Once we are born, we are all in the aging process. The 2 most critical and difficult periods of the aging process are early childhood and the elderly period. Getting your life started right as a baby and as a child affects the rest of your life. We are always aging but when you get closer to the end of your life the family dynamics of your care can be much more complicated.
I’ve read recently that one out of every four elderly is suffering in some way because of malnutrition. Why is this? What type of suffering? What can be done about this problem?
The issue of proper nutrition for the elderly has been a huge part of our lives for many years. My mom-in-law recently passed away at the age of 97 ½ years. My own mother is 93 ½ years old. My older brother is not what I consider elderly but is a widowed senior citizen living alone. My husband and I are at what I refer to as the youth of old age… we are in our early 70’s. We realize more than ever the importance of a healthy lifestyle.
Recently a grandchild contacted me with concern about her grandpa. Her concern is that he might not be getting his daily nutritional needs met. Just a couple months ago my brother and I were discussing his eating habits and the fact that he does not always eat properly. Those 2 incidents triggered my inspiration to write this blog.
- Living alone can cause a person to not want to bother with cooking and creating a mess. They justify eating quick, easy food that requires little preparation. That means pre-prepared meals or packaged foods that can be warmed up in the microwave. This is the reality for my brother. How real is that food and how much does microwaving chemically change the nutrients in food?
- Mental decline can lead to confusion about how to eat a balanced meal. My own Grandpa was living alone until one of my aunts just happened to visit prior to meal time. My Grandpa was heating the dishwater to eat as soup. That was in the years prior to microwaves and dishwashers.
- Lack of knowledge about how to properly prepare food can be a problem for some people.
- Too many medications can cause problems with nutrient utilization. Medications can cause loss of appetite, reduced taste and smell, constipation, nausea, drowsiness, confusion and other issues that can affect normal healthy eating habits.
- Dependency on other people can lead to malnutrition in some cases. Giving a nursing care facility total charge of my mother-in-law’s nutritional needs was a very difficult thing for me to do. She was given plain white refined bread with every meal instead of the sprouted grain bread we used to purchase for her. The vegetables were in the form of overcooked and iceberg lettuce with 3 or 4 little pieces of tomato. I knew that her chronic constipation problem was going to be made worse with just those 2 changes in her diet.
- Disabilities and low energy levels often make it difficult to prepare healthy food. Those with functional impairments may be unable to shop for groceries or cook for themselves. This is especially true for those who live alone.
- Lack of money or the perception of not enough money to pay for food can be a cause of malnutrition in the elderly. The cost of living has risen in all areas causing people to cut back on what they spend at the grocery store. This can lead to poor food choices. (Actually it really does not cost as much to eat healthy when you plan properly.)
- Another common problem with many elderly is that they have lost all or most of their natural teeth. This presents chewing and swallowing problems which can lead to malnutrition. Their selection of foods is more limited.
What type of health issues can be caused by malnutrition?
- A weakened immune system and slowed healing of wounds can lead to the risk of more infections.
- Muscle weakness and loss of balance can cause more falls and possible bone fractures.
- A loss of appetite leads to a disinterest in eating thus worsening the problem.
- Digestive problems such as bloating, gas, diarrhea and constipation easily become major problems.
- Impaired cardiac, respiratory, and kidney function can lead to complicated health issues.
- Depression and impaired mental function are aggravated by malnutrition.
- Unusual weight loss is one of the first signs that may indicate there may be a problem with malnutrition
- Dehydration can cause numerous health problems such as confusion, poor kidney function, constipation, dizziness, and lowered energy levels.
What can be done to prevent malnutrition for your elderly mother, father, grandmother, grandpa, aunt, uncle, or other family or friend?
Be aware. Be alert to any unusual changes in their health or behavior.
Educate yourself about any particular health issues experienced by your loved ones.
Learn about common or expected side effects of medications.
Protein is quite important in preventing malnutrition. It provides energy, prevents muscle loss, and contributes to a healthy metabolism. Adequate protein consumed at each meal can help prevent weight loss like was happening to my older brother. It can also help reduce obesity when that is an issue with the elderly.
Beef, poultry, and fish are best sources.
Protein drinks that have all 22 balanced amino acids and sweetened naturally are also good sources. Studies have shown that older men and women who use a protein supplement have greater strength and muscle mass gains when they exercise than those who do not use the protein supplement. (Reference: Evans WJ, Protein Nutrition, Exercise and Aging, J Am Coll Nutr, 2004.23(6):601S-609S.)
