"But Dad, You Just Ate": How Alzheimer's Changes Appetite and What to Do About It


Last updated: April 28, 2009
Semlor
Image by Per Ola Wiberg (Powi) used under the creative commons attribution license.

I grew up in the Clean Plate Club generation. My parents encouraged us to finish our green beans because "kids are starving in China" "“ neither a motivating nor very logical connection to me then or now. Dad, who's 87 and has dementia, still cleans his plate today. And then he's ready for dessert.

Soon enough, he's ready for dessert again. Hunger, world or personal, have nothing to do with it, however.

Dad eats, and eats again, because he can't remember having just done it.

Many people with Alzheimer's inadvertantly over-eat --- or often more dangerously, under-eat. Among the factors that cause their eating habits to shift:

  • A recent meal or the intention of a meal is lost in their faulty short-term memory.
  • They lose the ability to read the body's signals of hunger or fullness.
  • They're easily distracted.
  • They may lack impulse control, adding to overeating (and distraction).
  • They lack the ability to run through the steps of preparing a snack or a meal.
  • They may remember long-held beliefs about diet (e.g. "I can't snack, it's fattening") to the exclusion of the short-term need to eat at all.
  • Impaired senses of smell or taste (common in aging generally) contribute to a decreased appreciation of food.* They lack hand-eye coordination to manipulate silverware (later-stage disease).

If someone with Alzheimer's eats too much:

  • Consider the big picture, before you worry.

If the person is gaining weight to an alarming degree it makes more sense to be vigilant about quantity than if they are a normal weight or only slightly overweight. My dad, for example, is not gaining weight despite a prodigious appetite. But he also has an unbiopsied renal tumor (long story) and probable cancer. Curbing his eating habits made more sense 10 or 20 years ago than under current circumstances.

  • Consider disease stage, too.

Someone in early stage disease often still has the motivation to do everything possible to slow disease progress, and eating nutritiously may help keep blood sugar stable and cardiovascular health good. On the other hand, my Dad's disease is moderate and declining. He doesn't have all that many pleasures in his life. I don't see the point in denying him a second bowl of ice cream.

  • Serve restaurant-style rather than family-style.

If cutting back on seconds is needed, plate the food before you bring it to the table and prepare only enough for each diner.

  • Monitor and distract.

After a meal, don't linger over coffee and dessert. Get the person involved in an activity "“ if you've always run a dishwasher, you might discover that a willing and able aide in your relative with dementia. (Competent is another story. My Dad loves to do dishes but his rinsing is a little iffy. He's great on the drying, though.)

If someone with Alzheimer's eats too little:

  • Make sure they eat heartily early in the day.

Caregivers who don't live-in often take pains to prepare reheatable hot dinners for relatives with dementia (or for the convenience of a disease-free spouses to prepare). But it's the morning that's often the most alert time of day for people with Alzheimer's.

Better: Deliver breakfast casseroles containing eggs and meats. Or make sure there are other hearty breakfast choices like hot cereal, waffles, muffins, or smoothies.

  • Try helping the person focus on the meal at hand.

Easy tip: Use a placemat in a sold color that contrasts with the dishes, to draw attention to one's place setting. Bright colors are more effective than pastels. (And patterns are too distracting.) Put a small amount of food on the plate at a time so as not to overwhelm.

  • Serve small, caloric snacks instead of meals.

It's easier to coax some people to have a bite to eat during the course of the day rather than to make a production of a meal. Good options: Nutrition-supplement shakes, finger foods like cheese and crackers, nuts (if not a choking hazard, as they can be for people with late Alzheimer's who forget to chew).

Of course [keeping an eye on the eating habits of an elder with dementia] (http://www.caring.com/articles/how-to-solve-eating-problems-common-to-people-with-alzheimers-and-other-dementias) is part of the bigger picture of caregiving. And you should let a doctor know about five-pound weight swings in either direction.

For many people in mid-stage disease, though, mealtime behavior is just another quirk to roll with. One recent evening my sister and I were catching up and playing Scrabble while Dad read the paper at the other end of the table. Next time we noticed, the remaining half a coffee cake had vanished. It was amazing, and funny, and a little disappointing. We'd really wanted some.

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15 Comments So Far. Add Your Wisdom.

Anonymous said about 1 month ago

Should you feed your loved ones through the night when they are asking to be feed?


4 months ago

An eye opener and pleased I ran across this group


4 months ago

My wife just started the hungry theme today and ate a half loaf of bread. Glad I tuned in as I was getting angry but see that many others have the same problem. Many thanks.


Anonymous said over 1 year ago

My 90 year old mother-in-law has lived with us for over 25 years. She is near or in the final stage and still is able to talk, but she is not able to communicate a complete thought other than very simple comments/questions/answers. She has almost no appetite and has lost over 50 pounds over the past 3 years (currently weighs 72 pounds). We think her weight loss will take her before her diabetes, high blood pressure, or other complications from the disease. Getting her to eat is a challenge. Only liquids and soft finger foods, which need to be given constantly (she will only eat small amounts at a time). We think she is getting maybe 500 - 600 calories a day. Because she is lactose intolerant and cannot handle fruits, we are limited to foods that don't upset her stomach and/or result in diarrhea. Boost is the only lactose free nutritional drink that she marginally tolerates - recently Boost has caused diarrhea, but we don't understand why. At this point in her decline we are only trying to make her comfortable.


