An apple a day: Eating what’s right, when it’s right

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We all know the age-old saying about what an apple a day can do for us. But when it comes to loved ones whose bodies and systems are aging, an apple may not be a good thing at all.

As we start to see changes in the eating habits and needs of our parents and others who we strive to support, we often assume that they should eat much the same way as always, or much the same amount. Wrong, wrong, wrong.

Right off the bat we need to recognize that, generally speaking, older people eat less. They may eat more often—grazing, nibbling and munching. But in terms of overall quantity, they need less because things are slowing down and need less energy to manage.

But they also might not enjoy eating as much as they used to because things don’t taste as good or they don’t feel well after they’ve eaten. They might not be eating because they are depressed or lonely, or perhaps they’re filling up on sugary snack foods rather than eating proper meals. Regardless, we need to pay attention because without good nutrition a loved one is far more prone to weight loss, frailty, falls and overall poor health.

Independent living

If your aging parents are independent and using their own kitchen facilities, the most important thing you can do is try to keep track of what goes in and out. When you start seeing spoiled food in the fridge and non-perishables not moving off the shelves, or when they’re only drinking ginger-ale and eating crackers and cheese, you should ramp up the worrying and invoke some course of action.

At this point you may want to consider helping with shopping and meal planning and talk to community services such as meals on wheels. Also consider dropping by at meal times as much as you can and take a nutritious favourite snack or meal when you visit.

Sometimes it’s all about making meal time pleasurable again. After all, not many of us find it easy to cook for ourselves and eat alone day after day.

Assisted living

If you have a parent in an assisted living facility, it’s a good idea to keep a close watch on what what’s being offered and what’s being chosen. Usually, there are two to three options for at least two of the three daily meals.

Find out what your parents are selecting, especially if you see a change in their weight or energy levels. See if there is a balanced approach or just a hording of favourite foods that may not result in good eating habits.

If this is happening, the challenge is to find out why and then learn how to carefully and successfully move your parents onto better eating habits or nutritional supplements, if needed. This may need you to enlist the help and active support of the facility’s dietician.

Don’t be afraid to ask about what your parent is eating at each meal and what the right combination should be. Most importantly, find out how you and the staff can work together to improve the situation.

Home care/nursing home

The going gets much harder when our parents are either at home with significant care or in a nursing home. At this stage, they’re usually less able to make good selections and caregivers are much more involved.

Consider dispensing with the established norms (breakfast, lunch and dinner) and move to what’s most suitable and nutritionally helpful at whatever point in the day.

At this stage of our parents’ lives, we need to be sensitive to what kinds of meals their systems can process. We need to ensure they get the best possible combination of foods, because at this point there will be foods, tastes and textures they don’t like. And just like kids, if they don’t like it, they’ll rebel.

Food and my mother

As an example, over the past 18 months we’ve seen a real change in what my mother eats and how she eats it. A year and a half ago my mother was able to feed herself. As the months progressed she made less and less effort to eat and needed far more active assistance. Gradually stopped using utensils and started using her hands, and then not even those. She just waited to be fed.

At the same time, she also became less combative about the actual food. While she used to ferociously resist foods she didn’t like or thought she didn’t like, we discovered over time that she would initially reject a certain food but, if we tried again a few minutes later, she’d be willing to accept it. Patience prevails!

A few months ago the nursing home dietary staff in conjunction with the nursing team decided that for the most part they’d serve my mother her main meals in a pureed form because of growing concern over her ability to chew food properly. That’s another thing to watch for carefully: our parents’ chewing and swallowing. Especially with advancing Alzheimer’s, but equally with other types of degenerative conditions, one’s ability to chew and swallow can become an issue. Sometimes even a more thickened form of water is given for ease of ingesting.

So all in all, from my own experiences and from talking to others, I’ve come to understand that there are numerous considerations when it comes to what older adults need and want to eat and how they’re willing to eat it. It’s a delicate balance, for sure. As caregivers, it’s our job to lend our support, keep a watchful eye, ask questions and be confident that things are happening in the right way at the right time when it comes to healthy eating.

Six culinary questions to savour

  1. Who decides your parents’ diets and on what basis?
  2. Is there sufficient variation in what’s being offered?
  3. Are “treats” planned and given?
  4. Are food allergies carefully observed?
  5. Are chewing, swallowing and digestion patterns observed for changes that may signal new health issues?
  6. Do you share meals with your parents from time to time?
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