Dairy foods such as milk, yogurt, and cheese are good supplements to protein intake as long as there is not a problem with lactose intolerance. Lactose intolerance can be an issue because as we age our natural production of hydrochloric acid decreases making it difficult to properly digest milk products. Lactose intolerance can be addressed with supplementation of hydrochloric acid and digestive enzymes.
Eggs and legumes are also excellent choices for protein.
Healthy fats are essential to good mental and physical health in the elderly. Refer to my blog about the importance of a fat brain in preventing dementia. Omega-3 fatty acids are beneficial for cardiovascular and respiratory health as well as joint health. Essential fatty acids are essential for the health of cells.
Omega-3’s are found in fish and nuts although many seniors have difficulty chewing nuts so they might need to be ground.
- Cooking with olive oil, coconut oil, and butter improve flavor to foods as well as providing healthy fats.
- Avocados are an extremely healthy way to add fat to the diet.
Carbohydrates provide fiber, vitamins, minerals, and antioxidants for the elderly.
Vegetables are especially good. Often the elderly are unable to chew vegetables in the raw state so steamed is the next best option although stir-fried with meats and healthy oils provide a tasty option. Both my mother-in-law and my mother were able to eat raw leafy greens in a salad up until about the age of 90 as long as the leafy greens were fresh and crisp.
Fruit is great but again in a raw form some fruit is often difficult for the elderly to chew. Most fruit can also be steamed or made into naturally sweetened applesauce, etc. Avoid fruit juice or canned fruit with added sugar, especially high fructose corn syrup.
Grain products can be consumed but in moderation and as close to unprocessed as possible. White and most whole wheat breads are very high glycemic and should be avoided. Sprouted grain breads (purchased from health or natural food stores) are ideal bread choices for the elderly.
Salt intake is critical in the elderly. Too much can aggravate some health issues but not enough salt can lead to dehydration. As mentioned above dehydration can cause serious health problems. Salt helps support adrenal function. I suggest using unprocessed sea salt (available in health or natural food stores.)
- My mother was a person who wanted to eat healthy so she stopped salting any foods during cooking or at the table. She was critical of me and others saying we used too much salt. A few years ago her routine blood tests started showing she was low on sodium. Her doctor warned her she was at risk of becoming dehydrated and to start using salt in moderation.
Supplementation is generally necessaryl for the elderly to fill in the gaps of their nutritional needs
- It is quite common for the elderly to be low in the B vitamins, vitamins E and C. Low levels of vitamin B12 can lead to dementia, anemia, depression, gastrointestinal problems and urinary tract infections. A vegan diet or large amounts of medications can indicate a need to supplement with vitamin B12.
- Vitamin D and Calcium with magnesium are of particular concern because of lack of exposure to sunlight and many being lactose intolerant. Low intakes are related to increased hip fractures, muscle weakness and pain.
Essential Fatty Acids help in absorption of nutrients and ridding the body of toxins.
- There may be additional supplementation needed for individual health issues in the elderly. I am available to discuss this with you on an individual basis.
How do you deal with malnutrition in the elderly? I’ve listed some of the reasons the elderly may be malnourished. I’ve given you some of the health problems that can be caused by malnutrition in the elderly. And I’ve given you some suggestions of how malnutrition can be avoided.
In the comment section below tell me about your experiences in dealing with an elderly relative or friend. What are your concerns and how are you dealing with them?
Next week I will be blogging about some of the family dynamics involved in caring for an elderly relative or friend.
Much, much healthier than Ensure!
Pat has been married to the same man for 52 years, is the mother of 3 adult children, and grandma to 8 grandchildren. Growing up in the country gave her a head start to living a healthy lifestyle. This grandma became interested in nutrition as a mother and for the past 27 plus years she has specialized in teaching others the importance of good nutrition. Challenges along the road have been many; her father overcoming congestive heart failure with nutrition, her husband's battle with GERD and dealing with major heart issues, her daughter's battle with a brain tumor, her grandson beating Hodgkin's Lymphoma, her mother's stage 4 lung cancer, her mom-n-law's dementia, and others. Her goal is to empower the future health of others with wisdom, knowledge and common sense so they can have the BEST REAL HEALTH possible.
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