Food is an important part of life, far beyond the nutrition it provides.
We use food as ways to show sympathy when someone dies, to celebrate life and everything in between. Parents urge their children to eat – and adult children may worry that their aging parents aren’t eating well enough. And that can be something to worry about.
Malnutrition in the elderly can contribute to some illnesses, and it can worsen others. Not eating enough can cause weakness and dizziness, leading to falls or a fear of moving around. Not getting adequate nutrition can slow down wound healing, cause fatigue and depression, and more.
If you’ve noticed that an older person you care about isn’t eating well, or you are concerned it could become an issue, there are some things you can do to help.
According to the National Institutes of Health (NIH), the common eating problems that older people encounter include difficulty chewing food because of dental issues; physical problems making it hard to prepare meals or eat them once they are ready; and changes in taste and lack of appetite.
Seattle-based registered dietitian Ginger Hultin, spokesperson for the Academy of Nutrition and Dietetics and owner of ChampagneNutrition, added a few others: the ability to pay for food; mobility issues that may prevent people from going out to shop; and social isolation and depression.
“There are several things to consider,” Ms. Hultin told Medical Daily in an email. “Appetite (and thirst) can naturally decline with age. Another thing to consider is any dental or oral issues (needing dentures, proper denture fit, etc.) that can affect chewing and swallowing. Mobility challenges, even pain due to arthritis, can make it more challenging to procure and prepare food. Older adults also experience food insecurity due to financial [issues] and transportation, so ensuring that these aren’t limiting factors is important. Finally, unfortunately, social isolation and depression are also common factors that are barriers to eating enough, so mental health should be addressed.”
How to help
Some issues are easier to deal with than others. Here are some tips that may help your loved one not only eat in a more healthy way, but begin enjoying food again.
Regular trips to the dentist are a must for everyone, regardless of age, but even more so as we get older.
Good oral health is vital for overall health. In a study published in Dental Research Journal, the researchers found “a significant association between the dietary intake of elderly people and their oral health.” The authors concluded that there should be public health promotions regarding the importance of “functional dentition,” or a mouth that allows you to chew well, and eating well.
Regular dental checkups allow dentists to determine if teeth need to be fixed or pulled, and to adjust dentures or plates so they fit better. If you can find a dentist who specializes in treating older people, all the better.
Lack of appetite
As people age, changes to the body may make them feel full sooner than when they were younger, the NIH noted. Lack of physical activity could be one cause, as can some medications. It’s important that the doctor know about changes in appetite, because if it is due to a medication side effect, there may be other treatment options.
Lack of appetite is a tough one, said Ms. Hultin. She recommended discussing appetite issues with the care team. “There may be medications for them to consider, or specific meal timing or feeding strategies to implement.” Consulting with a registered dietitian and also a speech therapist, who can assess swallowing, can also be helpful.
It’s also important to consider the stage of life. “There are some end-of-life considerations, depending on the situation, because a decline in eating and drinking can be a natural part of the end-of-life process. It’s important to discuss this with a hospice care team, if this is the situation.”
Changes in taste
We know we have to eat to survive, but enjoying what we eat plays a big role in what we eat and how well we eat. Loss of taste or smell can be a real challenge, Ms. Hultin said.
She suggested reviewing medication to rule this out. “Assess that medications (sometimes referred to as ‘polypharmacy’ if there are many to be taken each day) are not overwhelming or contributing to loss of appetite, by discussing with the medical team and pharmacist.” Caregivers should avoid changing the diet too much, and should “definitely consider any culturally relevant foods that could be important to them.”
Experimenting with flavors may also be helpful.
While it may be tempting to just add salt to a meal that seems bland, using different herbs can have a significant effect on how a meal tastes. Don’t be afraid to try new-to-you herbs and different combinations. The NIH says that using lemon juice and vinegar can also boost flavor. A dietitian might also have suggestions on how to provide more flavorful meals.
How meals are prepared can also affect taste. The NIH recommends changing how they’re cooked: “Foods that are overcooked tend to have less flavor. Try cooking or steaming your vegetables for a shorter time, and see if that gives them a crunch that will help spark your interest.”
This problem may be more difficult to solve, but with some creativity, it may be possible to help a loved one eat healthier meals, despite physical limitations. An occupational therapist can make a home visit to help arrange the kitchen so it’s easier to navigate, or provide splints or special equipment to prepare or to enjoy a meal.
If it is difficult to shop, any grocery stores offer delivery services. They receive the list, fill the cart and then deliver the food. Other services can deliver orders on a regular basis.
If food prep is a problem, food plans or assistance, like Meals on Wheels, will cover a few meals a week. If eating itself is the issue – perhaps due to the tremors associated with Parkinson’s disease – these too might be solved with special tools.
Difficulty swallowing, called dysphagia, can cause a fear of choking. A speech therapist can assess chocking risk and provide tips on what to eat or drink, and the best ways to ensure someone eats enough.
“Individualization in nutrition care is key for older adults, and honoring their wishes with as liberalized a diet as possible is key,” Ms. Hultin said. “Think holistically – are finances or transportation a barrier? How’s their mental health? Oral health? Are their medications blunting their intake? Are they getting enough physical activity, or physical or occupational therapy? There’s a lot to consider with older adults’ health, but it’s worth the effort to keep them healthy and happy.”