Taking a Bite Out of Senior Diet Myths

The varied health concerns of seniors can make it difficult for caregivers to know how to manage their elderly loved one's diet.  Is it normal for a senior to lose their appetite or weight for no obvious reason? What combination of vitamins and minerals does a senior really need? Are supplements safe?  Ruth Frechman, M.A., a registered dietician and spokeswoman for the Academy of Nutrition and Dietetics, debunks some common myths about senior nutrition and offers advice for caregivers:

1. "A senior can eat whatever they want." Frechman feels that this misconception tops the list as one of the most common senior nutrition myths. "Proper nutrition is important at any age—how you eat affects how you age," she says. The key for seniors, according to the National Institutes of Health (NIH), is to look for foods that are low in calories, but high in nutrients. This includes: fruits, veggies, whole grains, lean sources of protein (fish, poultry beans, nuts)
2. "A senior's nutritional needs don't change when they get older." Following this line of thought is a big mistake, according to Frechman. There are a few important tweaks older adults should make to their daily diets. The U.S. Department of Health and Human Services advises seniors to cut back on their daily sodium intake, consume a higher volume of whole grains, increase their daily potassium intake, and eat foods fortified with vitamins D and B12.
3. "Dietary supplement pills are a safe way to make sure that a senior is getting all of their vitamins and minerals." Grocery stores often devote several shelves to vitamin and mineral supplements, but caregivers should be careful when considering giving these pills to their elderly loved ones. Seniors who eat a balanced diet should be able to get all of their nutritional needs met from the food they eat. Using supplement pills to make up for a deficit in an elderly person's diet may cause adverse reactions with prescription medications or cause them to overdose on a particular vitamin or mineral.
4. "Eating out all the time is fine, as long as we don't get the same thing every day." Caregivers (and seniors who live alone) may find it difficult to find the time and energy to cook meals. This may cause them to turn to dinner options that require less effort and time to prepare, such as restaurant take-out or pre-packaged frozen meals. But, according to Frechman, these seemingly handy short-cuts come with a price: high amounts of fat and sodium. This can be particularly dangerous for seniors with heart problems or high blood pressure.
5. "If a senior doesn't feel like eating a whole meal, a supplement shake is a fine substitute." Meal replacement and supplement shakes are not suitable alternatives to a balanced meal. When used too frequently, these shakes may cause a host of health problems, including: malnourishment, and diarrhea. A good rule of thumb to follow when it comes to these kinds of drinks is that they should be used periodically as a snack, not a substitute.
6. "It's normal to lose your appetite as you get older—I shouldn't try to get my loved one to eat if they're not hungry." An older person may lose their appetite for a variety of reasons, none of which should be ignored or brushed off as a symptom of aging. Medication side effects, problems with chewing and digestion, loneliness, depression, and a reduction in the ability to taste and smell are all things that can contribute to a senior's reluctance to eat. Frechman says a lagging appetite can cause a senior to become malnourished. She advises caregivers to entice seniors to eat by making the meal look as appealing as possible; using fancy silverware, lighting candles, and arranging the food in a pleasant manner. It may also be helpful if the senior has an eating companion. Try to schedule in some time to sit down and eat with your elderly loved one when you can.
7. "My loved one doesn't have diabetes, high blood pressure, or high cholesterol, so they don't need to see a nutritionist about their diet." Frechman feels that all seniors could benefit from consulting with a professional about their diet. She says that there is a great deal of conflicting and incorrect nutrition information out there, so it can be helpful to get advice from a knowledgeable source. Medicare Part B only covers dietary consultations if a senior has diabetes or renal disease. Some Medicare Part C Advantage programs will pay for a person to see a nutritionist, if their doctor deems it, "medically necessary." A senior's primary care doctor may also be a good source of information on proper diets for the elderly.

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Ways To Satisfy a Senior’s Sweet Tooth in a Healthy Way

Providing an elder with a balanced, nourishing diet is not too difficult; convincing your loved one to consume these nutritional foods is the challenge.
As people age, their appetites often lag. Medications, pain, problems with teeth or swallowing, and the inability to taste certain flavors are only a few of the many causes of eating problems in the elderly.

Most elders will, however, eat sweets. Understandably, caregivers who are trying valiantly to provide good nutrition to their loved ones can become frustrated when the only foods their elders want are sugary and devoid of nutrients.

Here are a few things to keep in mind about seniors and sweets:

• Most sweets have a high calorie count and a significant amount of fat. While this combination is generally not good for middle-aged caregivers, it may be okay for a senior, since aging bodies tend to lose fat reserves. If your elder is carving ice cream and the doctor doesn't forbid it, then let them have ice cream. (Naturally, people with diabetes need sugar-free products, but you'll already know that if you care for someone with the disease.)
• When it comes to your loved one's diet, if they're seeing a doctor regularly and you are following the doctor's orders as much as possible, then you are doing all that you can. Don't expect to put a lot of weight on your frail, elderly parent or spouse. You can try to improve their nutrition, but that may be all you can realistically do.
• If your elder has problems chewing, swallowing or digesting foods, it's natural for him or her to choose a soft sweet, such as a cupcake, over tougher foods, like meat. Dentures and tooth pain are both common reasons for problems with swallowing or chewing in seniors. Check with a dentist in case your loved one's dentures need lining or adjusting, and if there are signs of other tooth issues. For problems with swallowing and digestion, see their doctor. These complications can be caused by a host of health conditions, such as Parkinson's or celiac disease. Medication and modified diets may be able to help some, not all, of these issues so, for our own sakes, we caregivers need to learn what we can control and what we simply need to accept.

