Why do people with dementia hoard food?

According to research published by the Alzheimer's Society, changes in appetite and eating habits are common symptoms of dementia. This can manifest as food hoarding, a challenging behavior that stems from a combination of cognitive, emotional, and physical factors. Understanding why do people with dementia hoard food is the first step toward effective management and compassionate care.

Quick Summary

Dementia patients hoard food primarily due to memory loss, anxiety, and a profound loss of control, which are all effects of cognitive decline. Forgetting a recent meal can make them feel constantly hungry, while anxiety can create a powerful, instinctual urge to stockpile food as a coping mechanism for perceived scarcity.

Key Points

• Cognitive Decline: Memory loss and impaired judgment often cause a person with dementia to forget recent meals and misinterpret their hunger cues, leading to hoarding.

• Emotional Security: Food hoarding can be a coping mechanism for profound anxiety and the feeling of losing control over one's life due to dementia.

• Loss of Control: As independence fades, individuals may cling to the act of stockpiling food as a way to maintain some sense of power and purpose.

• Distorted Senses: Changes in taste and smell perception can lead to unusual food preferences or a decreased interest in eating, sometimes causing food to be forgotten and hoarded.

• Gentle Approach: Confronting or arguing with a person who hoards food can increase their anxiety; a calm, reassuring approach with redirection is more effective.

• Safety First: The primary concern for caregivers is preventing the person from eating expired or spoiled food, which requires regular checking of hiding spots.

• Stimulation Needs: Hoarding behavior can sometimes stem from boredom; providing engaging activities can redirect their energy and reduce the compulsion to hoard.

Cognitive Causes Behind Food Hoarding

Food hoarding in dementia is not a willful or malicious act, but a direct consequence of brain changes. Several cognitive impairments contribute to this behavior:

Memory Loss and Confused Hunger Cues

As dementia progresses, short-term memory is often severely impacted. An individual may genuinely forget they have just eaten, leading them to believe they are constantly hungry or that no food is available. This can prompt them to squirrel away food as a safeguard against a perceived lack of future meals. Their ability to interpret hunger and satiety signals can also become distorted, creating a persistent feeling of dissatisfaction or need.

Impaired Executive Function

Executive function refers to the set of mental skills that includes working memory, flexible thinking, and self-control. Dementia erodes these skills, affecting the person's judgment and planning. This can result in a breakdown of logic, where they save spoiled food without understanding the health risk, or hide food in illogical places. They may also lose the ability to organize their thoughts around mealtimes and food storage, leading to disorganized and secretive hoarding.

Emotional and Psychological Factors at Play

Beyond cognitive decline, powerful emotional forces drive the impulse to hoard.

Anxiety and Fear of Scarcity

A profound sense of anxiety is common in dementia. The world can feel confusing, unpredictable, and scary. Hoarding food can be a primal response to this fear, creating a sense of security and control. For some, it might be a subconscious reliving of past traumas or experiences of scarcity, even if the person has lived a life of abundance. The act of saving food becomes a way to manage deep-seated, irrational fears.

Loss of Control and Security

As individuals lose independence due to dementia, they may seek to reassert control in other areas of their lives. Hoarding food provides a tangible form of control—the power to decide what to save, where to hide it, and when to use it. This behavior is a coping mechanism for feeling powerless in a world that is slipping away from them.

Boredom and Lack of Stimulation

For those who are isolated or have lost interest in once-loved hobbies, boredom can become a significant driver of behavior. The activity of rummaging, collecting, and hiding food can provide a sense of purpose and stimulation that is otherwise lacking in their daily routine. This is similar to the general rummaging behavior that is also common in dementia.

Managing Food Hoarding: Caregiver Strategies

Addressing food hoarding requires a sensitive, non-confrontational approach. The goal is to minimize risks and reduce the anxiety that fuels the behavior.

Redirecting and Distracting: Instead of arguing or confronting them directly, offer a distraction. Engaging in a favorite activity or offering a different, healthy snack can help shift their focus away from the hoarding impulse.

Providing Reassurance: Gently and consistently reassure them that there is plenty of food and that they are safe and cared for. A calm, compassionate tone of voice can be more impactful than a lengthy explanation.

