Rite Aid is dedicated to helping caregivers take care of their loved ones - and that often means providing answers to difficult questions. Many commonly asked questions may have already been answered by our pharmacists and other experts. You can search here for more advice about elderly nutrition.
A: Eating with others almost always makes eating more pleasant. While this is not always possible, it is something that families can strive for. When serving food, try to add color and variety to the plate to make the meal more appetizing and serve it on a pretty placemat. Try not to overwhelm your parent with a plate that’s too full.
If your parent lives alone, try to eat with him or her several times a week. Or suggest that a friend or neighbor join your parent from time to time for a meal at home or in a restaurant. This is especially important if you are a long-distance caregiver as this can provide a good way to gauge how your parent is doing if you talk with the dinner companion afterwards.
If you are leaving a meal for a parent before you head off to work, you might try to set a place at the table—or set up a tray—with a pretty placemat and colored napkin. Some caregivers suggest leaving a card or caring note alongside the place setting.
If your parent needs help shopping or preparing meals—or wishes to share meals with others—there are community resources available, including senior lunches. You can find out about them by contacting your local Area Agency on Aging. To contact the agency, call the Eldercare Locator at (800) 677-1116.
A: While many older adults have dry mouth, it is not considered a normal part of aging. Everyone has the feeling that there is not enough saliva in the mouth from time to time, often when nervous, upset or taking certain medications. Your loved one’s dentist or doctor should be able to discover the cause of dry mouth. If your loved one is taking medications, your pharmacist can review them to determine if one of them is causing the issue. If it is caused by medicine, the physician may change the medicine or adjust the dosage. If the medicine cannot be changed, there are saliva substitutes that may be considered.
Because saliva helps protect teeth from decay, your loved one may be more likely to develop tooth decay or other infections of the mouth. Advise brushing teeth with an extra-soft toothbrush after every meal and at bedtime. Soften bristles in warm water if brushing hurts.
A: If foods seem to lack flavor for your loved one, try cooking foods in new ways or adding different herbs and spices, if allowed. If medicines seem to be interfering with appetite, talk with your loved one’s doctor. If the problem is chewing, talk to your loved one’s doctor or dentist. There may be a problem with the person’s teeth or gums—or dentures may need to be adjusted. Also, it may be better to offer softer foods, such as cooked vegetables or juices rather than raw vegetables. Serve ground or shredded meats, or replace meats with eggs, tofu, tuna fish, etc. and try to avoid foods that cause gas or other digestive problems if gas or bloating is a problem. It is always a good idea to discuss any of these issues with your loved one’s doctor and even ask to see a dietitian. Avoiding certain foods or not eating enough may mean your loved one is missing out on certain nutrients.
A: One reason older people lose interest in eating is that their senses of taste and smell change with age. Some foods become less enjoyable. Sometimes medicines change a sense of taste or cause a lack of appetite. Chewing and digestion problems—even gas—make eating less interesting.
A: Eating smaller meals several times a day is a sensible way to eat for most people and definitely makes sense for older people. They may find smaller meals more appetizing and less difficult to tackle. This is especially true for those who have lost their appetite due to illness or medications or who have trouble chewing and swallowing.
A: Many individuals with COPD become malnourished because they lose interest in food or lack the energy to eat, says Karen Novak, a registered dietitian and nutrition educator at St. Vincent's Medical Center, Bridgeport, CT. But helping your loved one with COPD maintain proper body weight with a diet rich in vitamins and minerals is important, she says. Someone too thin will lack energy and resistance to disease, while excess weight further strains the heart and lungs, which compromises breathing.
To ease breathing difficulties and avoid infection in those with COPD, Novak suggests these mealtime tips:
- Offer a varied diet with plenty of fruits and vegetables. Such foods are rich in antioxidants, which enhance lung function.
- Keep the calorie content up with nutrient-dense foods. Avoid snacks that lack nutritional value.
- Serve six small meals rather than three large ones. Feeling too full makes one feel short of breath.
- Provide fluids to thin mucus. Eight cups daily, served between meals, should help allow the mucus to be coughed up more easily.
- Serve the main meal early for all-day energy.
- Formulate a healthy eating plan with a dietitian or physician.
- Keep meals relaxing. A calm, attractive setting helps one, quite literally, breathe easier.
- Reduce salt intake. It causes water retention, which makes breathing more difficult.
- Avoid foods that cause gas or bloating, such as apples, avocado, beans, broccoli, cabbage, melon and soda.
