Having Their Cake and Eating it Too: An Exploratory Mixed-Methods Study on the Dietary Behaviours of Family Carers of Persons With Dementia.

Abstract

Introduction: While dementia caregiving is known to place considerable demands on carers, its impact on carers' own dietary behaviours and nutritional health remains poorly understood. Understanding how caregiving impacts carers' diet quality is essential to inform supportive interventions. Purpose: This study aimed to explore the diet quality of family carers of persons with dementia and identify caregiving-related factors influencing their nutrition. Methods: A concurrent mixed-methods design was employed with 30 family carers completing a quantitative online survey and 10 participating in qualitative semi-structured interviews to provide contextual depth. The online survey included demographic data, dietary intake via a validated 24-h recall, diet quality using the 14-Item Mediterranean Diet Adherence Screener (MEDAS), and food insecurity using the Food Insecurity Experience Scale (FIES). Results: Family carers were food secure according to the FIES, and their overall diet quality was moderate, with a mean MEDAS score of 6.6 ± 2.1. Eighty percent exceeded saturated fat and 43% exceeded free sugar intake recommendations. Only 33% of carers reported eating ≥5 portions of fruit and vegetables, with 23% meeting intake of dietary fibre. The findings from the semi-structured interviews demonstrated that caring for a family member with dementia could influence their own dietary behaviours, due to the practical aspects of caregiving and the evolving palates and capabilities of the person with dementia. Conclusion: Family carers of persons with dementia often fail to meet dietary recommendations despite moderate diet quality, with emotional burden, time scarcity, and competing priorities significantly influencing their own eating behaviours. These findings highlight the need for flexible, personalised interventions, such as digital tools, meal delivery services, embedded nutrition support, and peer network, that address carers' emotional stress, time constraints, and caregiving roles to improve their dietary behaviours.