Nutrition and Mealtimes: Supporting a Person with Dementia
Eating well is important at every stage of life. For a person living with Alzheimer’s disease or dementia, getting enough food and fluids can become more challenging as the disease progresses. Changes in appetite, taste, smell, memory, physical abilities, and swallowing can all affect eating.
For caregivers, mealtimes can sometimes feel stressful or overwhelming. Creating a calm environment, offering nutritious foods, and adapting meals to the person's changing abilities can help make eating more comfortable and enjoyable.
Focus on building a balanced plate.
Whenever possible, offer a variety of nutritious foods throughout the day. Aim to include fruits and vegetables, whole grains, lean proteins, dairy, and healthy fats for vitamins, minerals, fiber, and other nutrients. Rather than focusing on a perfect diet, focus on providing foods the person enjoys and will eat.
Encourage Fluids.
Dehydration can be a concern for people living with dementia. A person may forget to drink, may not recognize thirst, or may have difficulty getting a drink independently. Offer small sips of fluid throughout the day rather than waiting for the person to ask for a drink. Water, milk, smoothies, soups, and high-water-content foods, such as fruits and vegetables, can contribute to fluid intake.
Nutrition needs and the ability to safely eat and drink can change as dementia progresses. If a person is losing weight or has little appetite, adding calories to meals may be appropriate. Talk with a healthcare professional or registered dietitian about strategies to meet specific nutrition needs.
Make mealtimes calm and comfortable.
As dementia progresses, distractions, changes in perception, and difficulty making choices can make mealtimes more challenging. A few simple changes may help create a calm and comfortable environment for meals.
- Reduce distractions - Turn off the television and reduce background noise during meals.
- Keep the table setting simple - Too many dishes, utensils, or decorations can be confusing. Also, avoid busy patterns on dishes, tablecloths, and placemats.
- Check the food temperature - Changes in perception may make it difficult for a person to recognize when food or beverages are too hot. Always check the temperature before serving.
- Offer one food at a time – Serve only one or two items at a time to make decisions during eating easier.
- Offer manageable choices - Too many choices can be overwhelming. Instead of asking, "What would you like for dinner?" try offering two choices for them to pick from. If making choices becomes difficult, simply offer a familiar meal.
- Allow plenty of time - Eating may take longer than it once did. Avoid rushing the person through a meal and allow plenty of time to eat.
- Make meals social - Whenever possible, eat together. Watching others eat can provide encouragement and make mealtimes more enjoyable.
- Support Independence - A person living with dementia may be able to continue eating independently when meals and utensils are adapted to their abilities, such as providing finger foods, using cups with handles or lids, and using utensils with larger handles for better grip.
Make food easier to eat.
Depending on the person's abilities, foods may need to be softened, chopped, mashed, or cut into smaller pieces. If you notice coughing or choking during meals, taking an unusually long time to eat, avoiding certain foods, or difficulty chewing, talk with a healthcare provider. Changes in chewing and swallowing can occur as dementia progresses. These changes can increase the risk of choking, dehydration, and inadequate nutrition.
Monitor appetite.
A decreased appetite can have many causes, including changes in taste or smell, dental problems, medications, illness, difficulty recognizing a food, or difficulty using an eating utensil. If appetite is low or weight loss is occurring, try offering small meals and snacks throughout the day rather than expecting the person to eat three large meals. Sometimes the priority is simply helping the person eat enough. Offer favorite foods and make meals appealing with familiar flavors and aromas. Adding calorie- and nutrient-rich ingredients, such as nut butter, avocado, or healthy oils, may help increase the nutritional value of smaller portions.
Remember, mealtimes are more than only nutrition.
Food provides more than calories and nutrients; mealtimes can offer opportunities for connection, routine, comfort, and independence. Focus on creating a safe, calm, and enjoyable experience while adapting meals to the person's changing needs. Small changes such as offering familiar foods, reducing distractions, providing finger foods, or eating together can make a meaningful difference in the health of someone with dementia or Alzheimer’s.
by Chelsea King, Nutrition, Food Safety and Health Agent, MPH, RDN 2026