30 reasons people living with dementia might decline to eat

Some people say there are no stupid questions. I beg to differ. I regularly see stupid questions, or perhaps ignorant questions would be more accurate, being asked about people who live with dementia.

Often the questions come into my inbox from Quora. I answer the occasional one, like this query from a grandson for example. Most I ignore because the answers may be easily found with a quick google search.

Then there are the questions such as this that make me hot under the collar: “What does it mean when a person with dementia refuses food?” To which I couldn’t help but answer pointedly: “Oh for heaven’s sake. People with dementia are PEOPLE. Their behaviour is NORMAL. Ask yourself why you might refuse food, and you will have the answer to your question.”

I went on to give a list of thirty potential reasons someone living with dementia (or someone NOT living with dementia for that matter) might decline to eat:

1. He is not hungry
2. She doesn’t care for the food she’s being offered
3. He doesn’t like the way the food is presented (e.g. the colour, the texture, the fact that it’s pureed, or not, or it doesn’t even LOOK like food)
4. She doesn’t like the smell of the food
5. He doesn’t like the taste of the food / the food tastes bad.
6. The food is too hot or too cold
7. She is sick
8. She is tired and doesn’t feel like eating
9. He is in pain
10. Her tummy is upset, she has cramps
11. She’s having trouble swallowing and she’s afraid she might choke
12. He’s so sedated with drugs that he’s not interesting in eating or he physically can’t eat
13. She doesn’t remember how to use the utensils, and she doesn’t want to be impolite and use her hands
14. It’s not his usual mealtime; it’s too early or too late
15. Someone is telling her / giving her an order to eat and she hates people telling her what to do
16. Someone is trying to feed him, when he is perfectly capable of feeding himself
17. She needs help to eat, but she’s too afraid to ask or there’s no around to help her
18. It’s too noisy / it’s too quiet
19. She’s tired of eating the same thing all the time
20. The place he’s in is unfamiliar; he prefers to eat where he usually eats
21. She prefers to eat what she wants, and no one asked her what she wanted
22. The lights are too bright / the lights are too dim.
23. He feels constipated / she needs to go to the bathroom
24. She is surrounded by strange people and she wants to go home and eat with her family
25. She wants to sit with her friend at another table, but she’s not “allowed”
26. His dentures don’t fit properly and it’s hard for him to chew
27. She doesn’t seem to have her dentures anymore, and she can’t eat properly without them
28. Whenever he eats, he gets some kind of adverse reaction, so he’s refusing to eat to avoid the reaction
29. She saw someone crush pills into her food, and she doesn’t want to take the pills
30. He’s at the end of life, and I doesn’t feel like eating anymore

No doubt there are other reasons I haven’t thought of. The important thing is to remember that people who live with dementia are just like the rest of us. They are human beings with thoughts, feelings, needs, likes and dislikes.

If we took the time to ask ourselves smart questions about why people who live with dementia behave as they do, we wouldn’t need to ask stupid and ignorant ones!

And BTW, all of this is yet ANOTHER reason we need to #BanBPSD.

More posts and PDFs in the “20 questions”series.

101 potential causes of behaviour by people living with dementia that institutional care staff may find challenging

20 questions to ask when a care partner or resident walks around at night

“wandering” is not a symptom of dementia

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