Mealtime Tips and Aspiration Prevention in Dementia

As someone’s dementia progresses, mealtimes can become more challenging in numerous ways. They may lose interest in eating or drinking, have difficulty with or be unable to use utensils, be unable to judge the temperature of food and drink, become upset at mealtimes, have difficulty sitting still, or have problems swallowing (called dysphagia) causing the food or fluid to go into the lungs instead of the stomach (called aspiration). Weight loss, burns, dehydration, falls, and pneumonia are all things that often happen because of these difficulties. Here are recommendations to reduce their risks and make mealtimes less of a challenge.

General Tips:

• Make sure dentures fit properly and are worn during meals.
• Help them brush their teeth after meals to maintain good oral hygiene.
• Reduce distraction and noise at mealtimes. Turn off the TV, put only the necessary items on the table, use only necessary utensils, and serve only one or two things at a time to simplify choices.
• Don’t stand or lean over them; sit down with them.
• Be patient. Don’t rush them when eating. Talk with them.
• Use their name, especially when giving directions.
• Make sure to offer them water/fluids throughout the meal; you can alternate between small bites and sips.

Safety considerations:

• Test food/fluid temperature before giving it to them to reduce risk of burns.
• Supervise them during meals or when they are eating or drinking.
• Make sure they are in an upright position when eating and for 30 minutes after they finish eating.
• Be alert for signs that they are having difficulty swallowing such as coughing, throat clearing, a gurgling or wet sounding voice (especially after drinking), keeping food in the mouth or chewing too long, complaints of pain/burning, or something sticking to the back of the throat. If these are reported, let your health care provider know about it.
• Feed them slowly. Put only a small amount of food on the tip of the spoon/fork.
• Make sure all caregivers know how to do abdominal thrusts (also called the Heimlich maneuver).

Diet Modification:

As swallowing becomes more difficult, the diet may need to be changed to foods that are easier to swallow or fluids may need to be thickened so that they do not go into the lungs. Make sure to let your health care provider know right away if the person starts having difficulty with swallowing and discuss diet modifications with them. A speech language pathologist may need to evaluate for swallowing problems and can make recommendations on changes to diet. A nutritionist may also be helpful if changes to the diet are necessary.

AccentCare is always looking for new and innovative ways to help caregivers improve themselves and their skills. You can find more information on caring for patients with dementia, nutrition insight, and more on our dedicated Professional Resources page here.