Steps to introduce nutrition any way you can
Convincing a loved one to stick to healthy food can be challenging, so it's often best to start by injecting small amounts of nutrition into their dietary regimen. Here are a few steps to take when trying to get a senior to eat better:

• Find their favorite foods: First, make a list of foods that your elder liked best throughout their life. This list can offer insight into what to serve them now, even if you need to use different consistencies such as smoothies and purees.
• Don't deny dietary delights: I wouldn't try to eliminate sweets at this time. As mentioned above, most elders need calories and sweet treats are generally high in calories. Also, our loved ones have likely suffered many losses as they've gotten older. Allowing them to eat foods they enjoy seems only right. (Again, people with diabetes need special consideration, but sugar substitutes are available. Stevia, a plant extract that is 300 times sweeter than sugar, is now quite popular as a sugar substitute, but there are others. You'll need to experiment to find what tastes best to your loved one.)
• Temperature is important: My personal experience with my mother taught me that cool foods often go down better than hot. This is highly individual, however. Warm foods may be more appealing to some. Observe your loved one to see if they seem to have a preference.
• The power of the simple smoothie: Smoothies are all the rage among health food gurus, but don't write them off as a fad. Homemade smoothies can be full of nutrients, taste delicious and deliver much-needed calories. They can also adjusted to appeal to a senior's sweet tooth (see this recipe for a senior-friendly Shamrock Shake). The smoothies you make will be varied, but aim to include lots of fruits and vegetables, plain or vanilla yogurt or soy milk for a base, liquid multiple vitamins or an opened vitamin capsule, and powdered protein. Some vitamins and supplements for seniors can interfere with certain medications, so be sure to clear them with the doctor first. You can adjust the smoothie's thickness to the preference of your elder by adding ice cubes or water. Very dark green vegetables (such as kale) may taste bitter, so go easy on those at first. I'd begin by using mostly fruit for flavoring. Strawberries, blueberries and other sweet berries are usually enjoyed. These can be found frozen when out of season. Toss in a banana for some much-needed potassium and blend well. (A note on experimenting with flavor: most powdered proteins have some added sweetener already, but if you have one that tastes bitter, you can use stevia to sweeten the drink. Many proteins also come with flavoring such as chocolate, but that limits the other flavors from nutritious food that you can add. If your elder can't eat yogurt, look for a soy-based substitute. Eventually, you can make up smoothies with different vegetables and other foods that you can pulverize. There are many smoothie books on the market that can provide inspiration.)
• Mealtime shouldn't be a battle: Offering small bites of other foods such as meat, potatoes and vegetables, to a resistant loved one is necessary if you have any chance of tempting them to eat. But be aware that repeatedly offering foods that are unappealing may simply diminish their appetite even more. Be careful not to turn meal time into a battle of wills. Your loved one will likely end up eating less in the end.
• It's okay to be sneaky when it comes nutrition: Look for cookbooks with recipes that teach you how to "hide" nutrition in sweets and other preferred foods. There are many on the market, including those aimed at moms with children who are picky eaters. This is one of the few times that I feel it is okay to look to children's remedies for aging adults. Under these circumstances, hiding nutrition isn't demeaning, it's practical.
• Keep portions small: Even if it's just a smoothie, pour it in a small glass and offer it frequently.
• Pureed foods versus smoothies: If a physician or dietician has recommended pureed foods because of your loved one's swallowing issues, work with the professional to come up with the best consistency of the food you plan on offering them. If your elder will eat pureed foods, that's great. Personally, I haven't seen much enthusiasm for them. In fact, I've seen grimaces, heard comments about "baby food," and seen lots of refusals, including spitting. I'd much rather offer a power house full of nutrition in the form of a smoothie that will be consumed than offer standard pureed foods that will be rejected.

Unless the physician has banned a particular food because of diabetes or another disease, it's perfectly fine to allow your loved one to eat a cupcake or other appetizing dessert often. Even though you're trying to improve their nutrition, you want to offer enjoyment as well as calories.

If I make it to 80, I hope that my appetite – or lack thereof – is respected and that I can have foods that I like, even if they aren't "good for me." In my opinion, unless the food is a direct health threat, our elders have earned this right.

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Food Jags

Possible Causes

• Your loved one may find that familiar favorites are comfort foods, and anxiety may make these seem preferable.

Try these tips:

• Indulge food preferences as much as possible, provided the overall diet is reasonably balanced. It's okay to serve the same entrée day after day. (You can always cook something else for yourself.)
• Serve the same food more than once in a day if it's requested.
• Ask the doctor about adding vitamins if the diet seems unbalanced.
• Consider preparing the food in different formats: A hot chicken breast might be refused, for example, while chicken soup or chicken salad might be eaten without complaint.
• Try to serve old favorites from the person's childhood or prime of life; these are often still remembered and preferred.

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