Eating and drinking

5. Motor difficulties

Problems with co-ordination

People with dementia may struggle to handle cutlery or pick up a glass. They may also have trouble getting food from the plate to their mouth. A person with dementia may not open their mouth as food approaches and may need reminding to do so. They may also have other conditions that affect their co-ordination, for example Parkinson's disease. This could lead them to avoid mealtimes because they are embarrassed by their difficulties or want to avoid struggling.
  • If the person is struggling with a knife and fork, chop up food so it can be eaten with a spoon.
  • If the person appears to have difficulty using cutlery, you may need to prompt the person and guide their hand to their mouth to remind them of the process involved.
  • Try finger foods - eg sandwiches, slices of fruit, vegetables, sausages, cheese and quiche. These are often easier to eat when co-ordination becomes difficult.
  • Let the person eat where they feel most comfortable.
  • Speak to an occupational therapist about aids that can help, such as specially adapted cutlery, lipped (high-sided) plates or non-spill cups.

Chewing and swallowing

A person with dementia may have difficulties with chewing food. They may forget to chew or they may hold food in their mouth. Certain foods, such as sweetcorn or dry biscuits, may be more difficult for the person to chew or swallow. These should be avoided if chewing is an issue. Good oral hygiene is important. If the person is feeling pain in their mouth, chewing will be uncomfortable and difficult.

If the person wears dentures, they should be comfortable and fitted properly. People with dementia can get tired easily. Eating soft, moist food that needs minimal chewing can help.

As dementia progresses, swallowing difficulties (called dysphagia) become more common, although they can vary from person to person. If a person is having difficulty with swallowing, a referral to a speech and language therapist can help. Difficulties can include holding food in the mouth, continuous chewing, and leaving foods that are harder to chew (eg hard vegetables) on the plate. Swallowing difficulties can also lead to weight loss, malnutrition and dehydration.

If the person is drowsy or lying down, they may struggle to swallow safely. Before offering food and drink, make sure they are alert, comfortable and sitting upright (or, if in bed, well positioned). A physiotherapist can advise on positioning techniques and an occupational therapist can advise on aids for eating and drinking. Ask the GP for a referral.