hygiene. As well as this, alcohol consumption can also become a problem that those with dementia may be likely to face.

Additionally during the coronavirus outbreak and in the aftermath of lockdowns, more people have been subjected to heightened risks of malnutrition. It is both a cause and a consequence of ill health and is often a hidden problem that goes unnoticed. Malnutrition can have a devastating effect on physical health and emotional wellbeing and can often lead to or exacerbate long-term health problems. Yet sadly many of us are not familiar with the signs, symptoms and risk factors that would help us recognise that a loved one or somebody in our community is at risk of suffering from the condition. On top of this, the current cost-of-living crisis has meant that many people are feeling extremely worried about how to manage household finances, everything from heating to eating. High price rises in food and energy are forcing people to think twice about what they are buying. These tough decisions may lead to people skipping meals, increasing the risk of vulnerability to malnutrition.

What can you do if you are worried that someone you know may be at risk of malnutrition?

Generally, there are a few tips for how to ensure someone with dementia maintains a healthy, balanced diet and stays hydrated. By placing reminders around the home to eat at certain times, it becomes a lot easier for someone living with dementia to remember to eat and where food can be found, etc. You may have heard of a day and night clock – a clock that clearly shows both the time, and whether it is day or night. This way, managing mealtimes is a lot simpler and one’s diet will benefit from distinguishable morning and evening meals. For tips on staying hydrated in spite of the challenges associated with dementia, see our blog on Hot Weather.

You may also choose to decorate the kitchen with reminders about what appliances are used for and how to use them; maybe even suggested meals and clear labels on food. It may be the case that someone with dementia is refusing to eat or complaining that they aren’t hungry. If this happens, a selection of finger foods or small snacks could be placed around the house to encourage someone to eat. Someone with dementia may also confuse the desire to eat with that of thirst, so it is important to consider all the potential causes of malnutrition.

If you haven’t already, it may be a good idea to inform trusted neighbours of your loved one’s dementia and behavioural patterns. This helps to further ensure the person with dementia’s safety and can provide a closer point of contact if a problem arises. A common example regarding eating and drinking is that someone with dementia will throw out perfectly good ingredients or pre-cooked food. Having a neighbour to notice this acts as a catalyst for support and can make a huge difference. Many of the relatives of people we support order a weekly shop online, which removes the stress of food shopping that someone living with dementia may face. (If someone has expressed to you that they enjoy shopping, allow them to continue doing so, perhaps accompanying them to ensure nutritionally acceptable choices are made.)

It is important to remember that everyone with dementia is different and their dietary needs may change significantly, as per the development of their condition. As do their behaviours and attitudes to certain foods. If you would like advice on how to overcome specific eating and drinking difficulties, please contact us on 01474 533990 or email info@alz-dem.org.