Senior nutrition is a concern for many families. As we age, the intensive process of grocery shopping, cooking food, eating alone and then cleaning up the kitchen can seem overwhelming. Our appetites naturally decline as we get older and mealtimes may become more of a chore than a pleasure.
It is challenging for family caregivers to determine if seniors are eating well when they do not live together. Long-distance caregivers who are only able to make occasional in-person visits have an even harder time ensuring their loved ones are consuming a reasonably healthy diet. Malnutrition in the elderly is extremely common and can lead to additional health problems, so recognizing the signs and acting on them quickly is crucial.
Signs That a Senior Is Not Eating Well
Sometimes it isn’t immediately clear that an aging loved one isn’t eating a healthy, balanced diet. Many seniors say they’re eating well and may even believe they are, but the best way to find out is by putting eyes on them and their kitchens. Look for the following signs that might indicate your loved one’s diet is lacking.
Changes in Weight
Most people associate poor senior nutrition with weight loss, but it’s important to understand that a person can be overweight—even obese—and still be malnourished. Some fluctuations in an older adult’s weight are to be expected, but rapid and/or unintentional weight loss is a cause for concern. Conversely, weight gain can be problematic as well. Keep in mind that body composition does change naturally with age. According to the U.S. National Library of Medicine, “Weight loss later in life occurs partly because fat replaces lean muscle tissue, and fat weighs less than muscle.”
New or Worsening Health Issues
The diagnosis of new health conditions, such as diabetes, heart disease, osteoporosis or even recurrent infections could point to a poor diet. Signs that an existing chronic condition is not being managed, such as a heart attack, stroke or high blood sugar, are red flags as well. Deficits in nutrients, vitamins and minerals affect one’s immune system, daily functioning and quality of life.
Changes in health due to undernutrition are often subtle, though. Look for symptoms like low energy levels, increased falls, inability to stay warm, confusion, slow wound healing, digestive issues, and problems with chewing or swallowing. Some of these symptoms are a direct result of inadequate nutrition but others may also be contributing to the problem.
Poor Food Choices or Insufficient Food Supply
Peeking inside a senior’s refrigerator and pantry will tell you a great deal about their eating habits. Barren shelves might point to the fact that the senior is experiencing issues with mobility and possibly finding transportation to the grocery store. Rotten or expired items may indicate than an elder is forgetting to eat the food they have and neglecting to keep the kitchen well stocked and sanitary.
A senior may have plenty of food in their kitchen, but the type and quality of items they consume is important, too. An excess of processed foods is a cause for concern. Everyone is entitled to indulge and take short cuts from time to time, but if a senior’s stores consist mainly of high-sodium TV dinners, junk food or sweets, it’s a bad sign. Relying solely on meal replacement shakes is problematic as well since they are generally intended for use as a snack or occasional meal replacement.
How to Address Appetite Loss and Malnutrition in the Elderly
If you know that your loved one is not eating well or hardly eating at all, then you’re going to have to take steps to ensure that they get adequate nutrition. You can attempt to explain the importance of a healthy diet, but Mom or Dad may smile, politely tell you they’re eating and then continue doing exactly as they please. Understand that they have this right. As long as a senior is considered mentally competent and is not endangering themselves or others, they can make their own decisions—even bad ones.
With seniors who are more receptive or somewhat less independent, a bit of troubleshooting can go a long way to helping them regain their appetite and eat healthier. A elder’s poor diet can have any of several potential causes, including socioeconomic, physiologic, pathologic and psychologic factors. Addressing each of these areas will help you put together a comprehensive plan for ensuring they get the nutrients they need.
Schedule a Geriatric Assessment
The best place to start is with a doctor’s appointment, ideally for a complete geriatric assessment. This multifaceted assessment will evaluate a senior’s functional abilities, physical health, cognitive function, lifestyle, nutrition, medication regimen and many other factors that directly influence quality of life. A thorough assessment should reveal most underlying causes for appetite loss, changes in weight, and vitamin and/or nutrient deficiencies. Additional testing and evaluation may be necessary, depending on the results.
See a Specialist if Necessary
Based on the results of the medical assessment, a senior’s doctor may recommend working with a specialist who can assist in improving their nutrition. For example, a dietitian can help create a customized diet plan and menu to meet an older adult’s unique nutritional needs. Many Area Agencies on Aging (AAAs) offer a range of nutrition services, including nutrition screening, education and counseling.
Other specialists, such as dentists, speech-language pathologists (SLPs) and neurologists can assist with treating dental issues, difficulty swallowing (dysphagia) and cognitive issues respectively. These conditions can influence a senior’s appetite and diet, preventing them from eating well.
Find Supportive Services
Depending on why a senior isn’t eating a sufficient diet, there are several services that can provide the support they need.
SNAP BenefitsIf an elder can’t afford to stock their kitchen with healthy foods, consider helping them apply for the Supplemental Nutrition Assistance Program (SNAP). According to the National Council on Aging (NCOA), three out of five seniors who qualify for SNAP benefits (5.2 million older Americans) do not participate in the program. Visit BenefitsCheckUp.org to see if your loved one qualifies for SNAP and many other federal, state and private benefit programs.
Meal Delivery ServicesMany seniors no longer have the energy or interest in regularly grocery shopping and preparing meals. A carefully selected senior meal delivery program will provide nutritious meals delivered to their front door that are easily reheated and enjoyed. When healthy, delicious meals are readily available, older adults are more likely to eat them. Meals on Wheels is one popular organization that supports thousands of community-based programs striving to address senior hunger and isolation through the delivery of free and low-cost meals. Options for paid grocery and meal delivery services abound as well.
Elder Care OptionsSeniors who live alone and lack a strong local support system may not get the help, supervision and encouragement they need to eat well. For example, even if a long-distance caregiver sets up meal delivery for their loved one, there is no way to guarantee the meals are actually getting eaten. In-home care agencies can provide services like grocery shopping, transportation for errands, companionship, meal preparation and feeding assistance to ensure seniors get proper nutrition. If a loved one’s functional abilities have declined significantly and they are unable to perform activities necessary to live independently (e.g., shopping, cooking and eating), it may be time to consider a higher level of care, such as senior living.
Be Realistic About Age-Related Changes in Appetite
It is not necessary for a senior to eat three large meals a day; appetite and nutritional needs change with age. While it can be difficult, family caregivers must adjust their expectations for their aging loved ones when it comes to food and mealtimes. Understanding the reasons why these changes occur can help tremendously.
Some of the causes for appetite loss, poor diet and new food preferences have solutions, but some do not. As a family caregiver, just do your best to ensure that your loved one has access to healthy meals and snacks, timely medical care, and quality supportive services.