Caregivers Guide

A Guide for Family Caregivers of Older New Jersey Residents

Section 4 - Personal Skills Development

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4.9 Nutrional Challenges of the Elderly

Nutritional needs do not change much with advancing years, except for a somewhat lower calorie requirement. Take care to provide for an intake of essential nutrients without excessive calories. The older adult may not eat properly for several reasons.

These problems and suggestions for coping with them, are offered below.

Loneliness - share meals with the person.

Diminished sense of taste and smell - serve meals which look, taste and smell good.

Small appetite - prepare five or six small meals of high quality foods. (High protein-high calorie beverages may be easier to consume than large amounts of food. Consult a physician.)

Chewing problems - related to lack of teeth or poorly fitting dentures. Use tender-cooked ground meats, fish, eggs, cheese and legumes.

Fatigue - rest before meals may be beneficial.

Pain - serve food when pain-relieving medication is most effective.

Constipation - increase fluids in diet.

Improper mouth care - a bad taste in the mouth detracts from enjoyment of food. (See section on mouth care.)

Nausea - small frequent feedings and eating slowly may be helpful. After a stroke, facial weakness and swallowing problems may make it difficult for a person to consume fruit juices and water. Thickened liquids such as milk shakes, gruels, purees, yogurt, sherbet, gelatin and slush may be easier to take.

Modified Diets

Modified diets are an important part of treatment for persons with heart, kidney or liver diseases, diabetes and other health problems. Some medications may require restriction of certain foods because of a possible interaction. Other drugs may increase a person's requirement for specific nutrients. Whatever the modification, the individual must receive the essential food necessary to maintain or improve his health status and hasten recovery and rehabilitation.

A modified diet is sometimes prescribed by a physician. When a modified diet needs to be followed, the caregiver should be given a copy of the diet as a guide in food shopping and preparing meals. Some agencies have nutrition consultants to assist in developing a diet that is therapeutically acceptable and which conforms to the individual's likes and dislikes.

Help the person adhere to the prescribed diet. Compliance problems should be discussed with the patient's physician.

Feeding Others

Procedure:

• If possible, have the person sit as erect as possible, or positioned for comfort.
• Take time to make eating a highlight of the day.
• Do not rush the feeding.
• Be patient and understanding.
• Be gentle with forks and spoons.
• Wipe off the corners of the mouth as needed.
• Do not mix all the food together.
• Use straws and training cups as needed.
• Keep conversation pleasant.
• When offering a glass or cup, touch it to the lips.
• Offer the person an opportunity to rinse his mouth after eating.
• If the person is blind, explain where food is on the plate, using the hands on a clock as an indicator. For example, mashed potatoes at the five o'clock position.
• In case of one-sided facial weakness or paralysis, feed to the good side.

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