Posted on Jan 21, 2013
Many of us make New Year resolutions along the lines of eating better. Senior Helpers of the Twin Cities believes similar goals are equally important to older adults. In short, every calorie counts proportionately more towards better health, when the body and mind aren’t working as well as they once did.
So this week, Senior Helpers of the Twin Cities dedicates our Minneapolis and St Paul area senior service blog to nutritional health needs of seniors. Senior Helpers of the Twin Cities wants to empower families to take an active role in reducing nutritional health risks among their older adults who are not eating well or getting the best nutrients in their food choices.
First off, many older adults do not consume enough nutrients and calories to support minimum daily living needs. Personal changes in eating behavior are often associated with many personal variables, including social, environmental, physiological, and psychological changes as we age. If we don’t pay attention, observe, ask the right critical questions and proactively address these personal changes, food intake is frequently compromised, which in turn can lead to significant undernourishment.
Undernourishment is one of the greatest threats to health, well-being, and quality of life among older adults. Weight loss, increased risk of acute illness or infection, a weakened immune system, muscle atrophy, depression, and a lack of energy to complete chores around the house are strongly associated with adverse changes in older adult eating behavior.
What else may cause older adult eating behavior to adversely change?
One big concern is effect social isolation (living alone and eating alone) may have on meal decisions, i.e. restricting the number of meals per day or reducing dietary quality of those meals is profound. Older adults who live alone may feel depressed on a regular basis, displaying a lack of self-motivation to take care of their needs and engage in healthy activities such as making and eating wholesome meals.
Having difficulty managing chronic conditions also can lead to poor food intake. Most types of disability associated with aging (impaired vision, declining memory, hard of hearing) to some degree hinder one’s ability to obtain, prepare and consume food at least three times per day. Poor oral health (missing teeth, gum disease) and dry mouth impairs chewing and swallowing ability. Change in taste (from medications, nutrient deficiency) and smell abilities can make food less appealing. Gastrointestinal changes (slower gastric emptying) and feeling less hunger and thirst make it difficult to intake enough. Some of these physiological factors, e.g., lack of appetite, are modifiable, while others (e.g., poor oral health or sensory changes) are not.
Fortunately, a variety of foods can stimulate increased nutritional intake. Variety also curbs monotonous diets that typically decrease nutrient intake. We advise taking the older adult shopping. This helps to re-determine food likes and dislikes. Suggest alternate foods. Increase interest in foods and make provisions to have these foods available in the home. Meal fortification may be a good strategy for those who are deficient in rich caloric rich foods, notwithstanding persons who have cardiovascular or other chronic circulatory conditions. In the case of the former group, adding a sauce to a meal or snack, adding extra butter or cream to a dish or putting nuts on top of a breakfast meal can improve caloric and protein intake by up to 25 percent. Encourage frequent small meals and between meal snacks to improve nutritional intake.
Frequent snacking can be a problem, though, if it creates an avenue for consuming high sugar or empty nutrient foods. Snacks should provide nutrition. Suggest nuts, fruit slices, cheese and crackers, etc. rather than cakes and cookies. One last suggestion is oral nutritional supplements - liquid food that is used to improve nutritional intake.
Liquid supplements can supplement (be used as the in-between meal snack) or can replace a whole solid meal. If appetite is low, it may be easier to consume eight ounces of liquid rather than a small meal.
We, as caregivers, can help mitigate the effects of these changes by being more involved in nutritional decisions, similar to how parents of young children conduct meal planning for their little ones. In many cases, our parents, family members, loved ones, and clients need us to serve in this essential role for them. Take time to discuss the need for adequate intake (calories and nutrients) with your older adult. Provide suggestions for easy and nutritious meals and snacks. Make shopping lists together and define meal plans with them. Unfortunately, when disabilities are thrown into the mix, don’t be surprised if new knowledge and counseling alone do not bring about desirable changes.
If you are not sure where or how to start, a thorough dietary consult with a registered dietician (RD) is a good place to start. A professional can help you discern what’s best for your loved one, depending on who he or she is, as an individual. Dieticians are trained at counseling and effectively speaking with older adults privately, alongside their extended family, to jump start a new nutritional eating program.
Senior Helpers of the Twin Cities is fortunate to have a Register Dietician among its dedicated and professional staff to assist you accordingly. Please call 952-392-1999 for a short free consultation regarding the concerns and thoughts you may have about your loved one’s eating behavior and nutritional well-being. Our staff will be able to suggest a way or two to work privately with an RD who specializes in working with older adults in the community rather than in a nursing home or assisted living.
Taken in part from:
Nieuwenhuizen, W.F., Weenan, H., Rigby, P., & Hetherington, M.M. (2010). Older adults and patients in need of nutritional support: Review of current treatment options and factors influencing nutritional intake. Clinical Nutrition, 29, 160-169.