Advice after your nerve block for surgery
On this page…
The Importance of Eating and Drinking with Dementia
Dementia is a condition which gradually causes the loss of mental ability. In addition, other features commonly develop, such as changes in personality, a decline in social function and a decline in the person’s ability to look after themselves.
People with dementia often experience problems with eating and drinking, but it is important to eat well to maintain physical and mental well-being.
Under-nutrition can lead to:
- Increased risk of infection
- Skin problems and sores
- Poor wound healing
- Muscle weakness and poor mobility
- Cardiac difficulties
This booklet will look at common difficulties with eating and drinking and suggest some practical ways to help.
Common Difficulties with Eating and Drinking
Cognitive Difficulties
Cognitive difficulties might lead to:
- Reduced interest in food and drink
- Forgetting to eat and drink
- Not recognising hunger and fullness cues
- Short attention span
- Distraction
- Confusion about how to use utensils
- Confusion about how to eat the particular food
- Suspicions about food offered
- Reduced ability to prepare food
- Struggles following particular diets e.g. coeliac, religious / cultural diets
Chewing and Swallowing
Somebody with dementia might have difficulties chewing foods; they may hold food in their mouth and forget to chew. As dementia progresses, swallowing function deteriorates - this is called dysphagia.
If you observe any signs which may indicate a swallowing impairment e.g. coughing/choking when eating or drinking, then refer the patient to the Speech and Language Therapy team (SALT). More information on this is in the ‘Problems with Swallowing’ section.
Sensory Difficulties
People with dementia might struggle to judge the temperature of food, therefore food should not be served too hot. They may also struggle to recognise when they are hungry or thirsty.
You may also notice changes in food preferences for example a strong preference for sweet foods when they usually preferred savoury. Taste preferences can change throughout the progression of the disease.
Poor Appetite
Somebody with dementia might have a poor appetite due to depression,
pain, fatigue, medication, or a lack of physical activity.
Handy Hints for Helping with a Poor Appetite
- Encourage a little and often style of eating
- Try not to overfill the plate, small and regular portions work best. Offer seconds if plates of food are finished
- Have snacks available throughout the day and night
- Try naturally soft food as this is easier to chew and swallow—see opposite
- Provide a wide variety of food
- Provide gentle positive reminders to eat and what the food is
- If you find inability to concentrate prevents sitting down to eat, try finger foods—see opposite
- Make the most of the times of day when appetite is good (often breakfast and lunch) by providing foods which are good sources of energy, e.g. porridge, mashed potato or milky puddings
- Store food where it is easy to access and eat e.g. cereal in clear tubes so you can see what’s inside
- Use chilled or frozen pre-prepared meals – help may be needed to heat meals safely
- Put notes on cupboards / fridge / freezer with what’s inside
- Check stored food regularly and dispose of things which are out of date
Making the Most of Every Mouthful
- Encourage nourishing hot drinks such as malted milk, creamy soupsand hot chocolate
- Also encourage nutritious cold drinks such as milkshake or high calorie smoothies
- Provide extra energy by adding cream, butter and spreads, grated cheese, oil, and mayonnaise to savoury food
- Offer pudding even if the main course has not been eaten
- You may have noticed changes in taste and preferences, particularly a preference for very sweet food
- Try adding small amounts of sugar or honey to savoury food
- Try sweet sauces and chutney with savoury food
Examples of Foods that are Naturally Soft
Cereals and breads - breakfast cereals soaked in milk, porridge, rice or pasta in sauce, bread without crusts
Fruit and vegetables - tinned fruits, well-cooked root vegetables, mashed vegetables with lots of butter/other spread
Dairy - milk, ice-cream, custard, full fat yoghurt, cheese sauce
Protein foods - Mince, steamed or poached fish in sauce, tinned fish, scrambled eggs
Examples of Finger Foods
**These suggestions may not be appropriate for people with swallowing
problems**
- Buttered toast fingers
- Buttered crumpets/tea cakes
- Fruit cake
- Prawn crackers
- Corn snacks (e.g. Skips, Wotsits, Quavers)
- Biscuits and shortbread
- Sliced meat cut into pieces
- Sausages or meatballs
- Fish fingers or crabsticks
- Pizza
- Slices of pork pie
- Quiche
- Cheese cubes
- Boiled egg halves
- Cucumber sticks
- Cherry tomatoes
- Banana
- Melon
- Strawberries
- Grapes
Think Drink
Possible causes of lack of intake of fluids could be if:
- Losing the awareness of being thirsty
- Forgetting to drink during the day or with meals
- Deliberately not drinking to avoid needing to use the bathroom or commode and not having the mobility to get there in time
What to do:
- Offer liquids throughout the day, do not wait for the patient to ask
- Use a brightly coloured cup to draw attention to the drink
- Provide gentle positive reminders to drink and what the drink is. Do not just leave a cup on the side
- Offer a mix of hot and cold beverages, and vary the drink offered i.e. water, juice, milk, hot chocolate, coffee, tea, and squash
- If you are concerned about poor fluid intake, document it clearly on food and fluid charts
- Try using foods that are high in fluid such as soup, jelly and ice cream
Maintaining Dignity
Aim to maintain independence with feeding for as long as possible, by providing foods of a consistency which they can manage themselves. If they struggle to use utensils, focus on finger foods such as biscuits, bananas or sandwiches/rolls.
