When someone with dementia stops eating

Check these first

• Mouth pain — a loose tooth, sore gums, ill-fitting dentures or oral thrush. Look in their mouth.
• Constipation — a very common cause of loss of appetite in older adults. Ask when they last had a bowel movement.
• Medication side effects — especially new ones. Some dementia and antidepressant medications dull appetite.
• Depression — common after diagnosis and very treatable.
• Difficulty using utensils, or not recognizing food as food.
• Loss of smell and taste, which dementia accelerates.
• Overwhelm — a busy table, a loud TV, or too much food on the plate.

Then try these

• Smaller plate, less on it. A plate that looks 'doable' is eaten more often than a fuller one.
• Colored plates — bright red or blue increases food intake in dementia (the contrast helps the food register).
• One thing at a time. Entrée, then vegetables, then dessert — not all together.
• Finger foods if utensils are a struggle: small sandwiches, cheese cubes, grapes, banana slices, hard-boiled eggs.
• Calorie-dense over voluminous: whole milk, butter on everything, cheese, peanut butter, full-fat yogurt.
• Eat with them. Mirroring is powerful — they're more likely to eat if you're eating too.
• Quiet, calm room. Turn off the TV.
• Same time every day. Routine helps the body remember it's hungry.

When to call the doctor

Any sudden change in eating, choking or coughing while eating, weight loss of more than 5% in a month, or refusing fluids for more than a day — same-week PCP appointment. A speech-language pathology (SLP) swallow evaluation is covered by Medicare and worth asking for early.