With dementia in particular, getting proper nutrition can be a problem. Food may not smell or taste the same and the person may have issues of recognizing the food or managing the process of eating, in addition to simply forgetting to eat (or forgetting he/she ate already and eating more than intended). Meal preparation and the process of shopping and planning meals will become difficult as the disease progresses, and are often early signs of the cognitive problem. At late stages of the disease, those with Alzheimer’s disease generally lose the ability to feed themselves and may also experience swallowing problems.
Even older adults who do not have dementia will often face challenges when it comes to getting proper nutrition. Sense of taste and smell diminish with age. Some diseases and medications can impact sense of taste as well as appetite. Certain disease may affect swallowing. Loneliness and depression can affect appetite. Many people eat less when alone, or may be less likely to cook or take time to enjoy a full meal. Lack of physical activity also decreases appetite.
If you older loved one does not drive anymore he or she may have difficulty accessing a variety of food. The process of planning and preparing meals may become difficult and the senior may rely on highly processed foods or restaurants.
These challenges are made all the more difficult by the fact that older adults actually need to consume a more nutrient-dense diet. This is especially important when fighting certain diseases and in many medical conditions where special diets should be followed. Poor nutrition can worsen many diseases, diminish energy and cognition, and increase safety risks. The best medical treatment can be derailed if not accompanied by proper nutrition (such as a cardiac patient who has had cutting edge treatment but continues to eat a high fat, high sodium, low nutrient diet or a patient on blood thinners who does not comply with restricted foods).
Here are some ways to evaluate if your elderly parent is eating well:
- Take a look around the kitchen. Is there appropriate food in the refrigerator and pantry? Are there expired items?
- Go shopping and/or plan a meal together. This can be a fun activity, while giving you the chance to evaluate how your loved one thinks through the process and handles the tasks.
- Physical signs include weight loss or gain, dehydration (skin elasticity is one good indicator, urinary tract infections may also indicate a problem), passing out and overall poor health (weakened immune system, difficulty recuperating, indications in blood work).
- Get a professional evaluation and/or consider periodic care management assessment visits to ascertain if there is a problem proactively, especially if you are a long-distance caregiver.
- Consider the value of home caregivers providing meal preparation and senior nutrition services. Home caregivers can do everything from planning meals and shopping to preparing meals and providing company for meal times. Services are flexible, so a home caregiver could visit every day or prepare several meals in advance.
- For persons with dementia, continually evaluate and adapt as the disease progresses. Various types of reminders and memory aids may work, but this may change over time. You may be able to call your loved one with reminders at first, but at some point you might need to ensure a caregiver is there at meal times or assist with cooking and feeding.
- A variety of food is not only best for dietary needs, but also makes eating more appealing. Varied colors, textures and flavorings can help stimulate appetite. Herbs and seasonings can make up for taste changes, without simply adding more salt. Help your loved one with meal and food ideas and shopping for such items, or consider hiring help with this task. If you’re working with home caregivers, you can provide old family recipes or guidelines about dietary needs and preferences.
- Don’t underestimate the importance of meal time company. If your loved one is not eating well, consider making a plan to have someone visit during most meals (or at least one main meal/day). You could make a schedule of family, friends and home caregivers for meal visits. You can also check in to congregate dining programs offered in your county as a group option. Meals on Wheels and other such services can be good for nutritious meals and often the volunteers serve as another point of contact checking in on your loved one. However, this may not solve the issue of eating alone.
- Evaluate and fix potential physical problems. Bad fitting dentures or dental issues can make eating unpleasant. Medications may be impacting appetite. If you notice the person is coughing a lot or having trouble swallowing, be sure to get swallowing evaluated.
- Consider ways to bolster activity. Take a walk together, provide a variety of social contact, find appropriate ways to add physical activity/exercise to the daily routine (check with your doctor first). You might want to consider a personal trainer who specializes in older adults (we recommend At Home Fitness in Pinellas County). The caregiver can then help maintain the routine and encourage the activity.
