Meals and nutrition: why appetite drops, easy wins, and the help that delivers to the door

Why eating gets harder

Taste and smell fade with age. Dentures that do not fit, dry mouth from medicines, trouble swallowing, depression, and simply not wanting to cook for one all reduce eating. The Alzheimer's Association adds that a person with dementia may not recognize food, may forget they ate, or may be overwhelmed by a full plate. Weight loss is worth a doctor visit, not a lecture. Ask whether any medicines are affecting appetite and whether a swallowing evaluation or a dietitian referral makes sense.

What the doctor may want to check

• Weight over time, so bring the numbers.
• Medicines that cause nausea, dry mouth, or taste changes.
• Teeth, dentures, and mouth pain.
• Swallowing, especially coughing during meals.
• Mood. Depression often shows up as not eating.
• Whether a nutrition supplement or a dietitian visit is appropriate.

Easy wins at home

The National Institute on Aging's advice for older adults is variety, protein at every meal, and less added sugar, salt, and saturated fat. In practice:

• Small meals and snacks more often instead of three big ones.
• Protein that is easy: eggs, yogurt, cottage cheese, canned fish, beans, peanut butter, milk in the oatmeal.
• Pre-cut fruit and vegetables, frozen vegetables, and rotisserie chicken count.
• Fluids all day. Thirst fades with age; keep a glass where they sit.
• Eat together when you can. People eat more with company.
• Cook once, freeze in single portions, and label with the date.
• Season with herbs and lemon when salt is limited; stronger flavors help faded taste.

For someone with dementia

• One food at a time on a plain plate, with a plate color that contrasts with the food and the table.
• A quiet table: television off, fewer things on it.
• Finger foods when utensils get hard: sandwiches cut small, cheese cubes, fruit slices.
• Plenty of time, and a gentle cue to keep going.
• Sit them upright with the head slightly forward, and check that food is swallowed. Ask the doctor about soft foods if there is coughing or choking.
• Offer the same meal again if they forget they ate; a second half sandwich is not a problem.

Help that comes to the door

• Home-delivered meals: every county Office for the Aging runs a program under the Older Americans Act for people 60 and older who have trouble getting out, often called Meals on Wheels. A driver brings a meal and a friendly check-in. Contributions are voluntary and nobody is turned away for inability to pay. Call the county office or NY Connects, 1-800-342-9871.
• Community meal sites: lunch at senior centers and churches for people 60 and older, with company included.
• Grocery delivery and pharmacy delivery, set up on your account so they never enter a card number.
• Some Medicaid managed long-term care plans and some Medicare Advantage plans include meals after a hospital stay or for people with certain conditions; ask the plan.
• Home care aides can shop and cook as part of a care plan.

In CarePair

Add the meal program to the care team and the delivery days to the calendar. Note weights in the journal so the doctor sees the trend.