- Continue oxygen use during and after meals to ease digestion.
- Have your loved one rest between bites. Chewing can be exhausting if it interferes with breathing, so cut portions into small bites or serve soft foods.
- Avoid meals that are too hot or cold. Excessive temperatures can trigger coughing.
A: Sodium is the primary mineral that regulates the fluid levels in our body. If we think of our body as a bank and sodium as the currency, we only need about five hundred dollars (500 milligrams) to operate. However, the sodium we typically deposit in our “body bank” every day from our diet is about three thousand dollars’ (3,000 milligrams) worth. So, as you can see, most of us who eat American diets are “rich” in sodium. Unfortunately, a wealth of sodium is not at all healthy. Excessive amounts are often associated with high blood pressure as well as other problems.
The Food and Nutrition Board recommends a sodium intake of less than 2,400 milligrams per day. Choosing fresh, unsalted foods can lower sodium intake, as can avoiding processed foods (for example, cheeses, soups, cured meats and pickled vegetables) where salt is added during preparation. One large dill pickle can contain as much as 1,700 milligrams of sodium.
There are other, hidden sources of sodium to be aware of. Check labels for baking powder, baking soda, monosodium glutamate, disodium phosphate or sodium benzoate. Medications are also sources of sodium: antacids, cough preparations and laxatives often contain this mineral. Check with the pharmacist if you need further information on the ingredients contained in prescribed or over-the-counter medications.
When you restrict sodium in meals, it becomes a challenge to enhance flavors for someone who is used to eating with the saltshaker nearby. Try substituting lemon, onion, vinegar, pepper, garlic or parsley but don’t go overboard as you introduce a new seasoning. And keep in mind that two teaspoons of chopped fresh herbs equal one-half teaspoon of the herb in its dried form.
A: You're choosing between three of the best, according to Helen Rasmussen, PHD, RD, FADA, LDN, senior research dietician at the Jean Mayer USDA Nutrition Research Center on Aging at Tufts University in Boston. "What you're looking for is what's best in terms of good fats," she says. "I would opt for the olive oil; its monounsaturated fats tend to have more healthful contributions to the diet. And corn oil has polyunsaturates, which are fine—these are hair-splitting issues," she adds, noting that canola oil has the least amount of the undesirable saturated fat among the three.
In addition, she suggests, "If your parents have a preference for butter or margarine, things with [undesirable] trans fats, it's best to subtly wean them off that." It might also be necessary to remind your parents that certain fats are good to have in one's system.
"Some older people rabidly avoid any fats or oils. But small amounts need to be present to maintain health," Rasmussen says. "Eating raw spinach, you get only the roughage. But if you're using oil, it could backpack extra nutrients in the fat and scoot them into the bloodstream. If you sauté spinach in oil, it's great. That's a reason to use oils.
A: Water is our single most important nutrient, making up 55 to 75 percent of the human body. While we could survive for many days without food, we could survive for only a few without water. We need to replenish the water we use in our body (for cells to function and for metabolic reactions to proceed) from external sources. On a practical note, a diet with a high water content helps prevent constipation, dizziness, pressure ulcers and headaches.
Do you have to drink eight 8-ounce glasses of water every day? Actually, how much water any of us needs to drink to keep well hydrated depends on a few considerations. For example, changes in temperature can affect the body's water status. If it's very hot outside, a body will require extra water since its water supply is now working to keep it from overheating. Or, depending on how you eat, you may be meeting water requirements from all kinds of food. The foods containing the highest concentration of water (85 to 100 percent) are beverages, including milk and juice, and soups. Whole fruits and vegetables vary but are also water-rich. All of these can contribute to a person's water allowance.
A common problem in older adults is a decrease in the body's ability to respond to dehydration. Signs that someone may be suffering from dehydration can include a dry mouth, flushed skin, and an elevated body temperature, breathing and heart rate. Urine that is the color of dark apple juice is also a warning.
To add water each day, try these suggestions: Place a glass of water beside your bed or chair for water breaks. Include fruits or vegetables as afternoon snacks. Slice a tomato and add a dash of vinegar or low fat dressing, or cube an assortment of melons, such as cantaloupe, honeydew and watermelon. Add soup and low-fat yogurt or puddings to lunch and dinner menus.
Also keep in mind that timing is the key to preventing accidents of incontinence. You should drink more water when you know you will be at home or close to a bathroom for an extended period of time. When you are out, go to the restroom when you have the opportunity to do so and try to limit your liquid intake closer to bedtime.