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My dad is 73 with vascular dementia and terminal cancer on hospice. I’ve cared for him for the last 10 years and I’ve always known what he likes to eat. Now that his dementia is advanced when he tells me he’s hungry he can’t tell me what he wants. I’ve learned options aren’t an option because he can’t process it in his mind and becomes silent or says he will just eat later. It’s heartbreaking because I know he wants to eat but I have no idea what to feed him now. Any suggestions would be so appreciated.

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Feed him what he liked to eat before. You may have to puree it or cut it up in smaller pieces, but I would imagine that he still has the same likes and dislikes as he did before. My husband has vascular dementia and before he was on his death bed, I would show him 2 options(no more as that is too confusing for them) and have him point to which one he wanted. That seemed to work well for us, and it still gave him a say on what he was going to eat.

Also make sure that he doesn't have a swallowing issue, as that can make someone not want to eat. 21 months ago my husband had aspiration pneumonia, and for many months I had to puree his food for him. After that I made sure that all his food was soft and pieces were small enough for him to not get choked on. I also had to thicken his drinks with Thick-It.

Hope that helps. Wishing you the best.
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Something I've noticed in some people with dementia is that there can be a disconnect between what they want to accomplish and actually getting it done, so in your father's case he may be hungry and he may even desire the foods you bring for him but he can't connect that with the actual act of eating. You may need to insist he comes to the table to visit with you at mealtimes and that he remains there until the meal is finished, all the while encouraging him to try a bite of this or that, perhaps even feeding him. Keep portions offered very small, just a bit or two, so he won't feel overwhelmed, and try to offer tiny snacks often throughout the day.
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What would he have eaten while he was growing up? Was his family meat and potatoes kind of people? What was served in your house growing up? Whatever those foods are, he likely associates with comfort. You may want to make some protein shakes for added nutrition. What flavors did he like before the dementia? Banana? Strawberry? Peanut butter? Chocolate?
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I would continue to feed him the foods he likes with some adjustments. I would stay away from spicy foods. My mother is on a pureed diet and tried other foods, but she did not like them, lost a little weight which is typical on pureed foods. I went to foods she always ate and now her appetite is good. I make foods such as salmon pie without the crust, fish, sweet potatoes, vegetables , veggie sausage, tofu scramble with herbs, and so much more. For desserts, cheesecake with strawberries, assorted fruits, bananas, smoothies. All of these are pureed to a pudding consistency. There a lot of information online, just google foods your father might like and try the recipes. I also make shakes with avocado, banana and add a little protein powder.
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My mother lived on cream cheese on white bread soaked in strawberry yoghurt for several months, then finally just before she departed she suddenly refused all food.

If there’s any non traditional things he likes, don’t stand on ceremony, let him enjoy them. For Mom, sweets would always be welcomes, so dessert (nutritious, made with eggs, milk, everything soft and served in a small spoon) was fine if that was what she wanted.
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