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What would you do?

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I would make the meal anyway and hope to tempt her appetite. Worst that can happen is that you end up throwing it away.

If she's actively refusing food that you've placed in front of her... Well, it's bound to be a worry, but you shouldn't attempt to force her to eat. Whether her excuse that she's already eaten is the dementia talking or is just an excuse, either way she doesn't want to eat. Loss of appetite isn't so surprising in a person who is largely immobile and inactive. Try again with a small, nourishing, flavoursome snack a little while later and see if it tempts her.

I don't think this applies in your particular case, but in certain forms of dementia there is also a loss of "initiation." Initiation is the signal from the brain that starts off a process, such as lifting one's hand to pick up a piece of food and eat it. In that case, though, the person will say "yes, that looks lovely, thank you" and then... do literally nothing. Not eat, not even play around with the food. What you should do in that case is start her/him off - hand her the sandwich, or the fork or spoon, place her hand on the handle of the cup, whatever the person would naturally do to begin eating or drinking.
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I'm not sure what stage your loved one is in, but, my loved one used to go without eating a lot. She would say she wasn't hungry, she'd already eaten, save it for later, etc. She would eat hardly anything and lost a lot of weight.

She would eat just a few things. If you can figure out which few things she night like, it might help. It might not be the most nutritious, but.......under the circumstances, we just do the best we can. My cousin would only eat a chicken leg, chips, ice cream, banana, mashed potatoes....I think that's it. But, sometimes, she wouldn't eat at all. In AL, she would refuse to go to the dining room.

Later on she went on medication for depression and anxiety. Once that began to work, her appetite picked up and now she has a great appetite and likes just about anything.

I would discuss it with her doctor and see if she is depressed or anxious. Having dementia can make you that way based on what I have seen.
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Many elderly people will say they're not hungry if asked what they'd like to eat. Asking, "What would you like to eat?" is a pretty broad question for someone with dementia to answer. Your loved one may not remember eating anything.

Instead of asking what they'd like to eat give them two choices and let them pick which sounds better to them.
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My aunt with dementia eats best when I eat with her. I just make the food. Serve the plates and ask her to eat with me. If I ask her if she has eaten she usually says she doesn't remember. Once she gets started she seems to have a good appetite. I assume it would be different for more advanced dementia.
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