August 9, 2018

Nutrition and Hydration

Adequate nutrition is a basic, vital and ongoing requirement for maintaining life.  Nutritional status affects the overall health status and energy level of a person.  Many factors, both physical and mental, influence one’s ability and interest in eating.

As we age, our taste buds and saliva production both decrease.  We become unable to manage large quantities of food, along with delayed emptying in the stomach and decreased movement of food in the intestine.  On top of this, if you are caring for a patient with dementia, getting him/her to eat can sometimes be difficult.

Common Nutritional Problems of the Older Adult

Common dietary deficiencies among older adults 

  • Common dietary deficiencies among older adults include protein, Vitamins C and D, folic acid, calcium and iron deficiencies.
  • Nutritional deficiencies usually result from inappropriate food selections rather that inadequate food intake.

Factors Contributing to Poor Nutrition/Hydration

  • Difficulty chewing due to teeth, mouth or denture problems
  • Immobility, weakness, physical illness, or limitation
  • Memory impairment or dementia (forgetting to eat or drink)
  • Decreased sense of smell and taste
  • Bland or monotonous diet
  • Limited financial resources
  • Swallowing difficulties leading to frequent choking
  • Poor absorption of vitamins and nutrients
  • Decreased appetite due to lack of exercise
  • Stomach disturbance due to medications
  • Loneliness and depression
  • Impaired thirst sensation
  • Complex therapeutic diets
  • Ethnic and cultural preferences

Interventions to Increase Caloric Intake & Stimulate Appetite

  • Provide small frequent meals
  • If on a regular diet (one that is not a special medically prescribed diet) maximize caloric intake by offering high calorie, high protein foods.
  • Make foods visually appealing
  • Ask primary care provider about the necessity of supplements
  • Discuss timing of medications with primary care provider
  • Add high calorie items to meals (i.e., honey, butter, cream, mayonnaise)
  • Offer nutritious foods rather than junk foods and beverages
  • Maintain a calm and comfortable environment at mealtime
  • Offer favorite foods
  • Include the person in family mealtime as long as possible
  • Prepare foods for easier chewing
  • Soups may be placed in a cup for easier handling
  • Encourage independence as long as possible:
    • Serve finger foods or a meal in the form of a sandwich
  • Serve food on plates with a rim or purchase a plate guard
  • Divided plates with a rim helps separate food and prevents spillage
  • Provide weighted silverware for persons with hand tremors, such as those with Parkinson’s disease
  • A rocking “T” knife is helpful to persons who have the use of only onehand, such as a person who had a stroke
  • Provide a spoon with a large handle rather than a fork
  • Offer cups and mugs with lids and large handles
  • Fill cups half full
  • Allow plenty of time for the person to eat
  • Use non-skid matting under plates to prevent sliding

The caregiver should monitor the patient’s weight and eating habits to make sure he/she is not eating too much or too little.  Speak with the patient’s doctor about changes in eating habits.  If you would like more information on keeping your patient hydrated and healthy, please call the UAMS South Arkansas Center on Aging Education Center at 870-881-8969 24 hours a day.

*Information from the ElderStay at Home Home Caregiver Training Student Handbook And the National Institute on Aging.

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