One of the most vexing questions in elder caregiving is “Why isn’t my loved one eating?” Your loved one’s well-being is heavily dependent on nutrition, so a refusal—or the inability—to eat is frustrating and stressful for the caregiver.

Here are some thoughts on causes and ideas about solutions:

PROBLEM: Lack of desire to prepare meals.

POTENTIAL SOLUNTIONS: There are many ways to provide pre-pared meals—you or someone else does the cooking and puts the meals, ready to heat-up in the fridge. Services such as Meals on Wheels can help, and you can also set up a delivery system from your loved one’s favorite restaurants.

PROBLEM: Disinterest in eating.

POTENTIAL SOLUTIONS: Find out what the source problem is. Nausea from medications or chemo, dry mouth, problems with teeth or dentures can cause a lack of desire to eat. Check the setting—is it pleasant or dreary? What about the way the food is presented—is it appetizing? What does it smell like?  Would you want to eat unattractive bad-smelling food? 

Portion size can also cause disinterest in eating so keep portions small.  If necessary, only put one item of food at a time on the plate.

Use plates with plain backgrounds.  For dementia patients, the busy background of the plate can be confusing and make the food hard to find.
PROBLEM: Your loved only wants to eat the same thing over and over again and its food value is questionable.

POTENTIAL SOLUTIONS: If your patient only wants to eat ice cream, for instance, vary it and boost up the nutritional value by adding protein powder and fresh fruit in smoothies and milk shakes. Variations on the theme will help you add nutrition: add cheese to meat for more protein, or lots of veggies if they’re missing from pizza, add tempura veggies to fish and chips.  

Caregivers need to keep a perspective about what’s being eaten.  As parents of small children we worried about serving balanced meals, but with the elderly this may not be so important—they are not fueling growing bodies. A diet of ice cream, if that’s all they want at age 95 may not be all that problematic.

Finally a couple of questions to pose to your loved one when eating has become an issue:
“What do you want to eat? “ Whatever that may be, serve it, but keep portions small.
“What’s your favorite meal of the day?” Whether it’s breakfast lunch, dinner or something in between, make that the big meal of the day, and don’t worry too much about what they eat the rest of the time.

Blessings, Joanne