How to Sneak Calories and Nutrients Into a Senior's Diet
Read this article on how seniors manage their diet, calories, and nutrition as they age.
Caregivers know that seniors need proper nutrition in order to maintain and improve their health, but how do we make this happen when they don’t want to eat?
It is worrisome when an aging or ill loved one begins pushing away food because of digestive issues or a lack of appetite. For advice on this issue, I turned to Elizabeth M. Ward, M.S., R.D., who cared for both of her aging parents. As a registered dietitian, she takes a realistic approach to nutrition. Ward believes it’s important to consider each person individually when trying to come up with strategies for combatting poor nutrition. She also recognizes that devising these strategies involves a lot of trial and error and that effective techniques will probably change as time goes on. Ward addresses caregivers’ common concerns about senior nutrition below.
Reasons for Poor Nutrition in Elderly Individuals
There are several common issues that can prevent older adults from getting the nutrition they need. Some of these can seem like small annoyances, while others are medically serious and more difficult to accommodate.
Therapeutic Diet Orders
“One-size-fits-all restrictive diets can be problematic,” says Ward. A general therapeutic diet order, such as low sodium or low sugar, should not prevent an elder from eating enough. If it does, Ward suggests that the order may be too restrictive and should be reviewed with the doctor or a dietitian.
These orders are prescribed for a reason, she notes. “My mom had type 2 diabetes for years and restricted her sugar intake because of it. However, she lost a significant amount of weight between doctor’s visits one year. When her physician tested her blood glucose, we found that it was in very good control and she no longer had to take medication or follow a restricted diet. This is an excellent example of how nutritional needs change over time.”
Any caregiver can attest to the fact that most seniors take a lot of medications. Research shows that the average older adult takes four or more prescription drugs each day, but 39 percent of seniors take five or more prescriptions daily. While some of these drugs can save lives, they can also cause unintended problems.
“Side effects can include reduced appetite, dry mouth or a bad taste in the mouth,” Ward warns. “Some medications interact with the nutrients in healthy foods, such as blood thinners and vitamin K, to cause adverse effects.” She urges caregivers to read prescription inserts and work closely with a pharmacist and their loved one’s doctor to prevent and solve any medication issues. Food and Drug Administration (FDA) medication package inserts can be looked up on the National Library of Medicine’s DailyMed website.
As we age, our ability to enjoy food with all of our senses can be reduced. “One of the first senses to dull is smell,” explains Ward. “The ability to sense odors and scents is directly connected with our sense of taste, so many seniors tend to simply find food less appetizing. If you can’t taste and enjoy food, why eat it?” Vision problems can also affect a loved one’s appreciation of and involvement in meal times.
Age can wreak havoc on our teeth, mouths and the very beginning of our digestive tract. “Many seniors have lost teeth or wear dentures that can interfere with their ability to chew food comfortably and effectively,” Ward points out. Gum inflammation, oral sores or poorly fitting dentures can cause pain and discomfort while eating, and neurological conditions like dementia and stroke can cause swallowing issues that make it both difficult and unsafe to eat certain foods.
Basic Senior Nutrition Requirements
Older people do have some unique dietary requirements when it comes to vitamins, minerals, fluids, protein and fiber. Caregivers can use these guidelines when planning meals and cooking for their loved ones.
Vitamins and Minerals
According to Ward, seniors need more calcium and vitamin D but less iron than their younger counterparts. In addition, research shows that individuals aged 50 and older are more likely to absorb vitamin B12 poorly. The recommendation from the National Academy of Medicine is to get most of this vitamin from fortified foods or dietary supplements. The synthetic form of vitamin B12 used in these sources is better absorbed by the body than the kind that occurs naturally in foods.
Ward is also a big fan of a daily multivitamin. “My mom started with a regular pill for people over 50, which means it contains no iron or very low iron,” she says. “Eventually, that got to be too big for her to swallow comfortably. We cut it in half for a while, but then that didn’t work anymore either.” They switched to a chewable version and eventually settled on a liquid multivitamin. “It’s very important for seniors to get all the vitamins and minerals they need. Contrary to popular belief, daily multivitamins don’t overdo it on nutrients. In fact, most elderly individuals need calcium and vitamin D supplements to achieve the minimum required daily values.” This is especially important for those who do not go outside frequently and receive little or no sun exposure.
“I can’t say enough about making protein a priority in people of all ages,” urges Ward, “particularly in people with limited appetites who tend to gravitate toward simple carbohydrates when their hunger declines.”
Protein is responsible for preserving muscle strength, bolstering the immune system, and for the growth and repair of all tissues, including surgical wounds and pressure ulcers. “Inadequate protein leads to skin breakdown and muscle loss, which leads to inactivity, which then leads to a decreased appetite, and becomes a downward spiral,” Ward warns.
Low fiber intake can result in constipation. Plus, many medications can slow down the GI tract, which increases the likelihood of constipation and discomfort. “I found it difficult to work enough fiber into the diet of a limited eater,” Ward admits. Seniors need about 25 grams of fiber daily.
It is important that elders consume about 64 ounces of fluid daily, but that is a very general recommendation. These fluids do not all have to be consumed in the form of water. Coffee, tea, milk, juice, broth, fruits and vegetables all count toward the daily intake. If a loved one has a condition like heart failure, a physician may suggest that they actually limit their fluid intake. Recommendations depend on a senior’s individual situation.
How to Encourage a Senior to Eat
Since Ward knows all too well how nutrition plays a huge role in wellness, it was painful for her to witness her mother’s poor eating habits. Frustration can cause family members to cross the line between healthy encourag