Creating a Safe Environment: Remove dangerous items, including expired food, from hiding spots regularly. Consider securing kitchen or pantry access if the behavior becomes a safety hazard, such as causing a fire or illness. Offering small, frequent meals can also help manage their perceived hunger.

Encourage Hydration: Dehydration is common in dementia and can be mistaken for hunger. Keep appealing drinks like water, juice, or milkshakes readily available and visible to encourage regular fluid intake.

Here are some proactive ways to address the issue:

1. Reduce Access to Excessive Food: Keep smaller quantities of food out and store the rest out of sight in a locked cupboard or pantry. This helps prevent large-scale stockpiling.
2. Offer Healthy Snacks: Ensure healthy, ready-to-eat snacks like fruit slices or nuts are visible and easily accessible. This can satisfy the urge to graze and provides nutrition.
3. Use Visual Cues: Since memory is impaired, a simple visual aid can be helpful. A sign on the fridge saying "Help yourself to a snack" can serve as a reminder that food is available.
4. Mealtime Routine: Establishing a predictable mealtime routine helps create a sense of security. Consistency can reduce anxiety about when the next meal will arrive.

A Comparison of Hoarding Motivations

Motivation	Dementia-Related Food Hoarding	General Hoarding Disorder
Core Cause	Result of neurodegenerative brain changes impacting memory, emotion, and executive function.	Psychological condition linked to anxiety, perfectionism, and emotional attachments.
Awareness	The individual often lacks insight, genuinely believing the food is needed and not recognizing the behavior as problematic.	The individual may have some awareness of the issue but feels powerless to stop.
Triggers	Often triggered by confusion, fear, and feeling a loss of control in an increasingly disorienting world.	Can be triggered by emotional distress, grief, or personal trauma unrelated to memory loss.
Focus of Hoarding	Often focused on food, with other items sometimes collected. Hiding places can be illogical and disorganized.	Can involve any item, from papers to animals. The behavior is often more methodical and long-term.

Conclusion: Patience and Professional Guidance

Dealing with food hoarding is a test of patience, but it is essential to remember that the person's behavior is driven by their disease. Approaching them with empathy, understanding, and strategic intervention can significantly improve their quality of life and safety. If you are struggling to manage this behavior, remember that you are not alone. Seeking professional advice from a doctor, a dementia specialist, or a support group is crucial for finding personalized strategies. For further guidance and support on managing dementia symptoms, consider visiting the Alzheimer's Foundation of America.

Frequently Asked Questions

Why does my loved one with dementia keep hiding food?

They may be hiding food because of memory loss, forgetting they have eaten or where they left a snack. It can also stem from anxiety, creating a fear that there won't be enough food later.

Is food hoarding in dementia dangerous?

Yes, it can be. The main risks include consuming spoiled or expired food, which can lead to illness, and creating unsanitary living conditions that attract pests. Hidden food can also be a fire hazard if placed near heat sources.

How should I respond when I find hoarded food?

Approach the situation calmly and without judgment. Gently explain that the food has gone bad and needs to be thrown away. You can then distract them with another activity or a fresh snack to minimize agitation. Don’t confront them in an accusatory way.

Can medication cause food hoarding in people with dementia?

While some medications for dementia can affect appetite or cause other behavioral side effects, food hoarding is more directly linked to the neurological and psychological changes caused by the dementia itself. It's always a good idea to discuss medication changes with a doctor.

How can I prevent a person with dementia from hoarding food?

Focus on preventative strategies like offering smaller, more frequent meals to reduce feelings of hunger. Keep fresh, healthy snacks readily available and store excessive or unhealthy foods out of sight in a locked area to reduce temptation.

What is the difference between hoarding disorder and dementia-related hoarding?

Hoarding disorder is a distinct mental illness, often with a lifelong pattern, where individuals feel distressed about discarding items but may be aware of the issue. Dementia-related hoarding is a symptom of cognitive decline, typically starting later in life, where the person often lacks insight into the problematic nature of their behavior.

What are some early signs of food hoarding in dementia?

Early signs can include finding food in unusual places, an increase in food purchases, strong odors from decaying food, or seeing them refuse to discard expired items. A change in appetite or a fixation on certain foods can also be a sign.