Frail Elderly Face Nutrition Risks July 14, 2008

As our Central Texas population ages, there will be an increasing number of seniors in frail condition living in our region. Many of them will have trouble caring for themselves and keeping everything going nutritionally. If you or someone in your family is having trouble with nutritional intake, the following are tips to help you cope.

Seton Clinical Nutrition

"The elderly are at higher nutritional risk due to physical, cognitive, or functional decline all associated with the aging process," says Seton Northwest Hospital Clinical Dietitian Janessa Slatky, RD, LD. "There are many factors that can lead to poor nutrition in the elderly such as a chronic disease like Alzheimers; arthritis or osteoporosis that can interfere with meal preparation; and eating habits. Poorly fitting dentures, depression, poor dentition, gum disease, lack of exercise, or diminished sense of smell and taste may lead to poor nutrition intake. Elderly persons may also be on certain medications that can decrease appetite, or interfere with food or nutrient absorption."

This population is most susceptible to health risks from a nutrient poor diet. Often a multi-faceted intervention approach is needed to address the wide range of factors contributing to poor nutritional intake.

"Frail seniors require more protein to prevent decline in lean body mass than most adults, about 1-1.25 grams per kilogram of body weight. Metabolism slows about 30 percent in the elderly, so they need to be getting more nutrients but from fewer calories."

What to Eat

Janessa often counsels frail seniors who are getting ready to go home from the hospital to help them make appropriate choices to support their health and at the same time, avoid foods that don't contribute enough nutrition. Here are some of her tips:

Eat more nutrient-dense foods such as vegetables, fruits, grains, dairy products and protein sources (meat, legumes).
Drink milk or a product such as Carnation Instant Breakfast or oral nutrition supplements like Ensure or Boost to increase nutrients and protein in the diet.
Add nonfat dry milk to recipes such as shakes, casseroles, muffins, cream soups or puddings to increase protein. Two tablespoons provides five grams of protein and can't be detected in the food.
Avoid foods that provide empty calories such as sodas, candy, overly processed foods and junk food.
Avoid foods labeled diet or fat-free (except for milk).

A previous GoodHealth.com article featured a 10-day menu of simple quick meals that can be prepared in ten or twelve minutes from a combination of fresh, frozen and pre-packaged foods. It includes a shopping list and provides between 1,500 and 1,800 calories a day.

How to Eat

Lack of appetite is common for older adults. In some cases, managing when and how to eat improves the likelihood of maintaining good nutrition.

Eat several small meals a day, rather than three large ones.
Choose favorite foods at any time of the day, no matter what time. For example if breakfast foods are appealing, eat them for dinner.
Eat every few hours, dont wait until you are hungry.
Take advantage of times you feel hungry. If your appetite is best in the morning, eat your largest meal then.
Exercise lightly or take a walk before meals to increase appetite.

Other Suggestions That Can Help

If you are concerned about an elderly person who is losing weight or seems to have lost interest in eating, consider the following:

Schedule a visit to the dentist -- for complete check-up and denture fitting.
Arrange for grocery store transportation. Check bus and taxi service, including Capital Metro's Special Transit Service (512-389-7480).
Check with meals services such as Meals on Wheels (512-476-6325). Also the Personal Service Bureaus category in the yellow pages lists businesses that will do a variety of errands including groceries.
Research financial and service resources. Contact the Aging Services Council of Central Texas (Capco area, including Bastrop, Blanco, Burnet, Caldwell, Fayette, Hays, Lee, Llano, Travis, Williamson) or the Area Agency on Aging of the Capital Area.
If depression is suspected, encourage the senior to talk to his or her physician.

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