For many of us during this period of staying at home, food has become even more important as a way to keep us connected with our past, our memories and with comfort. The following is an excerpt from the new Helpful Hints for Eating and Drinking publication from the DSDC, and is part of a larger series of Helpful Hints publications that were written with family carers in mind.
What kinds of foods we can taste and how much we enjoy those foods changes throughout our lives. As we age, however, we generally find that our taste buds ‘dull’, meaning that things that we used to enjoy often don’t taste as strong or as satisfying as they used to. This can have a real impact on what tastes good to us. You may notice that someone with dementia often favours sweeter food over savoury or spicy options. This is likely due to how well they can taste the flavour of those foods. This may influence the foods they choose to eat, as well as how they season their food. You may find that they increase the amount of salt (for example) to reach the same flavour level that they are used to. It may also lead to someone complaining about the quality of food which probably hasn’t changed, and which you may find that others in the family continue to enjoy.
Use of spices and herbs as flavour enhancers in a dish may help, but this might be a time to try some new foods. While it is not unusual for an individual to begin to eat something they used to dislike or to stop eating something that was a favourite, it is important to remember that this process may be distressing for family and loved ones for whom a particular foods may be tied to emotional memories of the past. In these moments someone changing their preference might contribute to family members feeling as though dementia is taking away the person that they have always known. Despite this, it is important to remember that this is often not due to a ‘loss’ in ability or significant progression in someone’s dementia, but to a loss of taste sensitivity.
Where dementia does introduce real challenges, however, is in the introduction and maintenance of special diets. For example, some people with dementia may also need to follow low sugar or low salt diets, require lactose free meals and snacks and so on in order to manage other health conditions. This can cause a great deal of strain and stress for carers, particularly if they feel that they are responsible for ensuring what the person with dementia eats, and how well the keep to their special diet. It is important that you try to make this as easy on yourself as possible if you find yourself in this situation. If a special diet is medically advised, have a conversation with the GP about the possible risks to the individual should they choose not to follow that diet. Is it something that can be adapted if needed? In other words, pick your battles. If the diet is essential to the person’s health, it may be difficult to avoid the tension that occurs-if it’s optional, suggested, or flexible, then consider carefully where those lines are drawn and when it is worth giving ground.
If you find you need to be sugar savvy, identify the places where sugar can be eliminated without impacting the appeal to the individual who is struggling to get the nutrients needed. Many calories are empty, meaning that they do not provide other needed nutrients that a body needs to function well. A can of regular cola, or a biscuit are good examples of empty calories, whereas a banana is an example of a sweet option that also contains important nutrients. If an individual needs to reduce sugar intake for health related reasons, look for the items they regularly consume which provide them with calories without supporting good nutrition. Save the calories for food and drinks which provide a nutrition contribution.
This leads to questions that come up frequently for all carers: what about long-term dietary choices? What is the carer’s role if, for example, a person with dementia who has followed a vegetarian diet for most of their life begins choosing meat options? There are not hard and fast rules about what a carer ought to do in this circumstance and the support given to each individual must be considered separately. That being said, however, there are a couple of questions to ask that can help clarify the situation a bit.
Has this person followed a particular diet due to ethical or religious reasons?
Do they follow this diet because they dislike the taste, texture, smell, or process of cooking something?
The answer is important because a choice made on an ethical or religious basis should be supported as part of supporting the persons ongoing identity, whereas (as discussed above) preferences for tastes and textures often change over time. This is not to suggest the issue is black and white, however, and it is important to consider each person’s situation individually.
You can view DSDC's range of Helpful Hints publications via the John Smith Bookshop.