Anorexia of ageing is contributed by physiological changes, comorbidities, medications, and social factors. Food refusal in older adults with dementia is one of the behavioural and psychological symptoms of dementia. Modifying diet texture, fluid consistency, feeding techniques, and environmental factors can assist in overcoming food refusal. This case illustrates the challenges encountered in patients with dementia demonstrating food refusal behaviour, measures that can be taken to optimise their nutrition, and how these challenges may impact their long-term care.