Eating right is important at every age. However, as bodies age the ability to maintain a healthy diet can be challenged.
“As people get older, they are doing less high-energy calorie-burning tasks,” said Dr. Valentina Remig, registered dietician. “They need fewer calories, but the same nutrients.”
Why Do Dietary Needs Change With Aging?
The Academy of Nutrition and Dietetics estimates that women over age 50 need 1,600 to 1,800 calories per day and that older men need about 2,000 calories per day.
Experts note that there are a number of differences for the elderly population and those in need of senior care when it comes to eating a nourishing diet:
1. As saliva production decreases, so does the ability to make stomach acid that easily digests our food. Dietary changes may be needed to ensure that nutrients are still being processed.
2. Senses deteriorate with age, including the ability to taste and smell. This can mean overuse of salt and sugar in some diets since the flavors are not as easily detected. Too much salt and sugar can lead to other health problems such as type 2 diabetes.
3. It’s important to keep a stable body weight and not over or under eat. If the caloric intake is not adjusted for the decreased physical activity, then people easily put on weight and this can lead to high blood pressure, diabetes and other illnesses. Not eating enough can lead to osteoporosis, memory loss and other conditions.
4. Eating alone can be depressing for some people, so they might often forgo preparing or eating meals for one.
5. Many medications can affect appetite and taste for certain foods. Always check with a medical professional to see if medicine may be affecting your diet.
Fluids help nutrients flow through the body and do their job. Hydration is an essential part of a healthy diet, and Dr. Remig points out that many older adults have a “decreased thirst mechanism” and may not realize that they are thirsty. In home caregivers, individuals and caregiver agencies should remind seniors to drink plenty of water with meals and throughout the day.
Specific nutritional needs evolve as bodies age. For example, although 85-percent of adult bone mass is acquired by age 18 in girls and age 20 in boys, older adults need more calcium and Vitamin D in their diets to maintain healthy bones.
A healthy diet should include protein from eggs, dairy, fish, meats and poultry; whole grains and other carbohydrates such as fruits and vegetables; fiber; healthy fats that are found in fish, oil, nuts and foods fortified with omega-3 fatty acids.
Nutritional and Dietary Support
Many of the challenges to maintaining good nutritional habits for the elderly can be finding the right in home caregiver or caregiver agency to help with buying groceries and delivering groceries and meals.
“Being able to drive to the supermarket, to afford groceries every week, and having an appetite are the biggest challenges for the elderly population,” said Elizabeth Tscholl, a registered dietician at Cherry Creek Nutrition in Denver.
Other obstacles to a healthy diet for seniors can include illnesses such as Alzheimer’s. “People with Alzheimer’s forget what their favorite foods are, that it’s time to eat, and tend to like really sweet foods,” said Ms. Tscholl. Often the only way to get them to eat is to sweeten up foods, such as adding honey or brown sugar to a bowl or oatmeal with fruit and low-fat milk.
For additional information about nutritional guidelines, visit the American Dietetic Association’s website at www.eatright.org.
Malnutrition and the Elderly
Some studies estimate 5-10% of elderly people living in a “community setting” are malnourished; about 60% of hospitalized older adults and anywhere from 35 to 85% in long-term care facilities are experiencing malnutrition. With people age 65 years and older now the largest population segment, these numbers are likely to increase. To help, the American Society of Parenteral and Enteral Nutrition sponsors Malnutrition Awareness Week, Sept. 26-30, with two days devoted to discussing the topic of malnutrition in older adults.
“Despite increasing awareness of malnutrition and its effects, one in three patients continue to be malnourished with an annual cost of $156.7 billion for disease-related malnutrition in the U.S.,” the organization explains on their website. “Malnutrition is not just contained within the parameters of the hospital or in a certain population. It is also becoming a leading cause of hospital re-admissions for the aging individual.”
During this week, there are webinars about nutrition, including two days devoted to malnutrition in the older adult population.
Malnutrition: What & Why
Basically malnutrition is the condition that occurs when a person’s body does not get enough nutrients. When it comes to seniors, malnutrition is not as simple as eating enough calories or the right kinds of foods.
Older adults are more likely to have underlying medical conditions, such as dementia, that can lead to physical difficulties with eating. The senses can become diminished—eyesight, taste, smell—and decrease appetite or ability to feed one’s self. Medications can also play a role in appetite or how the body absorbs nutrients. According to the Mayo Clinic, other factors can also contribute to malnutrition:
· Restricted diets, such as a low-salt diet or low sugar diet, might alleviate one medical condition while decreasing nutritional intake.
· Living on a limited income might affect how much food someone buys and therefore lead to not getting enough nourishment.
· Loneliness can cause a person to stop eating when they are alone and cannot enjoy cooking or eating a meal with loved ones. When someone is depressed, it can also make them lose interest in food.
· Dental hygiene issues that cause pain when chewing.
One Bite At a Time
The signs of malnutrition include weight loss, more bruising and poor wound healing. Spending time with loved ones during mealtimes can be an opportunity to observe nutritional intake.
A health care provider should be consulted to address the root cause of any nutritional deficits and make recommendations to improve diet. Other tips to improve appetite and eating are:
· Encourage more physical activity, which can increase hunger.
· Engage a service like Meals on Wheels or in home care to prepare or deliver healthy meals, or see below to learn more about Chefs for Seniors.
· Experiment with new flavors to spice up a dull diet.
· Sneak in healthy treats, like a fruit smoothie between meals or sprinkle nuts on yogurt.
