In the last post I discussed some of the current struggles with feeding and nutrition in the elderly. This follow-up post focuses on some practical tips to improve feeding and nutrition. Factors affecting appetite can be categorized into environmental, social and medical.
The Environment
Setting the atmosphere can make a surprising difference in seniors’ nutrition. Things to set the mood:
- Having a good view.
- Proper lighting is important so they can see what they are eating.
- Avoid clutter entering into the dining area as well as on the table.
- Playing enjoyable music can really set the tone.
- Having clocks readily visible can cue people for meal time.
Engagement
Engagement increases the enjoyment and amount of intake. Suggestions include sitting down at the same level with the person and making eye contact with the senior. Make conversation. Even if they are not able to respond verbally, conversation will improve intake. Studies have shown that older adults will eat more in the presence of others than when alone. Cueing them with actions like putting utensils in their hand are helpful to prime someone with dementia for eating.
What is on the plate obviously matters too. When comparing facilities, ask what are the daily raw food costs. To illustrate, the range of raw daily food cost can range from $4.34/day to $17.22/day. I am certain there’s a limit to what even the best chef can wring out of $4.34/day on a consistent basis.
Feeding programs in long term care homes increase weight and muscle mass. However it should be noted that some care staff are often overly focused on completing the task of feeding and forgetting that eating is a social affair. The above mentioned study averaged 37 extra minutes were required for each patient. I can attest that rarely happens in a long term care facility.
Medical Conditions
The list of medical conditions causing decreased appetite could easily fill a book. However common addressable conditions include hypothyroidism, mood disorders, and infections. If you notice a consistent change in your loved one’s appetite, let their doctor know. Our caregivers have been able to tip off family members and their patient’s doctor about a change in their appetite.
Protein intake is a common problem in senior’s nutrition. While it is accepted that the elderly have less caloric requirements, the same is not true of protein. The elderly require the same protein intake as the rest of the population. Eating adequate protein is protective against weakness and functional disability. Supplement protein intake by adding protein powder to their meals. Inactive elderly seem to primarily benefit from animal protein, whereas active elderly benefit from both animal and vegetable based proteins, for those who really want to know.
Celebrate
Lastly, eating is a universal pleasure in life. Unfortunately this is frequently forgotten as people age and meals somehow seem to evolve into mere sustenance. Don’t let that happen with your loved one. Let’s celebrate their food.
References
https://the-ria.ca/wp-content/uploads/2018/08/Food-Beverages-FINAL.pdf
Locher et al. The effect of the presence of others on caloric intake in homebound older adults. J Gerontol A Biol Sci Med Sci. 2005;60(11):1475.
Simmons et al. Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance. J Am Geriatr Soc. 2008;56(8):1466. Epub 2008 Jul 15.
McLean et al. Dietary Protein Intake Is Protective Against Loss of Grip Strength Among Older Adults in the Framingham Offspring Cohort. J Gerontol A Biol Sci Med Sci. 2016;71(3):356. Epub 2015 Nov 2.
Bradlee et al. High-Protein Foods and Physical Activity Protect Against Age-Related Muscle Loss and Functional Decline. J Gerontol A Biol Sci Med Sci. 2017;73(1):88.
