Dementia: Eating and drinking habits

Medically Reviewed by: Dr Jackie Gray, Public Health Expert and Retired GP
(Carents Trusted Reviewer Programme – Last reviewed March 2026)

You should always seek urgent medical advice for any eating or drinking difficulties.

Swallowing problems can be a sign of serious illness and may not be caused by dementia. They can be life threatening and must be assessed urgently, usually by a speech and language therapist.

For other eating or drinking problems, expert help is still essential. NHS dietitians can help prevent dehydration, malnutrition, and unintentional weight loss.

It is also important to consider other possible underlying causes, such as:

• Dental problems or ill-fitting dentures

• Side effects of medication

• Depression or low mood

• Constipation, indigestion, or other stomach problems

Dementia affects everyone differently, but many people experience changes in the brain, body, and behaviour that affect eating and drinking over time.

Eating problems are thought to affect more than 80 percent of people with advanced dementia. These difficulties increase the risk of weight loss, dehydration, and poor overall health.

Changes in taste, smell, appetite, thirst or perception

Many people with dementia experience changes in how food tastes or smells. A reduced sense of smell can appear early and may reduce interest in food.

Some people lose their appetite, while others eat more than before. A preference for sweet foods and carbohydrates is common. Reduced thirst is also frequent, increasing the risk of dehydration. In later stages, people who rely on others for meals may struggle to express hunger, thirst, or food preferences.

Some people may no longer recognise food or may confuse it with inedible objects.

When people with dementia refuse food and drink 

People with dementia may refuse food or drink for reasons that are not immediately obvious. Pain, fear, confusion, or changes in hunger, thirst or perception can all play a role. A plate of food may no longer look familiar, or the person may not recognise it as something safe to eat.

Some people become suspicious or frightened, especially if dementia affects their understanding of what is happening around them. Others may feel overwhelmed by noise, movement, or too many choices.

Refusal is rarely about being difficult. It is usually a sign that something does not feel right. Observing patterns, such as time of day, environment, or food type, can help carents understand what is triggering the problem and adjust support accordingly.

Difficulties planning, preparing, and remembering meals

Dementia can make shopping, cooking, and meal planning increasingly difficult.

Some people forget to eat or drink unless prompted. Others forget they have already eaten and may overeat. 

Swallowing or chewing difficulties

Swallowing difficulties are common, especially in later stages of dementia. They affect up to half of people with the condition. However, swallowing difficulties can be serious and can be cause by problems other than dementia so please note the health warning above. 

Chewing problems may be caused by fatigue, memory loss, denture issues, medication side effects, or mouth pain.

Swallowing problems increase the risk of choking and chest infections caused by food or drink entering the lungs. Anyone with these symptoms needs urgent expert assessment, usually by a speech and language therapist.

Problems with coordination

Tremors or reduced coordination can make it hard to prepare food, use cutlery, or bring food to the mouth. These difficulties often worsen over time.

Changes in mood or behaviour

Agitation, restlessness, or pacing can increase calorie needs and lead to missed meals.

Busy, noisy, or uncomfortable environments can be distracting or distressing and make eating much harder. Poor lighting, strong smells, or too much visual clutter can all be overwhelming.

The most important step is ensuring access to expert support. A GP can assess the situation and arrange referrals when needed.

Swallowing difficulties, technically known as dysphagia, should never be ignored. Speech and language therapists are the right specialists to assess swallowing safety and recommend support.

Unintentional weight loss is common in dementia and can happen even when someone appears to be eating regularly. Changes in metabolism, increased movement, and difficulty absorbing nutrients can all contribute.

Carents can feel guilty or responsible when weight drops, but this is rarely due to lack of effort. The key concern is rapid or ongoing weight loss, loose clothing, or visible muscle loss.

Early involvement of a dietitian can help stabilise weight and reduce health risks. Regular weight checks and keeping notes on food intake can provide useful information for professionals.

NHS dietitians can help create a plan that suits both the person with dementia and their daily routine.

Their approach usually takes the following topics into account: 

1. A full and detailed assessment of the nutritional requirements  alongside the practical difficulties and challenges 

2. Food fortification  – in the initial stages they will try and maximise the amount of nutrients  a patient eats or drinks.  This is not just about eating lots of calories, it’s about ensuring that each meal and snack contains all the necessary foods required for health including plenty of protein, vitamins and minerals alongside fats and carbohydrate.  The term used is “nutrient-dense” foods and typical examples might be about adding skimmed milk powder to any rice pudding

3. Finger foods  – foods that can be picked up and eaten by hand can help to improve food intake.   This is not about typical “party buffet”  foods, it might be a roast dinner with chunks of meat and roast potatoes alongside vegetable batons.   This approach can help adults who find it difficult to use cutlery or prefer to wander around at mealtimes

4. Food texture – changing the texture of food can help those who have chewing or swallowing difficulties.  Soft foods like mashed potato, stews, scrambled egg, fortified yoghurt can be useful

5. Food flavour and smell – strong flavours and smells can help to distinguish food and make it more attractive. Adding savoury seasonings like vinegar, herbs and spices or sweet flavours like honey or jam can help to make food more palatable

6. Mealtime arrangements – when and how meals are served can all make a difference to the ease or pleasure of eating.   Common approaches, depending on individual needs and setting, include:

•  improving visual cues by using colour -contrasting plates, mats or tablecloths.  

• Minimising distractions such as the TV, radio, cluttered place settings

• Using eating aids such as adapted cutlery or cups  

• Involving the person with dementia in preparing meals,  serving foods or clearing up afterwards. 

• Providing plenty of time for meals

7. Prescribing oral food supplements  – these are typically in the form of yoghurts, juices or milks which have been fortified  with all the necessary nutrients.  They can seem like a quick fix or easy solution but are well regulated to ensure that they are not used unless the dietary changes listed above are inadequate

8. Tube feeding  – if all of the methods described above are not working, or if someone has a severe swallowing problem then this approach might be used.  This approach is not pleasant for individuals and carries other risks and so it is not recommended unless it is in the person’s best interests.

Caring for a parent with dementia who is struggling to eat can be emotionally exhausting. Many carers describe meals as one of the most stressful parts of the day.

You may feel pressure to “get it right” or worry that every missed meal is causing harm. It helps to remember that perfection is not possible, and small wins matter.

Seeking help early, sharing responsibility, and accepting professional guidance can reduce stress. You are not failing if eating becomes difficult. You are responding to a complex illness that changes over time.

The internet is full of advice, but eating and drinking problems always need proper medical assessment.  Professional dietitians and therapists can provide expert input so do seek help. 

Swallowing or appetite changes may not be caused by dementia and can signal other serious conditions.

Early support can prevent complications and reduce distress for everyone involved. If you are worried, trust your instincts and ask for help.

Medically reviewed by Dr Jackie Gray, March 2026