Nutrition and hydration for older adults are key elements for better health and good quality of life. Unfortunately, malnutrition is very common in older adults. The older the person, the less nutrients are absorbed by the body from food. Adequate food intake and proper hydration promote quicker recovery and shorter hospitalisation periods, as well as avoidance of hospital readmission, following illness and surgery in older adults.
Ideal Meal Plan
An ideal meal plan should include:
- Breakfast
- Snack
- Lunch
- Snack
- Dinner
Nutrition for Older Adults
A healthy balanced diet helps maintain physical and mental well-being. Eating less than required may lead to weight-loss, vulnerability to infection, reduced muscle strength, and fatigue. Causes of weight loss may include:
- reduced appetite
- cooking difficulties
- inability to recognise hunger cues
- inability to ask for food
- lack or poor coordination skills
- cognitive impairment
- physical disabilities
- sensory disabilities
- depression
- medication
- fatigue
- dysphagia
- inability to chew properly
- lack of physical activity
- pain (denture problems, sore gums, painful teeth, lack of oral hygiene)
In older adults with late-stage dementia, the nurse should ensure adequate nutrition is being provided, and in some cases, a high-calorie diet may also be appropriate.
An older adult experiencing weight-loss should be referred to a nutritionist or dietitian.
Meal Supplementation for Older Adults
Meal supplement options for older adults include:
- Snacks
- Yoghurts
- Protein Powder (check liver/kidney function prior to administering protein powder)
- Enteral Feeds (can be administered in between meals or as replacements if needed)
Vitamin supplements can be avoided if the person eats a varied and balanced nutritional diet.
Common Chronic Illnesses in Older Adults
- Diabetes
- Hypertension
- Hyperlipidaemia
- Renal Disease
- Cancer
- Gum Disease
- Arthritis (certain proteins eg. nuts, legumes, and seeds, deposit fats in joints, which is very helpful for patients with arthritis)
- Refeeding Syndrome (shifts in fluids and electrolytes resulting from hormonal and metabolic changes which may occur in malnourished individuals receiving enteral or parenteral artificial feeding that may lead to death)
Common Problems in Older Adults
- anaemia
- depression
- overweight / underweight
- constipation
- food allergies
- inability to chew food appropriately
- dysphagia (problems encountered in swallowing)
- cooking methods
Assessing Older Adults
Nutrition and hydration in older adults should be assessed:
- to identify any existing problems
- to provide help with existing problems
- to promote safety
- to improve quality of life
- to improve current available services
- to create new / better services
Encouraging Nutrition Intake in Older Adults
- provide regular snacks or small meals
- foods with low glycemic index (low GI) are more digestible
- provide food that the older adult actually likes
- provide appealing foods for appetite stimulation
- experiment with different types of food such as smoothies and milkshakes
- experiment with foods containing strong flavours and sweet flavours
- find the right time to offer foods based on the individual’s day/night routines
- provide dessert even if main meal is left unfinished or untouched, as it may be preferred
- avoid giving cold food – reheat if necessary
- if the older person finds it difficult to chew or swallow food, try opting for softer-textured foods such as scrambled egg or stewed apple before considering pureed food
- provide encouragement
- provide a relaxed friendly atmosphere
The Importance of Hydration for Older Adults
Water is helpful for bloating, oxygen saturation, headaches, circulation, depression, digestion, kidney function, metabolism, and promotes healthy skin. Moreover, the brain requires water to function well. More than 2/3 of the brain is made up of water. With age increase comes a reduction of thirst sensation, which may lead to dehydration.
Older adults with dementia may become easily dehydrated if they are unable to communicate or recognise thirst cues, or if they forget to drink. Dehydration may lead to headaches, confusion, UTIs and constipation, all of which can worsen the symptoms of dementia.
- Older adults should be encouraged to drink between 1.5-2.5 liters of fluid on a daily basis.
- Older adults may be taught to check their hydration level by observing their urine’s colour and smell.
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