Nutrition and the Elderly
By Terri Murphy
Eating well is important at every age. Good nutrition affects the quality of our lives, helps keep us healthy and helps speed healing if we become ill. Unfortunately, experts say many adults – especially older adults – don’t get the nutrition they need.
- One-third of people over 65 suffer from nutritional deficiencies.
- The incidence of protein-calorie malnutrition is higher among the elderly.
- Older adults absorb fewer nutrients from the foods they east and the ability to digest fats decreases with age.
- Fewer calories are needed to maintain body weight.
- Anorexia, depression, social isolation, and failure to thrive are common among the elderly; these directly affect eating and nutrition.
- Loss of appetite because of a decreased ability to taste or smell food is common among the elderly. The inability to smell or taste food can be a result of normal aging or can result from medications and disease.
- Ill-fitting or painful dentures can make eating difficult.
- Some medications can affect how the body absorbs nutrients. For example, habitual use of laxatives can decrease absorption of minerals such as calcium and potassium. Chronic aspirin use has been associated with Vitamin B deficiency.
- People with Alzheimer’s or dementia may forget to eat or may lose interest in food, and a lack of transportation may make it difficult for them to shop for food.
- A noisy or chaotic dining environment and frequent interruptions during mealtimes may make eating an unenjoyable event.
Dietary Recommendations for the Elderly
Nutritional needs change at various stages of life. The diet recommendations for the elderly take into account:
- A decreased ability to absorb nutrients and fats.
- Decreased energy needs, which means fewer calories.
- An increased need for nutrient-rich foods.
- An increased need for fiber.
- Specialized recommendations for seniors 70 years of age and over are:
- Choose the lowest number of recommended servings from each food group.
- For grain products, choose whole grain, enriched/fortified products: brown rice rather than white, and high fiber breakfast cereal fortified with Vitamin B-12 and folic acid.
- Choose whole food rather than juice, and choose fruits and vegetables that are deeply colored: dark green, orange, red and yellow ones should be chosen often.
- Dairy choices should be low in fat, with at least three calcium-rich servings daily or the equivalent in calcium-fortified orange juice or nutritional supplements.
- Choose a variety of lean cuts of meat and poultry from the protein group. East fish at least once a week and a legume (dry bean) dish at least twice a week instead of a meat dish.
- Most fat choices should be limited. Those chosen should consist of a variety of unsaturated liquid oils, rather than hydrogenated or saturated fats.
The Importance of Water
Water is vital to health and well being. It is necessary to drink 6 – 8 cups of water daily. The body needs water to digest, to flush and eliminate toxins, to maintain body temperature, and to prevent dehydration.
- Many older people suffer from dehydration. Some medications can contribute to dehydration.
- The thirst response decreases as we age. Older people don’t feel thirsty as often.
- People who suffer from incontinence may limit their fluid intake in order to avoid embarrassment.
- Encourage the person in your care to drink fluids, especially water. Serve foods that are high in liquid content, such as watermelon, citrus fruits, tomatoes, cucumbers, and clear soup. Avoid caffeine and alcohol, which can cause dehydration.
Warning Signs of Dehydration
- The Person complains of thirst.
- The mouth, tongue, lips, and skin will appear dry. The lips may be cracked. The eyes may look sunken.
- Urinary output is decreased. The urine may be dark amber in color, rather than yellow. The average urine output is 1 ½ – 2 quarts per day.
- Vomiting and diarrhea.
- Fever and excessive perspiration.
- Feeding Someone Who Cannot Feed Himself
- Encourage the person to participate as much as possible.
- Wash your hands. Tell the person what you plan to do.
- Wash his face and hands. Suggest any mouth care that would make eating more desirable. Check to see that dentures, if any, are in place. Bring the person into a sitting position in the bed or preferably in a chair. Drape a napkin over the chest and under the chin. Keep a moistened hand towel nearby for any cleanup.
- Serve food on a tray. Use thermal bowls and cups to keep food at the proper temperature. Bring the food to the person, telling him what you have prepared. Sit near the person.
- Cut food into bite-sized pieces and pour or prepare liquids as necessary.
- Ask the person which food he or she wants first.
- Let him set the pace. Feed one bite at a time, using a half-filled spoon. Place the tip of the spoon to one side of his mouth. Remove the spoon when he has taken the food from the spoon.
- If possible, have the person hold finger foods or bread.
- Use a straw for drinking cool beverages. Wait until he finishes chewing before offering something to drink. Guide the straw or the edge of the cup to his lips.
- Offer praise and encouragement. Mealtime is an excellent time to have conversation.
- When he has finished, wash his hands and face and remove the tray. This is a good time for routine oral hygiene. Clean up any spilled food or drink.
- Wash dishes, utensils, and your own hands.
- Decreased appetite and any swallowing difficulties should be reported to the doctor, nurse, Home Helpers office, and family.
Eating Aids That Can Make Mealtime Easier
- Swivel spoons for those with limited wrist movement.
- Foam cylinders that fit over and enlarge gripping surfaces of utensils.
- Plate guards and high-sided dishes that keep food on the plate and make it easier to scoop food onto utensils.
- Rocker knives that cut food using a rocking motion. Small pizza cutter or rolling knives work well
- Food warming dishes for a person who eats slowly.
- Rubber-tipped baby spoons and a child’s feeder cup or plastic glass.
All of your hard work will pay off. Maintaining a healthy diet can yield numerous benefits, including increased energy, good mental health and mental abilities, resistance to disease, faster recovery from illness, accident, or surgery, better medication effectiveness, and improved management of chronic health problems. The overall result of an emphasis on good nutrition will be an improvement in your quality of life, mobility, and independence.