Seniors are in need of a Meal-Time Makeover. Many of our elderly have been reduced to microwaving TV dinners as a mainstay of their diets.
When it comes to something as instinctual as eating, most of us can’t even fathom it becoming a problem. Yet for many seniors, eating is riddled with obstacles: difficulty chewing, lack of appetite, and constipation. These are in turn common causes of poor nutrition, and may ultimately lead to such problems as slow wound healing and a poor immune response.
Perhaps the most obvious challenge to eating is the lack of teeth or poorly fitting dentures, which make chewing difficult and eating frustrating. While most of us take eating for granted, statistics show that 27% of the seniors over age 65 have no remaining teeth. A second, less obvious appetite obstacle is an older person’s diminishing sense of taste and smell. Then the doctor puts them on a no salt, no fat diet and heck that is an appetite depressant if ever there was one.
Poor appetite is also a side effect of many medications, and the average senior takes 5 prescription drugs a day (and some take many more than that). These medications contribute to constipation and dry mouth, and can even interfere with nutrient absorption, making it especially important for the elderly to make wise food choices. Yet according to Lipski, author of Digestive Wellness, “Elderly people often eat low-fiber foods, rely on packaged and prepared foods, take medications that interfere with normal bowel function, and have decreased mobility.” Is the answer more drugs? Constipation is a common complaint– one that seniors are shamelessly obsessed with and have no qualms talking about. Theirs was the generation of cod liver oil which has mostly been replaced now by faithful dedication to Milk of Magnesia. At least one study shows that pharmaceuticals are unnecessary: Constipation in nursing home residents was alleviated simply by adding two slices of whole-wheat bread and two teaspoons of bran to their daily diet.
Constipation isn’t the only health problem facing the elderly. Because cooking presents a challenge to many seniors, they resort to microwaving frozen foods. The results are dull, unappealing dishes, unevenly heated and dreary to eat, that lack the aroma that accompanies traditional cooking. It’s that aroma that makes a person salivate in anticipation, thereby increasing the appetite that seniors often lack. These monotonous diets lack adequate ratios of nutrients to calories, and are low in energy, protein, and fiber. Nutritional deficiencies may in turn lead to weight loss, decreasing muscle mass, and fatigue.
Seniors with caregivers may have their own unique challenges. For example, the caregivers may cook ethnic foods that the senior is not familiar with and does not like. One wife of a patient stated that they lived at an Assisted Living where the chef only cooked Filipino food. She said her husband hated it and she liked it but “not everyday!” She said the residents’ council finally complained enough and that “it’s gotten better.”
Caregivers may not always practice safe food handling procedures and unfortunately many of the elderly already have compromised immune systems. One grandson told me that his grandparents’ caregiver often left food, like cans of opened soup, on the counter all day long. Unsafe food handling can lead to salmonella or other bacterial infections. Children, senior citizens, people with chronic illnesses and those with weak immune systems tend to be at highest risk for complications due to salmonella, according to the National Institutes of Health.
Perhaps the caregivers themselves are not really very good at cooking. One caregiver was reported to have tried to feed an elderly gentleman a boiled egg with BBQ sauce on it to which he stated, “I can’t eat this!” After working with seniors for more than a decade, I am not aware of any caregiver agencies that provide its caregivers with safe food practices or instructions on how to cook for seniors, never mind how to cook for a senior who has a special dietary need such as a diabetic diet. I am not advocating that caregivers spend all of their time in the kitchen, they have many other important matters to attend to, but someone should consider what a senior is eating and how they will receive their daily nutrition.
If all of that isn’t discouraging enough, there are emotional components to eating that should be considered. Perhaps someone is newly single and does not know how to cook or as one woman told me, “It’s just me, so why bother?” Loneliness, depression, and social isolation lead to loss of interest in food. If you have spent all your life eating in the company of others suddenly finding yourself alone at the table can be devastating.
Clearly, the elderly have been forgotten in all this talk about eating local, organic, quality foods. Seniors may have some challenges around meal time but they are challenges that we as their concerned family, friends, neighbors, caretakers, and a community can help them meet.
5 Tips for a Meal Time Makeover
1. Appetite & Flavor Enhancers: Who can’t relate to the smell of garlic and onions cooking on the stove, or a chicken baking in the oven? Smell and anticipation (waiting-what we used to do before microwaves) gets us ready to eat. It may be helpful for seniors to invest in one of the newer crockpots with an automatic turn off. Not only will crockpots make the house smell good all day long, the food cooked inside will be very tender and easy to chew. Also remember to include fresh herbs and spices in ones diet. If someone’s sense of taste or smell has changed, keep these things handy to brighten up their food: a lemon and a lime, some cider vinegar, some pure maple syrup and a stick of real butter to dab onto foods. Additionally worth noting is that zinc improves taste acuity.
2. Biggest meal should be lunch. Many of us are used to dinner being the big meal. If a senior can make the change to lunch being the big meal there will be plenty of time to digest before bed, which is especially important if you are prone to heartburn. Eating earlier when one has a higher energy level makes meal preparation less of a strain. Seniors should also be willing to try new foods since they may taste differently than they remember. Adding variety to ones diet allows one to get different vitamins and minerals throughout the week.
3. Hydrate. Since dehydration can lead to imbalances in the system let’s tackle this issue. For those of you who are trying to force seniors to drink a big pitcher of water every day, forget it. It’s intimidating and uninspiring. So, use a small glass or cup and fill it through out the day with any combination of the following: water, water with lemon, bubbly water with natural flavorings or plain, teas–iced or hot, juices mixed with bubbly or plain water, warm broth, and smoothies made with yogurt and fresh or frozen fruit. As a nutritional chef I love the idea of having soups as not only a nutrient-dense food but also to help with hydration. There are also many vegetables and fruits, such as zucchini and melons, that have high water content.
4. Fiber. Most of us do not get enough fiber in our diets and the elderly are no exception. Try adding beans to ones diet for a high fiber power food. Start slowly to help your body get used to increase in fiber and to minimize gas and bloating. Beans should be soaked the night before, drained and put in the crockpot with fresh water, garlic, some onion and sage. Beans are very inexpensive and there are so many varieties it’s hard to get bored. One of my favorite meals for seniors is minestrone with white beans and lots of mixed vegetables. Lentils are also a favorite as they cook quickly are very flavorful, and are full of nutritional value.
5. Loneliness. If someone is eating alone, I recommend that they go on an outing. First order of business is to splurge for a nice placemat. Next, purchase an inspiring plate–art deco, whimsical china, or Italian—your local thrift store is a great way to get one of a kind items and recycle at the same time! Chefs know that the way you plate a meal, that is presentation, makes a difference in how your feel about your eating experience. Seniors often need something exciting and different to remind them that their food choices do matter! Seating should take place at a nicely prepared table, in front of Jeopardy where one can readily yell out the answers, with a Word Find book close at hand or on a tray in the easy chair may be the way to go. If possible, I encourage single seniors to visit their local senior center for one meal a week and socialize; .Or have a few friends come by for dinner and have them each bring a little something; Or accept your friends invitations instead of staying home.
Remember the goals are to choose a variety of colorful nutrient dense foods and maintain fluid balance. Well nourished older people spend less time in the hospital, have a better resistance to illness, higher energy levels, faster recuperation times, and a more robust immune system.
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