Everyone knows that maintaining a healthy diet and staying physically active is important in life. But as LBD progresses, exercise and good nutrition can be a challenge. Cognitive skills and mood changes make motivation and following instructions difficult. Balance, flexibility and muscle tone may be affected by movement symptoms. Preference for certain foods may change as dementia progresses, such as wanting only sweet foods like fruit or ice cream. Malnutrition, weight loss and dehydration may also occur, so caregivers have good reason to worry. But how much focus should be placed on diet and exercise as LBD advances?
Certainly in the early stages, it matters quite a bit. A healthy diet provides not just calories and nutritional value but also fiber, important in managing constipation in LBD, as well as anti-oxidants and anti-inflammatory compounds, which will help maintain health. Exercise builds muscle and cardiovascular strength and helps with balance, which may minimize falls.
In the middle stage of LBD, increasing confusion or behavioral changes can lead to resistance to care. In order to reduce stress in their daily routine, it’s ok to take a more relaxed approach to diet and exercise. Instead, caregivers can encourage healthy choices by continuing to provide well-balanced meals. Respect the wishes of the person with LBD if their appetite changes, and consider supplementing their diet with a nutritional drink like Ensure. Offer them opportunities to exercise followed by an enjoyable activity or special treat. But offering criticism, negativity or pressure are likely to result in resistance and frustration for both the person with LBD and the caregiver.
As dementia becomes more advanced, comfort care should become the number one priority. When it comes to nutrition, consuming adequate calories and fluids becomes more important than getting the perfect nutritional value.
Here are some suggestions on things you can do to make it easier to maintain a healthy diet and exercise as long as possible.
- Use plates that have a contrasting color to the tablecloth. It makes it easier for the person with LBD to distinguish the food in front of them.
- Purchase silverware with larger handles that are easier to grasp and balance.
- Transition to using cups with lids and straws and encourage adequate fluid intake to avoid dehydration.
- If swallowing is difficult, request a swallowing study be ordered and get a referral to a speech therapist.
- Use prune juice, stool softeners and fiber supplements as needed to minimize constipation.
- Try playing upbeat music the person enjoys during exercise to make it more enjoyable.
- Arrange exercise to take place with a friend as part of their social interaction.
- Suggest easy playing seated games with a few friends, like kicking around a playground ball or keeping a balloon up in the air.
- Provide visual cues by also doing exercises yourself.
- Make it fun.
- If exercise isn’t enjoyable or possible, provide comfort and stimulate blood flow through gentle massage.