Eating well can improve a person’s chances of living independently and living life fully at every age. Mealtime can be a joyous celebration of relationships, food, and traditions so caregivers can make meal preparation fun and meaningful for both the person who needs care and themselves. There can be interesting conversation about favorite or least liked foods, stories of holiday meals, sharing recipes, and ways to make new memories around healthy meals.
Chefs for Seniors
Homewatch CareGivers has a relationship with Chefs for Seniors, a service that brings trained chefs into the home to prepare nutritionally appropriate meals for older adults.
Much like working with a professionally-trained caregiver to provide in-home care services such as assistance with grooming and bathing, light housekeeping, medication reminders, and more, the meals for seniors service starts with a consultation to better understand individual needs.
“Chefs for Seniors determines what a healthy meal is for someone by gathering information on dietary restrictions during the initial consultation, and also by using general guidelines based upon the DASH diet (Dietary Approach to Stopping Hypertension) eating guidelines,” says Nathan Allman, COO and Co-founder of Chefs for Seniors. “We try to emphasize fresh fruits, vegetables, whole grains, lean proteins, and healthy fats such as olive oil.”
Much like home care, some long-term care insurance policies and Medicare plans will cover the costs of meals for elderly.
Also, like home care services, Chefs for Seniors can customize the frequency of meals.
“They can utilize Chefs for Seniors weekly or bi weekly and the chef will prepare 10-12 customized meals that they can enjoy throughout the week,” Allman explains about their meal plans for seniors.
For many people, age and chronic conditions can create physical limitations to successfully preparing nutritious meals at home. Allman notes that these include:
· Standing for prolonged periods of time
· Lifting heavy pots and pans
· Reaching for things in cupboards
· Carrying groceries into the home
· Chopping vegetables and fruits
· Memory impairment that could lead to leaving the stove or oven on
Some of the issues can be addressed by a caregiver making some simple choices such as rearranging kitchen storage, purchasing pre-cut fruits and vegetables, investing in a device to remind someone to turn off appliances, and setting up grocery delivery. A caregiver can be on hand to pre-clean the kitchen for the chef, who will clean up their mess when the meal is prepared.
Allman also has a few go-to meals that typically meet nutritional needs for seniors:
1. Citrus salmon with baked sweet potato and steamed broccoli
2. Hummus veggie wrap
3. Chicken and veggies with whole grain pasta and pesto
Other favorites from the Chefs for Seniors menu that can be made with minimal prep time and some easy flavors to appeal to most tastes such as a squeeze of lemon or a sprinkle of curry or pepper:
4. Roasted Veggie Couscous
5. Curry Egg Salad lettuce wraps
6. Quiche—either with onions and peppers, spinach and mushroom, or another combination of savory veggies—as it can be good for breakfast, lunch, or dinner
7. Stuffed bell peppers—try scrambled eggs in the cheesy filling to make this a breakfast favorite
8. Enchilada casserole—use black beans for a vegetarian spin or the protein of your choice along with green chilies, onions, zucchini, and corn.
9. Turkey veggies sliders for a savory lean protein meal
10. Shrimp pasta salad is perfect for a light lunch or dinner
If you crave something sweet, toss some pre-cut fruit on a sweet chia pudding or vanilla rice pudding.
Chronic Conditions and Nutrition
Sometimes there are necessary dietary changes due to illness or medication for illness. It’s critical to meet with a health care provider for specific guidelines on what to eat that could prove to be beneficial for symptoms and also what to avoid that could cause medication side effects or worsening symptoms of an illness.
The painful symptoms of arthritis can be exacerbated by excess weight, so experts recommend a low-calorie diet to lose weight and reduce pressure on the joints.
In addition to eating a Mediterranean diet rich in omega-3’s, these foods are suggested to help alleviate arthritis symptoms:
Get more tips on arthritis and nutrition here.
Diabetes is intricately related to diet, particularly type 2 diabetes. A person’s weight, exercise and other lifestyle choices can impact how well they live with this disease.
There is no “diabetic diet” and those who are living with diabetes will need to consult with their healthcare provider about their individual needs while monitoring their blood sugar.
Learn more about diabetes and nutrition here.
There can be many causes for heart disease—genetics, exercise, lifestyle choices, and diet.
We’ve provided some tips here for people who are living with heart disease and The American Heart Association has these tips:
Eat a wide variety of fruits and vegetables
Minimize salt and added sugars
Choose healthy sources of protein such as legumes, fish, lowfat dairy
Limited or no alcohol intake
Click here for more AHA diet tips.
Make Meals for Seniors Easy
Whether it’s breakfast, lunch or dinner, there are things that a caregiver can do to make mealtime easy for seniors.
Plan Ahead: When working with an organization like Chefs for Seniors, the planning is done together. If you’re on your own or a family caregiver, start by making a list. Maybe put time on your calendar for each Sunday evening to choose recipes, make lists of ingredients, then place the order for grocery delivery or schedule time to go to the store.
Don’t Go it Alone: Meals are more fun with more people. Are there opportunities to share a meal, make a special meal for someone who is visiting, or try a new dish? Each of these scenarios can create conversation and stimulation, with something to look forward to and do together. Maybe a client can share a favorite recipe and explain it while a caregiver does the prep work and clean up?
Be prepared: If your meals for the week include veggies and couscous and then turkey and veggie slider, chop up and store all of the veggies on one day, then it can minimize time spent making the second meal a couple of days later. This way a caregiver can do all of the prep during their shift.
Enjoy your easy and healthy meals!