How much should you push to get an older adult to eat?

Dear Carol: My mom’s got dementia and has stomach-related issues, but even so, she needs to eat. I make her three nourishing meals a day and try to tempt her with healthy snacks like fresh fruit. Still, it seems what she really wants is ice cream and pudding, so she just picks at the rest. Having dementia shouldn’t make people hate nourishing food, should it? I hate to go to meal replacement drinks because they aren’t all that healthy, either. Any advice? – SO

Dear SO: This is a common frustration for caregivers, and much depends on why your mom can’t/won’t eat. Check with her primary doctor about her stomach problems in case there’s something that can be done to help. The physician who treats her dementia may also have suggestions.

Even medical professionals can’t provide solutions that work for everyone in this situation, but I’ll list some for experimentation.

• Offer smaller, more frequent meals and snacks.
• Remember that both medications and dementia can affect the taste buds. You may need to increase seasonings in your mom’s food to amp up the flavor.
• For some, a schedule helps their body expect a meal, but others may need to eat when they are hungry, regardless of the time.
• Finger foods can be great. Many foods can be cut into portions that can be managed this way.
• Focus on foods that are lighter on the stomach and experiment. Does she eat better with cool food such as fruit and even cold meat? That worked with my mom. Others may prefer warm foods like soup and oatmeal.
• Nutrient-dense food is best, of course, but depending on your mom’s stage of dementia, you may have to give her what she’ll eat as opposed to what you’d like her to eat. Yes, that includes ice cream or pudding.
• Smoothies! These can be made nutrient-dense yet yummy and are easy to drink even with a light appetite. Keep servings small. You can offer to refill the glass if she wants you to or provide more later.
• There’s no surer way to shut down an appetite than to try to force a person to eat. This also creates tension at mealtime — another sure appetite killer. Instead, offer her something and if she doesn’t want it, let it go and offer something else. Her refusal isn’t personal.
• Present choices so she has some control. It’s awful to have food forced on you, and no one wins.

You weren’t specific about your mom’s stage of dementia, but all caregivers should understand that once a person reaches an end-of-life stage, the body will start to shut down. This means that food can cause nausea and discomfort since it’s not being digested. Before your mom ever reaches this stage, you might consider hospice care. They can support you and your mom as they help you deal with your feelings that she needs to eat even when she can’t. Sending a caregiver hug. It’s tough, I know.