Nutrition and the ElderlyAre the Seniors in Your Life Eating Well?
-- By Leanne Beattie, Health Writer & Nicole Nichols, Health Educator
Eating well is important at any age. But health issues and physical limitations sometimes make it difficult for seniors, the fastest-growing segment of the U.S. population, to get the nutrients they need for a balanced diet. Poor nutrition and malnutrition occur in 15 to 50 percent of the elderly population. But the symptoms of malnutrition (weight loss, disorientation, lightheadedness, lethargy and loss of appetite) can easily be mistaken for illness or disease. If you are a full- or part-time caretaker for an elderly parent or grandparent, there are plenty of steps you can take to help your loved ones maintain good nutrition as they age.
Whether it’s because of physical limitations or financial hardship, many seniors don’t eat as well as they should. Arthritis can make cooking difficult, while certain medications can reduce appetite, making meals unappealing. A 1990 survey by Ross Laboratories found that 30 percent of seniors skip at least one meal a day, while another study found that 16 percent of seniors consume fewer than 1000 calories a day, which is insufficient to maintain adequate nutrition. There are many reasons why a senior may skip a meal, from forgetfulness to financial burden, depression to dental problems, and loneliness to frailty.
Possible Causes of Poor Nutrition
The best ways to find out why your loved one isn't eating well are to pay attention, look for clues and ask questions. Encourage him to talk openly and honestly, and reassure him that he is not a burden to you or anyone else. Some of the most common reasons for poor nutrition in the elderly include:
Decrease in sensitivity. The aging process itself is a barrier to good nutrition since it is common to for appetites to diminish as a person ages. A decline in the senses of smell and taste also affect a person’s ability to taste and enjoy food. If a meal isn’t appetizing, a senior is less likely to eat as much as he should.
Side effects of medication. Certain medications (whether over-the-counter or prescription) can reduce appetite, cause nausea, or make food taste differently. If a senior doesn't feel hungry due to medication side effects, she is less likely to eat even though her body does need food and calories.
Poor dental health. Seniors are more likely to suffer from dental problems. Ill-fitting dentures, jaw pain, mouth sores and missing teeth can make chewing painful. All of these factors make it increasingly difficult for the elderly to eat healthy foods.
Financial burden. Many seniors are on fixed or limited incomes. If he is worried about money, a senior may cut back on grocery expenses or buy cheaper and less-nutritious foods to stretch his budget. Lacking money to pay for adequate foods can result in a host of nutrition problems.
Lack of transportation. Shopping today is also more difficult with many food stores located in large shopping malls and on crowded streets. In order to go grocery shopping, a senior must drive to the store, navigate through heavy traffic and park far away from the door. Add snow and ice to the mix and you have a very treacherous situation for the elderly.
Physical difficulty. Seniors can become frail as they age, especially when dealing with debilitating conditions like fibromyalgia, arthritis, vertigo (dizziness) and disability. Physical pain and poor strength can make even simple tasks (opening a can, peeling fruit, and standing long enough to cook a meal) too challenging.
Forgetfulness. Dementia, Alzheimer's disease, and poor memory can hurt a senior's ability to eat a variety of foods on a regular schedule and remember what to buy at the store. One may keep eating the same foods over and over without realizing it, or skip meals entirely because she doesn't know the last time that she ate.
- Depression. As people age, life can become more difficult. Their loved ones may be gone (or far away), their body may be failing them, even if their mind is sharp, and loneliness can take its toll. Feeling blue or depressed can decrease one's appetite, or make him feel apathetic about caring for his health. Depression is a manageable disease when treated correctly, but left untreated it can lead to many other nutrition and health problems.
If you are concerned about the diet of an elderly person in your life, here are some practical tips to ensure he or she is getting proper nutrition:
Offer nutritionally-dense foods. Since many seniors aren’t eating as much as they should, the food they do eat must be as nutritious as possible. Encourage whole, unprocessed foods that are high in calories and nutrients for their size. Some examples include: healthy fats (nut butters, nuts, seeds and olive oil), whole grains (brown rice, whole wheat bread, oats and whole grain cereals), fresh fruits and vegetables (canned and frozen are also good choices), and protein-rich beans, legumes and meat and dairy products. This will help ensure that they are getting all the vitamins and minerals needed to maintain proper health.
Enhance aromas and flavors. Appealing foods may help stimulate appetite, especially in someone whose senses of taste and smell aren't what they used to be. Seniors can intensify flavors with herbs, marinades, dressings and sauces. Switching between a variety of foods during one meal can also keep the meal interesting. Try combining textures, such as yogurt with granola, to make foods seem more appetizing.
Make eating a social event. Many seniors who live alone or suffer from depression may stop cooking meals, lose their appetites, and depend on convenience foods. If you are worried that your parent or grandparent isn’t eating properly, make meals a family occasion. Bring a hot meal over to her home or invite her to your house on a regular basis. She may become more interested in food when other people are around.
Encourage healthy snacking. Many seniors don’t like to eat large meals or don't feel hungry enough to eat three full meals a day. One solution is to encourage or plan for several mini-meals throughout the day. If this is the case, make sure each mini-meal is nutritionally-dense with plenty of fruits, vegetables and whole grains. Whole grains and fortified cereals are a good source of folate, zinc, calcium, Vitamin E and Vitamin B12, which are often lacking in a senior’s diet. Cut back on prepared meats, which are high in sodium and saturated fat.
Take care of dental problems. Maintaining proper oral health can enhance nutrition and appetite. Make sure dentures fit properly and problems like cavities and jaw pain are being properly managed. Insurance plans, including Medicare, cover certain dental procedures. <pagebreak>
Consider government assistance. Home-delivered meals, adult daycare, nutrition education, door-to-door transportation, and financial assistance programs are available to people over the age of 60 who need help. For more information, visit the U.S. Administration on Aging website at www.AOA.gov.
Take them to the store. If lack of transportation is an issue, take your loved on to the grocery yourself. You can also hire a helper or neighbor to do this if you aren't available. Another option is to order his groceries for him, either from local grocers that make home deliveries (for an additional fee) or from an online grocery website. Many seniors might not be savvy enough to order food from the internet, but you could schedule a regular order for them so that groceries will be delivered right to their doorsteps. Check out the following sites: www.NetGrocer.com, www.Groceries-Express.com, and www.DrugStore.com.
Give reminders. If poor memory is interfering with good nutrition, schedule meals at the same time each day and give visual and verbal reminders about when it's time to eat.
Maintain food storage. Keep extra food on-hand in case of an emergency. Elderly people who live alone should keep some canned and non-perishable foods in the cupboard in case weather or health problems make it difficult to go shopping.
Use supplements carefully. While it’s tempting to take vitamin supplements to make up for nutritional shortfalls, be careful about toxicity. The elderly do not process Vitamin A as quickly as younger people do, making them susceptible to Vitamin A toxicity, for example. Certain vitamins can also interact with medications, so make sure you or your loved ones discuss the idea of supplements with their health care provider.