Food, Dignity and Dementia: How to Support Better Eating at Home and in Residential Care

Eating well becomes more challenging as dementia progresses, but with the right support, mealtimes can remain enjoyable, dignified and nourishing. Whether someone is living at home with family or in residential aged care, small, thoughtful changes can dramatically improve nutrition, hydration, safety and quality of life.

As an Accredited Practising Dietitian specialising in aged care and dementia, I see every day how eating difficulties evolve, and how early, person-centred nutrition support can prevent weight loss, malnutrition and distress. The strengthened Aged Care Quality Standards (2025) place a strong focus on Food, Nutrition and Dining, and carers at home can benefit from these same principles.

This guide explains why eating changes in dementia and what you can do to support better intake, comfort and wellbeing.

Why Eating Changes in Dementia

Dementia affects more than memory. As the brain changes, so too does the way a person recognises food, experiences hunger and participates in mealtimes. Common reasons include:

• Reduced appetite or difficulty recognising hunger

• Taste and smell changes — food may seem bland or unusual

• Difficulty recognising food or understanding how to start eating

• Attention changes — unable to stay focused on the meal

• Chewing or swallowing difficulties (dysphagia)

• Motor difficulties — trouble cutting food, using cutlery or holding a cup

• Emotional changes — apathy, agitation, anxiety and fatigue

Understanding these changes helps carers respond with compassion rather than frustration.

Early Signs Someone Needs Extra Support

These signs often appear gradually, but they matter:

• Weight loss or loose clothing

• Eating less at meals or leaving food untouched

• Narrowed food preferences (often only sweet foods)

• Forgetting to drink

• Swallowing difficulties- coughing, choking or pooling food in the mouth

• Difficulty using cutlery

• Becoming overwhelmed in busy dining rooms

• Loss of interest in food

• Fatigue or reduced ability to sit at the table

• Hiding food

If you’re noticing these changes, a dietitian and speech pathologist review is recommended.

Practical Strategies That Make Eating Easier

Eating difficulties in dementia can feel overwhelming, but many challenges can be reduced with simple, well-targeted strategies. Whether you’re caring for someone at home or in a residential setting, the following evidence-based approaches can help improve intake, comfort and confidence at mealtimes.

1. Create a calm and supportive mealtime environment

A quiet, predictable environment can transform intake.

In aged care:

• Minimise noise, rushing and interruptions

• Use contrasting-coloured plates to help food stand out

• Seat residents with supportive tablemates

At home:

• Turn off the TV

• Reduce clutter on the table

• Sit together — social eating boosts intake

A calm environment helps the person process what’s on the plate and reduces stress.

2. Support independence while offering gentle cues

Maintaining autonomy preserves dignity and confidence.

• Offer adaptive cutlery and non-slip mats

• Present finger foods if cutlery is difficult

• Use hand-over-hand assistance only when needed

• Allow plenty of time - slow eating is normal

• Serve meals in single courses to avoid overwhelm

“Doing with” rather than “doing for” promotes independence.

3. Choose familiar, appealing foods

People with dementia often respond best to simple, recognisable meals from earlier life.

• Use favourite foods and family recipes

• Enhance flavour with herbs, spices and sauces

• Serve warm meals - aroma improves recognition and appetite

• Avoid overcrowded plates

Familiarity brings comfort and increases intake.

4. Offer small, frequent, nourishing meals

Three large meals can be overwhelming. Instead, aim for:

• small meals

• snacks

• nourishing drinks (milkshakes, smoothies, fortified milks)

• soups, yoghurts, custards and soft proteins

Frequent eating helps maintain energy, weight and hydration.

5. Prioritise hydration throughout the day

Dehydration is common but preventable.

• Offer fluids every 1–2 hours

• Use favourite drinks

• Try two-handled cups or straw cups

• Place drinks where they can see them (visibility increases intake)

• Offer warm drinks in cooler months

Hydration improves cognition, mood and physical comfort.

6. Adjust textures safely when swallowing changes

Signs such as coughing, choking, watering eyes or “pooling” food in the mouth require review.

• Pause the meal

• Offer sips between bites

• Refer to a speech pathologist for a swallowing assessment and guidance around texture modification

• A dietitian can help maximise nutritional intake in a texture modified diet while maintaining mealtime enjoyment

Texture changes should always follow professional guidance.

7. Respond gently to behavioural changes

Behaviour is communication.

If the person refuses to eat:

• Try again later

• Offer a different food

• Reduce noise or move somewhere quieter

If wandering or restlessness occurs:

• Provide quick, easy-to-hold foods

• Offer meals at flexible times

If agitated at meals:

• Approach with calm reassurance

• Reduce demands

• Avoid confrontation

Flexibility is essential as appetite varies day to day.

8. Use mealtime as a moment of connection

Food is deeply tied to identity, memory and comfort.

• Eat together when possible

• Talk about familiar foods or past meals

• Invite family to bring meaningful foods (where safe in aged care)

• Use gentle conversation or soft background music

These small touches make mealtimes feel safe and meaningful.

When to Seek Professional Support

A dietitian review is helpful when:

• Weight loss is occurring

• Intake is poor or declining

• Malnutrition is suspected

• Swallowing concerns appear (a speech pathologist review is also warranted)

• Dehydration, recurrent UTIs or pressure injuries develop

• Eating behaviour changes suddenly

• Diabetes management becomes difficult due to unpredictable intake

A dietitian can assess nutritional risk, guide texture modification, suggest strategies, and partner with carers to support wellbeing.

For Aged-Care Providers: Meeting the Strengthened Standards (2025)

Under Standard 6: Food & Nutrition, providers must:

• Deliver meals that are nutritious, appetising and culturally appropriate

• Offer choice, independence and dignity at mealtimes

• Identify and respond quickly to nutrition risks

• Ensure dietitian and speech pathology involvement where needed

• Monitor intake and weight proactively

• Support residents with dementia to eat safely

• Create a positive, person-centred dining environment

These principles also support family carers at home.

Final Thoughts

Eating is more than nourishment, it’s comfort, identity, connection and pleasure. With the right support, people living with dementia can continue to enjoy food and maintain their dignity at every stage of their journey. Whether at home or in aged care, small, compassionate strategies truly make a difference.

Need Support?

If you’re an aged-care provider, community carer, or family member supporting someone with dementia, I can help. Please feel free to reach out.