over 1 year ago

Dose any one no why my mum keeps wiping her tongue all the time is it a habit as there is nothing wrong so the doctor says


over 2 years ago

Once again this info is so helpful. My mom is in mild to moderate Alz. She loves chocolate and junk food. The only nutritious food she eats is when I get home and prepare dinner. After reading these comments I now believe that mom is also having a difficult time chewing meat and or is uninterested in it because it isn't junk or sweets. Thanks for the info it really helps to hear others situations and answers to this disease that changes ones habits on a daily basis.


over 2 years ago

I've noticed that my mum thinks gravy and parsley sauce and any kind of sauces are greasy. I feed her mini shredded wheat with cut up strawberries and banana and at about 2 in the afternoon I give her brown bread and tin cream of chicken soup, for dinner she will only eat fishcakes or corn beef however on a sunday she will eat chicken but now without gravy I have to drain it off her plate am I giving her the right foods I tried her on other things but she will not eat them. Recently she has also started getting me to buy her bags of maltessers if I take her into the shops she started grabbing at the chocolates she was diagnosed with glucose intolerance a few years ago but since being diagnosed with Alzheimers the doctor said to let her have what she wants she can feed herself and walk however her mental state is not good she hears things that is not there and constantly says people are in the house and that she is not going to hospital etc.The doctor says she has severe alzeimers.


about 3 years ago

Info on increase of eating-but still maintains weight. Was concerned


My mom is a chocolate freak too. She will eat that no matter what. The sugar on the food sounds like a good idea. I bet anything that if you read the ingredience in a jar of spagetti that sugar is one of them. I Know that they put it in some chilies so I dont think that is that unusual.


over 4 years ago

My mother overeats, eating constantly like a nervous habit. She is not gaining weight so that is not my worry. She is diabetic but she is 89 and stage 2 AD so as in the article, I don't worry about her diabetes. Her blood tests are ok, controlled with medication. However, she is eating us into a hugh grocery bill and frequently eating things in excess to cause herself diahrria. One too many whole grain wheat pieces of bread, apples or grapes. This morning I put out 2 bananas. She will eat those within 15 minutes of getting up. She then ate almost all of an cooked apple/raisin desert I had just made by standing over it at the counter, spoon in hand, eating all the time I was in the shower until she ate equivalent of 3 appleas in 15 minutes. I try to distract her, I try to have healthy things out -peanuts, whole grain cerials, fruit, carrots. But she will eat it all as fast as I put it out. If I limit what is there, like the bananas (I hide the rest) she starts hunting in the frig and cupboards. So I'm hiding more and more food and controlling what is out. She will eat a large meal which I make sure is at the same time each meal. Then get up and start grazing on anything in sight, or ice cream. After lunch she will immediately start on ice cream and after about 5 bowls, one right after the other go through half a gallon of ice cream in one day. I spend most of my caregiving time dealing with food and grocery shopping. We are on fixed income and I am starting to wonder how I will be able to control the grocery bills, and yet keep her happy and healthy. Am I the only one with this problem? Can you tell how frustrated I am? Trying not to control her yet wondering how to at the same time. Any suggestions?


Anonymous said over 5 years ago

I was so encouraged when I read that your dad eats and eats-my dad lost my mom 9 months ago suddenly-he has dementia/alzhimers/altered mental status- he has gained 40 lbs in 9 months- he neds to lose instead of gaining, keeps gaining, he falls all the time, never breaks anything and sometimes does not know who I am- the only child-or who his grandchildren are- I have to work andmy usband works night shift-so I stay at home in the morning til my husband comes home-so we are with dad most of the time-dad can hardly walk, he has sat in a chair for 9 months and done nothing, tried physcial therapy- he will nto do the excersies, he just wants to be with mom-which is out of his hands- I need a support group so I can hear things like I did, that some of these patients eat and some don't-dad does liket drink gin, and that does not help any of the issues, but he keeps saying you have taken everything away from me, please don't take the gin- I hope that someone will read my short story- (sorry it is so long) and help me with just a e mail of support- thank you Bonnie Lassiter bglassiter1@bellsouth.net


Anonymous said over 5 years ago

I have extreme difficulty getting my mother to eat anything, except chocolate. She won't do the Ensure or milkshakes - some days are a bit better, but she seems disinterested in food.


Anonymous said over 5 years ago

I've also noticed my dad only likes foods that are easy to eat. Meats particularly are very difficult as he has lost many teeth. Most afternoons I fix a milkshake with whole milk and an Instant Breakfast and then he has an Ensure Plus two times a day along with his meals. That way, I know he's getting nutrition even though he may not eat much of his meals. A health care worker told me once that they would put sweet 'n low or sugar on the elder person's food no matter what it was. Seems they would eat anything if it was sweet. I haven't tried it yet as the thought of sugar on spaghetti just doesn't sound too appetizing. But I may soon.


over 5 years ago

Dad also doesn't always remember eating a meal. My question to anyone who can help, he has Alzheimer's & also is Diabetic. Does the additional Sugar he got a way with also contribute to the forgetfullness? Cuz He's always hungry. tried different combinations of meds for both.


Anonymous said over 5 years ago

I've noticed that my mother prefers meals that she doesn't have to chew too much ie. soups,casseroles etc. When she has too chew foods like meats etc. she quickly becomes disinterested and stops eating. Smaller snacks throughout the day such as tuna fish or egg salad on a soft bun seems to be effective. Also she likes pizza.


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