Cooking and Caregiving: Tips for Providing Special Dietary Needs

Chewing and swallowing difficulties​

Whether your loved one is experiencing swallowing difficulties from dementia, Parkinson's, ALS or another chronic condition, it’s crucial to understand their individual needs to manage nutritional requirements effectively.​​

Swallowing difficulties are actually more common than many people realize. A 2024 research paper in the journal Age and Ageing, which reviewed 18 studies with 12,500 older adults with different types of dementia, found that swallowing difficulties affected about 58 percent of people with dementia. Among the types studied, those with Alzheimer’s disease had the highest rates of swallowing problems (around 46.5 percent), followed by Parkinson’s disease dementia (about 35 percent), vascular dementia (19 percent), mixed dementia (16 percent) and Lewy body dementia (12 percent).​

“Difficulties affecting the coordination of swallowing can lead to complications like dehydration and malnutrition,” says Khuong.​​

She emphasizes the importance of using thicker liquids and pureed foods for those with swallowing challenges, as thinner fluids may be harder to control and can increase the risk of aspiration, which happens when food or liquid accidentally enters the lungs instead of the esophagus and stomach. See sidebar for three easy-to-make pureed food recipes. ​

When pureed foods are the safest options due to swallowing issues, find ways to make them more visually appealing, recommends Planells. “People eat with their eyes, so appearance matters. Use molds or shaping tools to help pureed food resemble its original form, like a chicken wing, scrambled egg or lasagna slice.”​

Andy Brenz started using baby food to feed his wife, Saranette, who was diagnosed with ALS in 2011. “She got to the point where table food was choking her. We both wish we had started using baby food much sooner.”​

When every pound matters​

Mary Lou Falcone struggled to maintain her husband’s weight after triple bypass heart surgery, and later, when he was diagnosed with Lewy body dementia, the second-most common form of progressive dementia after Alzheimer’s disease. Falcone’s husband, Nicky Zann, an artist and illustrator, lost 10 pounds immediately after surgery and it was difficult to reverse.​

“Getting him to eat three meals a day was a challenge. I would very often cook several meals for him a day, one would be rejected, the second one too and sometimes even a third,” says Falcone, who chronicled their journey with Lewy body dementia in the highly acclaimed book, I Didn’t See It Coming.​

Much of Zann’s distaste for food was related to diarrhea, she admits. When they addressed that problem with the addition of Imodium, following his doctor’s advice, he regained some of his interest in food. Falcone added nutritional supplements like Boost and Ensure at mealtimes to add calories to his diet.​

Kapp has incorporated healthy fats like olive oil and avocado into meals, drizzling olive oil over dishes such as chili and chicken and rice to add extra calories without increasing volume. Kapp also mixes hemp seeds into yogurt, granola and oatmeal, and uses chia seeds in puddings and smoothies to increase calorie and nutrient content.​

Reviving the appetite​

Avoid food fatigue by regularly varying flavors and ingredients, experimenting with new recipes, and keeping the overall eating experience fresh and new.

“It’s important to regularly change up flavors and ingredients to keep meals interesting, especially when appetite or food enjoyment starts to decline,” says Khuong.​​

Enhance flavor without adding sodium by using fresh herbs like basil, oregano and cilantro, aromatic spices such as ginger, turmeric and paprika, and seasonings like lemon, vinegar or spice blends. Khuong suggests:​​

• Cook noodles in chicken broth instead of water to add flavor and savoriness without much extra effort.​
• Include milk or gravy to pureed foods to improve texture and enhance taste, making the food smoother and more flavorful.
• ​Embrace various textures like crunchy, creamy and chewy elements to create a more enticing eating experience.​
• Use fragrant herbs like basil and parsley to enhance the aroma of the food, which can stimulate appetite. ​
• Blend smoothies or milkshakes with plenty of fruit to boost both calories and flavor appeal.​

Preparing for a feeding tube

After months of relying on baby food, Brenz’s doctor recommended a feeding tube to provide more consistent nutrition and help maintain Saranette’s weight.​

“Once I was trained in the hospital, using the tube was straightforward,” admits Brenz. “The real challenge was finding a formula that didn’t upset her. The usual ones didn’t work, but everything changed when we found some alternative formulas.”​

Though weight loss is common in people with ALS, Duffin’s weight has remained relatively stable since her diagnosis in 2022. She lost five pounds after an illness last November, but was able to gain it back in a few months.​

Earlier this year, a feeding tube was inserted to avoid the risks of anesthesia down the line and maintain good hydration. “Tressa is still eating solid foods well and we’re hopeful that the feeding tube won’t replace regular meals for quite a while,” says Kapp.​

“Even as her illness advances, Tressa is still finding joy in food,” Kapp says. “It reminds me that the simple rituals of cooking and sharing meals continue to bring us comfort and keep us connected.”​

​Must-have kitchen gadgets​

When a loved one’s dietary needs change due to illness, having the right tools on hand doesn’t just make cooking easier — it can make meals safer, more nutritious and more enjoyable for everyone. Whether you’re managing portion sizes, preparing softer foods, or aiming to reduce salt and fat, these kitchen essentials can support your caregiving and help meet specific dietary goals with greater confidence and care. Planells recommends these essential tools:​

Air fryer: This all-in-one appliance can fry, bake, roast and reheat a wide variety of food quickly with less oil and typically crispy results.​

Food scale: Accurately measures portions that are critical for managing calories, carbohydrates and sodium.​

High-quality blender or food processor: Great for pureeing foods for people with swallowing issues (dysphagia), making smoothies or preparing soft-texture meals.​

Stick or immersion blender: Allows for quick pureeing or thickening of soups and sauces right in the pot so there’s less mess and more control.​

Slow cooker or instant pot: Helps cook tender, easy-to-digest meals with less hands-on time. Perfect for soft foods and meals low in added fats or sodium.