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Considering Nutrition
Clients with dementia have a tendency to loose weight (Finucane, Christmas & Travis, 1999). This weight loss can lead to malnutrition. When modifying diets, the nutritional needs of the client must be considered. Wright, et al (2005) found that clients on modified diets in hospital were not receiving the energy and protien they needed. Another study by Suominen et al (2005), which looked at one particular rest home in Sweden, found that 29% of residents suffered from malnutrition (p. 580). One of the things this was highly related to malnutrition was the existence of dementia and swallowing difficulties. The clients with dementia may be unable to regulate their own dietary needs and can have behaviours that contribute to this, such as food refusal (Finucane, Christmas & Travis, 1999). This can contribute to malnutrition. The decrease in the desire for food and the decrease in taste sensation mentioned above, can also contribute to the problem. It is therefore essential to ensure that clients are receiving adequate nutrition and collaboration with a dietician is almost inevitable. Consideration for this is needed when planning interventions.

Maintaining Nutrition and Preventing Malnutrition
The risk of malnutrition is increased in clients with dementia because they are often unable to feed themselves (Easterling and Robbins, 2008). They therefore rely on others to fulfill their nutritional needs. There are a few strategies that can help to increase a clients nutritional intake. One of these is through supporting their diet with numerous high calorie snacks throughout the day. A study by Boczko (2005) showed that patients who were given timed snacks two hours after each meal improved their nutrition and hydration over four weeks. The study by Boczko found that it is most successful if the snacks are tailored to the clients personal preference. Another way to increase a patient nutrition is to support their diet with nutritional supplement drinks. These are not a replacement for food. They are to be consumed in addition to their existing diet.
The Actual Meal

Encouraging interest in food is important to increase nutritional intake and decrease food refusal. This can be helped by making food look good and more inviting. Allowing patients touch food can also increase interest. It is important to encourage self feeding for as long as possible (Easterling and Robbins (2008). This often not done as the clients will often still require supervision and this can often mean that the meal time will take longer. Providing food choices can encourage interest in food and allows the client some control over what they eat. Clients with Dementia often enjoy highly flavoured food that are sweet, sour and/or spiced and this increases the sensory input and can assist with swallowing. (Easterling and Robbins (2008).