Make every effort to preserve dignity, e.g. do not fill drinking cups/beakers to the brim to avoid spillages and use plastic tablecloths which are easily cleaned after spillages.
What to do:
- Lower expectations and do not make a fuss
- Spilled food can always be cleaned up - it’s more important to eat and make a mess than cause a distraction through cleaning up
- Place a napkin on their lap before serving (it might not stay there, but it is a start)
- Cut up foods before serving
- Try a spoon with a thick handle which is easier to hold
- If one-to-one help is required, place your chair opposite and engage in conversation; talk about what you are offering to help remind them of tastes and flavours
Eating Environment
A good eating environment can have a positive impact on health and wellbeing and can even affect the amount that is eaten.
Tips for carers:
- Make eating a social activity, this can encourage copying behaviours and remind the person how to eat
- Make sure the person has enough space and try to keep the environment free from distractions, e.g. turning off the TV
- Make sure the food is colourful and use plain coloured plates to make the food stand out
- Make sure the colour of the table and plate are different from each other
- Make sure the room well lit
Making Mealtimes Easier
- Minimise the potential for confusion by only presenting one course at a time
- Remove clutter from the table (papers, books, tissue boxes) particularly in end stages of the disease when there is a risk of eating non-food items
- Avoid coaxing and cajoling, which can set up a power struggle; try to focus on more subtle strategies
- It is better to offer matter of fact, gentle prompts during the meal (in later stages of the disease) i.e. ‘pick up the fork’, ‘scoop up the potatoes’, ‘take a bite’
- Allow plenty of time for meals so the person does not feel rushed
- If the person has problems with coordination chop up the food so it can be eaten with a spoon and use a plate with a lip
- **Speak to an occupational therapist about other adaptive cutlery that may be available**
Problems with Swallowing
If you observe any signs which may indicate a swallowing impairment e.g. coughing/choking when eating or drinking, then refer the patient to the Speech and Language Therapy team (SALT).
If you know SALT are already involved for swallowing difficulties, ensure you follow any recommendations in place for food/fluid consistencies. Safe feeding support is essential; the following are general tips, if you need more specific advice please contact your SALT.
If you are supporting somebody with eating and drinking:
- Make sure they sit fully upright and are well supported
- They are eating when fully awake and alert
- Give the person your full attention and ensure they have swallowed before offering more
- Prompt chewing/swallowing if needed
- Provide oral care post eating/drinking
- Monitor for any signs of aspiration
If the thickened fluids are required to help them swallow safely:
- Ensure the fluid is mixed following SALT instructions
- Use flavours that the patient is known to prefer
- Offer smaller amounts of fluid more regularly during the day to encourage intake
- Make a fresh drink each time to provide a drink at the correct temperature
Useful References
Alzheimer's Society - Eating and Drinking guidelines can be found from alzheimers.org.uk
Contact us
If you have any queries relating to this information, please contact the Dietetics service.
About this information
Service:
Dietetics
Reference:
DT/050
Approval date:
1 March 2026
Review date:
1 March 2029
Click ‘show accessibility tools’ at the bottom of the page
Then click ‘select language’
Alternative formats
You can use the accessibility toolbar at the bottom of your screen to:
-
Change the text size
-
Adjust the font
-
Modify the colour contrast
-
Use the translate function
If you would like this information in another format, such as Braille, audio, or easy read, please speak to a member of staff.
You can also print as well as download as PDF using the “Print this page” button at the end of the page.
Staff will print a copy for you on request
Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.