Many seniors are not eating a balanced diet as they age, whether they live on their own, with family or in a senior living facility. Seniors who live alone are at increased risk because there is no one to observe their eating habits. There are many causes for seniors who are under-eating, over-eating or not eating nutritious meals.
By the time he was 97, my father had multiple problems that made it difficult for him to eat a balanced diet. During the last few months of his life, the only thing he ate willingly was strawberry ice cream. The assisted living center he called home provided 3 nutritious meals a day and snacks in between meals on request. They were very accommodating with his diet–limiting sweets and carbs, cutting everything into small pieces and eliminating foods known to be a choking or swallowing hazard. However, unless a family member was there with him at meal time to encourage him to eat or even help to feed him, he rarely ate vegetables and expended most of his energy and appetite on small bites of protein and the ice cream that easily slipped down his throat.
Causes of poor nutrition
Some of Dad’s problems could be similar to what’s causing your elderly loved one to under-eat, over-eat or not eat a balanced diet. Watch for these risks and hazards interfering with a balanced diet, and consider what can be done to prevent or get around them:
- Poor appetite – not motivated to eat: Many seniors’ sense of smell and taste diminish with age. Nothing looks good or tastes good, and often times there’s no one there to direct them toward healthy choices and encourage them to “eat to live.” They often don’t associate what they are eating with how they feel or could feel. They don’t even feel hungry. We continually reminded Dad of the relationship between his diabetes and his need eat in order to increase his energy level.
- Nothing looks good: Especially if someone else is fixing them food they’re not used to, seniors might not recognize the food they’re given and resist trying it. Even when familiar food was cut into small pieces for Dad, he would often say, “What in the world is that?” We would have to tell him before he would try it. When we were growing up, we had a large vegetable garden and ate meat sparingly. But somehow in his later years Dad lost his appetite for anything green and insisted that at his age he shouldn’t have to eat vegetables! Broccoli was the worst!
- Swallowing problems, choking and food aspiration: Just like other parts of our body, throat muscles and valves can wear out and cease to function normally. Food may go only part of the way down and have a hard time getting into the stomach. Problems with the trachea (windpipe) can include narrowing, inflammation and even failure to close while swallowing. Problems with throat muscles and valves can cause food aspiration and choking. Seniors become fearful of eating for fear of choking to death.
- Fatigue—too much effort, lack of eye-hand coordination: Sometimes an elderly person feels too fatigued to get out of bed to eat breakfast, starting a downward cycle of energy loss. Even the act of getting food to the mouth or chewing can seem like too much of an effort, especially when not driven by hunger. Embarrassment over spilling can also be a deterrent.
- Missing or broken teeth/chewing problems: Some seniors have missing or broken teeth that make chewing difficult. Others have dentures, but find them uncomfortable and not as easy to chew with as their original teeth. It may be difficult to get them to brush regularly, but regular trips to the dentist for cleanings and smoothing of rough edges can help.
- Medication side-effects: Sometimes medications can affect appetite or interfere with digestion. Check with the Dr. to rule this out as a cause and to determine what supplements might be helpful.
- Loneliness or depression can cause a person to not want to eat.
Strategies to Try:
- A 91-year-old friend of mine likes foods that are spicy or sour. Try adding herbs and spices to food, or try foods that are naturally more flavorful.
- If your loved one lives in a facility and can go out, try taking him or her to a restaurant or to your house for a home-cooked meal—someplace where food is likely to smell and look different. Sometimes we brought take-out in to Dad. He ate a huge meal at my house on Thanksgiving, but he was too weak to come often.
- A speech therapist can help to diagnose swallowing or aspiration problems. Stretching the trachea or esophagus may help. Swallowing exercises and strategies can sometimes shorten choking episodes. Avoiding foods with crumbs like toast, breading, ground beef or cookies, may eliminate some hazards. A Dr. may prescribe drinking only thickened liquids and cutting food into small pieces. Having an in-home caregiver present at meals to act as a coach can often help. Dad had a hard time remembering the strategies he was taught.
- A glass of juice or a protein drink consumed while still in bed might jumpstart someone without the energy to get up or move to a table. Sometimes help with eating is needed. Soup or stew could be served in a mug, enabling the food to be brought closer to the mouth without spilling. More activity can equal more energy and enhance appetite. An in-house physical therapist can suggest low-stress exercises appropriate to a person’s age and health.
A home care aide from Dakota Home Care can provide a range of medical and non-medical services to help with personal care, housekeeping, meal preparation, transportation, or just friendly companionship. Our home health aides can also administer medications under the supervision of our registered nurses. Call Dakota Home Care today for a free, in-home evaluation of services needed. 701.663.5373