Skip to main content

Eating and Drinking Well with Dementia

Optimising food and nutritional care for people with dementia

Research led by the Ageing and Dementia Research Centre at BU has resulted in the development of a toolkit that’s helping to transform nutritional care for people with dementia. This has reached almost 1,000 known recipients to date – receiving a positive response from nurses and allied health professionals, hospital and care home staff, and helping to reverse trends such as weight loss among people living in care homes.

Patients eating in a care home

Around 850,000 people in the UK have dementia. One outcome of the condition is that eating and drinking becomes increasingly difficult, which heightens the risk of severe malnutrition and weight loss. As a result of research conducted by Professor Jane Murphy and Dr Joanne Holmes, lecturers at BU, best practice guidance is now available in the form of a toolkit for front-line nurses and care home staff to help people with dementia to eat and drink according to their needs.

Ensuring appropriate food and nutrition is a vital part of delivering dignity in care for people with dementia. Yet as dementia progresses, it’s not uncommon for people to lose weight, which can lead to further physical and mental decline.

The reasons behind weight loss are diverse. Some people face physical difficulties with chewing and swallowing, while others may struggle to identify when they feel thirsty or hungry. For busy care home staff, managing this and knowing how best to support people they care for – each with their own needs – can be a real challenge.

Despite these known concerns, there are no standardised ways to maintain adequate nutrition in people with dementia.

The launch of the research

To tackle this gap and assist front-line care staff, Professor Murphy and Dr Holmes were awarded a grant by The Burdett Trust for Nursing to undertake a groundbreaking research project.

“We worked with local care homes in Dorset to find out how much people were eating and drinking each day. Our results showed that around half of our participants weren’t eating or drinking enough to meet their daily energy needs. We also found that many people were spending a high proportion of their day sitting or sleeping, which may explain why some had small appetites,” says Professor Murphy.

The next stage was to work with local care homes to draw out examples of best practice and strategies to help people with dementia to eat and drink well. A whole-care-home approach was a key element of the project, involving service users, families and carers of people with dementia who were able to inform and guide the research.

“Working collaboratively with care staff was essential to developing these resources as we were able to draw on the expertise of and best practice used by frontline staff,” continues Professor Murphy. The BU team also worked in partnership with local councils, Partners in Care, the Dorset Local Enterprise Partnership and national and private care home organisations.

View Professor Murphy's staff profile

Professor Jane Murphy

Professor of Nutrition

Most encouragingly, we’re beginning to hear stories of people with dementia who were at risk of or actually losing weight, beginning to reverse that trend.

The Eating and Drinking Well with Dementia Toolkit

Based on their findings, Professor Murphy, Dr Holmes and the team developed the toolkit to provide freely available resources (a film, workbook and guide) to deliver person-centred nutritional care in dementia. The toolkit has been used all over the UK and overseas, as far afield as Australia is the winner of the 2019 CN Award for Nutrition Resource of the Year.

The workbook and film aim to develop knowledge and skills around nutrition and hydration to provide best-quality care that also offers an excellent CPD opportunity, completed flexibly. To date, almost 1,000 known recipients of the workbook (including nurses and allied health professionals, hospital and care home staff) have reported benefits and inspired action to reconfigure the way in which nutritional care is delivered.

You can watch the film by visiting our training resources page. You will also be able to download for free the ‘Eating and Drinking Well with Dementia: A Guide for Care Staff’ and the ‘Eating and Drinking Well: Supporting People Living with Dementia’ workbook.

Emma Connolly

Programme Director for Greater Manchester Nutrition and Hydration Programme

The guide is simple yet comprehensive. It focuses on supporting people living with dementia to eat and drink well in a dignified way with positive and practical tips for care staff. It has the potential to transform nutritional support in care homes.

Testimonial commissioner of care services

We used the workbook as a superb resource to input in our action plan to improve nutrition care in our borough across health and social care providers for people living at home and in a residential home.

Professor Jane Murphy talks about nutrition in dementia care

Positive feedback

“We chose to make resources that can be used at any time, as we know that care staff are extremely busy, and taking time to travel to training sessions can be difficult,” explains Professor Murphy. “The training tools explain why ensuring good nutrition is essential and provide practical tips for how staff can support people to eat and drink as part of their person-centred care. These range from getting to know people’s personal preferences, to ideas for encouraging people to drink enough, developing appealing menus and even improving the environment for meal times.”

The response to the resources indicates the impact and difference small changes can make on nutritional care. To date, over half of the recipients have reported that people with dementia who had poor appetites or were losing weight are eating more as a result of the suggestions and interventions in the guide. Quality improvements in nutritional care have led to increased Care Quality Commission ratings in care homes.

One user has commented how “we are now developing taste sessions within the home and being more creative with the menu and presentation.”

Another said: “This workbook has been a hugely useful tool… I have been able to communicate best practice in supporting people re eating and drinking well with dementia just by handing them this work book and explaining the relevant information.”

“Most encouragingly,” says Professor Murphy, “we’re beginning to hear stories of people with dementia who were at risk of or actually losing weight, beginning to reverse that trend – as many as 40% of those who have reported back since engaging with the resources. This shows us that the strategies we highlighted in our resources are making a real difference.”

News from the Faculty of Health & Social Sciences