Dementia is one of the worlds most feared illnesses. Its cruel and relentless nature and the way it impacts families is certainly harrowing. We often hear about people dying from heart disease and diabetes, but did you know that dementia is the second leading cause of death of Australians and the leading cause of death for women?
This year, just under half a million Australians are estimated to be living with dementia, and more than 60% of those in residential care have the disease in its moderate-severe stages. September is Dementia Awareness Month and the team at Dementia Australia are encouraging us to learn more about this disease to increase support, reduce social isolation and improve care for those living with dementia.
What is dementia?
Dementia is a condition of the brain characterised by a collection of symptoms. It can affect the way we think, feel and act and can significantly impact our memory. There are multiple types of dementia including Lewy-Body (death of nerve cells in the brain), Vascular (caused by brain damage), Frontotemporal (damage to the fronto or temporal lobes of the brain) and Alcohol related dementia (due to excessive alcohol consumption)– however Alzheimer’s is the most common form.
Symptoms of dementia may include memory loss, increasing confusion, difficulty with writing, speech or comprehension, mood changes and difficulty completing everyday tasks. Dementia does not discriminate and can affect both men and women of all ages, however the risk increases as we get older with 1 in 10 people over the age of 65 effected by it.
The Impact of Dementia on Nutrition
Nutrition is one of the many domains that is significantly impacted by dementia. Common nutrition related issues associated with the disease include:
Forgetfulness people may simply forget to eat, forget that they have already eaten (so will eat again), forget how to eat/how to recognise food, forget how to self-feed etc.
Inability to prepare meals this is especially impactful on those living in the community/living alone as they may be unsure of how to shop, prepare and cook meals, they may forget how to store food safely which increases the risk of food borne illness etc.
Difficulty using cutlery people may be unable to feed themselves as they can no longer use a knife and fork or drink from a cup.
Swallowing impairments progression of the disease can result in impaired chewing/swallowing function which can result in decreased oral intake and/or increased risk of choking/aspiration.
The Impact of Dementia on Communication and Swallowing
Additional to the impacts of Dementia on nutrition and swallowing impairments, it can also significantly impact upon a person’s speech and communication. This is particularly devastating for the individual and family members to witness, as these are aspects of our lives that most of us likely take for granted every single day.
What does this look like?
The impact of Dementia on swallowing – the individual may forget to eat, and have difficulty with chewing or swallowing.
This can lead to severe consequences such as choking, or aspiration pneumonia. Aspiration pneumonia is caused by food or foreign substances entering the airway, causing a significant infection. Unfortunately, this can lead to severe illness or death.
An individual with Dementia may not be able to express their needs or wants to others. This may look like difficulty finding the right words to say, or being confused with what they need at a particular time. This can be very distressing for the person and others.
Someone with Dementia may also have difficulty with social skills, such as understanding the way others are feeling and how to respond to them in conversations.
Support someone with Swallowing difficulties:
If the individual is showing signs (such as those discussed in this article) of swallowing difficulties, please contact a Speech Pathologist immediately. The Speech Pathologist can complete an in-depth mealtime and swallowing assessment, and provide individualised support and recommendations. It is important to seek help as soon as possible, to avoid more severe and longer-term consequences of a swallowing disorder.
Top tips to support someone with Communication difficulties
When communicating with someone with dementia, it is best to change your communication style depending on what the person needs.
Some examples may be:
Speaking clearly and slowly
Use shorter sentences – too many words at once can be overwhelming and difficult to process
Include the person in conversations and decisions – people with dementia are at risk of social isolation and should be included in social settings where possible
Give them simple choices e.g. a choice between two items or places to start with, as opposed to too many options at once
Use visual aids such as a calendar or pictures to request and explain different topics
Malnutrition
As a result of these many negative impacts of Dementia on nutrition and swallowing impairments, people with dementia are at an increased risk of unintentional weight loss and malnutrition/dehydration, particularly in the latter stages of their disease. Malnutrition can increase the risk of morbidity and mortality by delaying wound healing, reducing muscle mass and strength as well as increasing the risk of falls, fractures, infection, illness and fatigue.
Top nutrition tips for those with Dementia:
Eat to the clock (set an alarm to remind you it’s time to eat so you don’t forget mealtimes)
Look into meal service supports to ensure safe, nutritionally balanced meals are available to you at home (e.g., Meals on Wheels)
Seek support from friends and family when shopping for food and cooking
Stock up on nutritious snacks that do not require preparation (such as custards, yoghurts, cheese and nuts)
Finger foods to maintain dignity and promote independence with feeding – try sandwiches cut into triangles, bananas/apples/pears, vegetable sticks, rolled up slices of meat, cheese + crackers, yoghurt/custard pouches, ice cream cones/sticks etc.
What can I do to optimise my brain health now?
Unfortunately, as dementia does not discriminate and the genetic, environmental and lifestyle risk factors cannot be avoided, there is no guarantee that the choices you make today will prevent the onset of the disease later in life. Following a balanced diet with a variety of foods from the 5 food groups, limiting alcohol and discretionary choices however is vital in promoting good overall health and protecting our heart/blood vessels which in turn, supports and promotes healthy brain function.
Top foods to include in your diet for better brain power include:
Omega-3 rich foods – think oily fish such as salmon, mackerel and sardines as well as plant-based sources including avocados, walnuts and linseeds.
Berries – rich in flavonoids, research has shown an improvement in memory
Green leafy vegetables – options such as kale, spinach and broccoli are rich in vitamin K, folate and beta carotene which may help slow cognitive decline.
For more information on the nutritional and communication impact with dementia, go to https://www.dementia.org.au/ or get in touch with an Accredited Practising Dietitian (like us!) or a Certified Practising Speech Pathologist (like us!).
Our team can provide tips and tricks on how to best manage nutrition in those with dementia for both community and residential care living. As well as for more information on Communication and Swallowing difficulties associated with dementia. Through our clinic, In Home services and our Aged Care team, we can assist.