Q. My husband has dementia. Recently he has lost a lot of weight —and I’m concerned. We went to a gastroenterologist and after a complete work-up it was determined that it is a direct result of the dementia. The doctor recommended that we consult a nutritionist who could make recommendations for dietary and behavior changes and suggest some supplements. I don’t want to irritate my husband with changes if they’re not going to do any good… Can this help?
Nancy F., Wellington
A: Your physician was wise to recommend a consultation with a nutrition expert, especially one who is experienced working with geriatric patients, such as Barbie Lazar MS, RD, CDN, Clinical Nutrition Manager at Miami Jewish Health Systems. She told me in an email that weight loss is a common challenge for people with dementia and the main culprit is usually undereating. She offered this advice:
“The mealtime environment plays a very important role in promoting adequate intake. Reducing distractions, maintaining adequate lighting, and using appropriate utensils can assist in maximizing how much he eats. Try interacting with him at mealtime. Provide encouragement and reminders for him to complete his meal. Also, observe if he has difficulties chewing or swallowing. If so, consider softer or pureed foods.”
She also added that your husband may prefer smaller meals with snacks in between rather than large meals.
“ Consider high calorie snacks such as pudding, ice cream,” she added. “A better and more natural option that any artificial supplements would be homemade smoothies. High calorie, high-protein ingredients can include avocado, bananas, yogurt, silken tofu and protein powder.”
Lazar added that “Food First” is the best approach to solving your husband’s under-eating.
"Doing what you can to increase his caloric intake — hopefully with more healthful foods than sweets — will likely improve your husband’s energy level and disposition. And if testing shows that your husband has nutritional or absorption deficiencies, a nutrition expert will know how to rectify these issues through diet and/or supplements."
To find a registered dietitian and nutritionist who specializes in geriatric nutrition, use the referral service offered by EatRight.org which allows you to search by zipcode and specialty.
For more information, I recommend these online resources:• The National Institute on Aging website offers answers to common questions about nutrition in the aging population and other helpful information in " Smart Food Choices for Healthy Aging."
• “My Plate for Older Adults,” located on the website of Tufts School of Nutrition Science and Policy, is very good.
Finally, for high-calorie smoothie recipes, take a look at this website: http://www.smoothie-handbook.com/protein-smoothie-recipes.html
Nancy Stein, Ph.D., is the founder of SeniorityMatters.com, a local caregiver advisory and referral service for South Florida seniors and their families. You can contact her at nancy@ senioritymatters.com.