Alzheimer’s and the Senses Part Four: Taste

Taste is one of our five basic senses. It is essential for life, for it regulates our food intake and choices, nutrition, and overall health status.ice-cream-cone-1635436_640The current belief is that humans detect five taste sensations: sweet, sour, bitter, salty, and umami (savory). These taste qualities combine with oral sensations like temperature, aroma, texture, and spiciness to produce “flavor.” Flavor helps us recognize whether we’re eating beef or pork, a pear or apple, etc.

How Our Sense of Taste Works

When we’re born, we have about 10,000 taste buds in our tongue, roof of our mouth, and the lining of our throat. The taste buds are the sensory organs, clustered in projections or bumps called papillae. Taste buds perform the “task” of recognizing and generating the signals that lead to the brain. According to the Monell Chemical Senses Center, “Each papillae can contain one to seven hundred taste buds, depending upon its location on the tongue, roof of the mouth and in the throat. Each taste bud contains 50 to 80 specialized cells. At the top of each taste bud is a taste pore, a small opening where a few cells are exposed to the inside surface of the mouth. dec-5-taste-budThese exposed cells contain the receptors (microvilli) that detect taste stimuli.” The cells that are activated communicate with other cells within the taste bud, and relay messages to nerves traveling to the area of the brain known as the gustatory cortex. Some areas of the tongue are better at responding to certain taste than others.

Smell and taste are intertwined functions in our brain. As we age, we start to lose our taste buds. By age twenty, we already have only half the number of taste receptors we had in childhood. There is an even further decline as we continue to age. As we age, our ability to smell also declines. Food may begin to taste boring and bland, similar to when you have a head cold and blocked nose. Taste sensitivity and food preferences may change across our lifespan and are determined by many factors, including genes and experience.

Nutritional Health and Taste

Taste and appetite are closely linked. The taste of food in our mouth signals nerves to cause a release of hormones and enzymes in our saliva, stomach, intestine, and pancreas. These all contribute to how we digest, absorb, and metabolize nutrients as they are processed in the stomach and intestines, and then absorbed into our blood stream.

Persons with Alzheimer’s may develop a loss of taste due to the way the brain interprets the sensation of taste. They may adopt new food preferences and an increase in unhealthy cravings. Heavily flavored foods, either sweet or salty, can be more appealing to people with dementia because they don’t experience flavor in ways they once did. A preference for sweet foods seems to be innate in all humans. Enhancing food with herbs and spices may stimulate the appetite.

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In the later stages of Alzheimer’s, people may lose an interest in food and eating, and even forget that they have eaten. They may also be at a stage where they do not recognize the foods served to them or forget how to eat and use utensils.

How You Can Help

Taste is an important sensory experience that influences health. Here are a few ideas recommended by the National Institute on Aging:

  1. Ensure your loved one gets food with vitamins and minerals to stay healthy. Give them a variety of high-calorie, healthy foods to eat or drink, such as high-protein milk shakes.
  1. Foods that are bulky, sticky, creamy, and thick stay in the mouth longer and stimulate taste and sensory receptors for a longer time.
  1. Try marinating fish, beef, or chicken in sweet or tart fruit juices, sweet and sour sauces, or salad dressing.
  1. Prepare some food and beverages with lemons or oranges to give a tart-like taste. This stimulates the mouth’s sensory nerves and the sweet and sour receptors.
  1. Discuss the use of diet supplements with their doctor if you think they are not getting enough important nutrients and calories.
  1. Keep a routine, if possible, by trying to serve meals at the same time each day. This helps the body “get ready.” Eat meals together.
  1. Make meal time as pleasant as possible. Lessen distractions by turning off a radio or TV and putting on soft music.
  1. Sometimes a full plate or too many items on the table are distracting. Keep the dining table free from clutter.
  1. Check your loved one’s dentures to make sure they are tight fitting and in good condition. Sore gums or painful teeth could also be problematic.
  1. Serve bigger portions at breakfast, the first meal of the day. You may even have to revert to five small meals a day with snacks to ensure that they are getting enough nutrients.
  1. If your loved one has diabetes or high blood pressure, check with the doctor or a nutrition specialist about what foods to limit.
  1. If your loved one is at the stage where they have difficulty using utensils, switch to finger foods such as: cheese, chicken fingers, shrimp, fish sticks, sandwiches made with pita bread, fresh fruits, vegetables.
  1. In the later stages, your loved one may no longer be able to chew or swallow easily. Food must be soft enough to eat, such as: yogurt, soups, ice cream, applesauce, custards, bananas, mashed potatoes and gravy, milk shakes, and smoothies.
  1. Cold drinks are easier to swallow than hot drinks. Add thickeners to thin liquids such as coffee, tea, water or broth because these are hardest to swallow. Avoid using straws that might cause swallowing problems.
  1. Allow plenty of time for them to chew and swallow each mouthful. Don’t hurry them. You may even have to say “swallow” to remind them while gently stroking their neck in a downward motion.
  1. Your loved one may not eat much at certain times, no matter how well you plan or cook. They may simply not be hungry when you are ready to serve the food.

The sense of taste has a tremendous impact on a person’s quality of life. Caregivers play an important role both in encouraging and identifying eating-related problems. It can be a challenge when your loved one does not want to eat. Understand that eating is a complex process for a person with dementia: from forgetting to eat, to seeing food clearly, to the mechanics of scooping up food and bringing it into one’s mouth, to chewing and swallowing. Keep experimenting and tracking what you’ve tried. A relaxed and flexible approach to mealtime is important. Look at this as a time to connect with your loved one rather than a task to “get through.”

I wish you peace, joy, courage, and patience in your caregiving today and every day!

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For more nutrition tips, go to: http://www.alz.org/care/alzheimers-food-eating.asp.

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Dementia advocate and trainer, Teepa Snow, demonstrates tips on “Helping a Person Eat and Drink in Late Stage Dementia,” in this six-minute video:  https://youtu.be/sNPAESrllgQ?list=PLoHm_hpg785tIVS6Hbfm7UslSUMlZF3KX.

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The National Institute on Aging has an excellent article, “Encouraging Eating: Advice for At-home Dementia Caregivers.” It is a few years dated, but still contains good information. Check it out: https://www.nia.nih.gov/alzheimers/features/encouraging-eating-advice-home-dementia-caregivers.

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