Why Do Alzheimer's Patients Stop Eating?

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

Constipation

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

Dry mouth

Metallic taste in the mouth

Nausea

Heartburn

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

Depression or anxiety

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

Fever

Pneumonia

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.