As we get older, our appetite often decreases due to many factors such as hormones, medication, illnesses like dementia, and depression. This can be a real worry for the elderly, who are prone to extreme weight loss – making them frail and vulnerable to further health problems. Although I am not a qualified nutritionist, I look after the elderly on a daily basis under the strict direction of doctors and registered nurses. I would like to share with you some knowledge and techniques passed down to me so that you too can make a difference to another individual’s health and wellbeing. Here’s how…
1. Routine is important
Elderly people are creatures of habit. This is because one feels safe and comforted in the hands of time, especially for those with a tendency to forget things. If you are in charge of cooking meals for an elderly person, try your hardest to devise a meal schedule consisting of breakfast, lunch and supper, with a few light snacks scattered in between. Avoid eating too late and too close to bedtime because this can cause problems with digestion and sleeping patterns
2. Small portions
The second thing to remember is portion size. The last thing an elderly person needs is a huge meal sat in front of them. Although it is tempting to fill the plate, large portions will often put an elderly person off eating. This in turn has a direct affect on calorie consumption. It is far more productive to serve a small portion then offer second helpings when a person needs it. This approach is far less overwhelming and also allows the individual to play an active role in his or her own decision making.
3. Fortified foods to increase calorie intake
Fortifying is a term used to enrich meals with more nutrition and calories to ensure that minimum dietary requirements are met. Butter, cream, whole yogurt, olive oil and mayonnaise can be added to foods such as mash potato and soups, whilst making it taste better in the bargain (always a plus)!
Super foods such as Goji Berries, raw chocolate powder, Spirulina and Maca powder can also be taken in smoothies to add tonnes of nutrition – it’s amazing how little you need of these foods to make a huge difference. Even good quality honey can be substituted where ordinary sugar is used.
Where possible, substitute refined salt with something like pink Himalayan sea salt which is packed full of nutrition and goodness. Not only is it great for you, it adds the most amazing flavour to otherwise bland foods.
4. Being creative with ingredients
If you are finding it hard to encourage an elderly person to eat sufficient vegetables and fibre, try the discreet approach – they don’t even have to know it’s in the food they eat! This is where a food processor really comes in useful when preparing sauces and preparations. A few extra veggies can go undetected if blended sufficiently.
Talk to the person you are cooking for (if they are able) and try to find out what foods they used to cook when they were younger or what their mother used to make them as a child. You can then adapt these much loved recipes to fit ones individual dietary requirements. If communication is a problem, try talking to members of their family or people who knew them when they were younger.
5. Food for the eyes. Food for thought.
Just like you would a child, follow the rules of food psychology and make food look as appealing as possible. Presentation is everything when lack of appetite is concerned so experiment with different colours and textures until you produce a winning formula. Keep a food diary if you really want to do it the proper way.
To entice the eyes, try offering a selection of nibbles and h’orderves throughout the day. Even a few pretty chocolates in a decorative bowl can do the trick. If you are stuck for time, put out some dried fruit and nuts and leave it within arm’s reach of the elderly person – this is on the assumption that they can chew and swallow their food ok. If not, make an attractive smoothie or milkshake that can be consumed throughout the day.
6. Personal taste and cultural upbringing
We all know that food in the old days was a lot different to the way it is now. An elderly person brought up in the UK would be familiar with traditional hearty favourites such as Sunday roasts, Toad in the hole, Sheppard’s pie and fish and chips. Offering foods that are too different from ones cultural heritage could appear off-putting, depending on the person of course. For instance, spicy curries, pasta, and Mexican food could be a bit too exotic for the older generation – unless of course the individual was born overseas or travelled a lot.
The secret is to maintain a balance. Be creative, yet respectful of the individual’s cultural heritage.
7. Food intolerances and allergies
Did you know that the foods we often crave are actually the foods we most likely have intolerance to? To be sure, arrange an allergy test with your local health intuition to find out what foods to avoid or to cut down on. For instance dairy can cause diarrhoea, resulting in severe dehydration and electrolyte imbalances. If the elderly person feels unwell, or lives in fear of constant toilet trips, they won’t want to eat at meal times.
8. Feeding approach
If the person in question needs feeding, always make sure you set a nice atmosphere and talk to them whilst you do it. If you rush them or stay silent, the individual will think you are trying to force feed them. This could quite easily instil a sense of fear at meal times; a negative association that will have a lasting effect in some elderly people. They might refuse to eat because they are scared, or spit out their food as a defence mechanism.
If the individual has a tendency to get distracted at meal times, try turning the television off and motivate them without being negative or showing signs of frustration. Constant encouragement really helps - you just have to have the patience of a saint at times!
9. Poor fitting dentures
Sometimes dentures are more of a nuisance than they are worth – continuous wear or ill-fitting dentures can cause sore gums and discomfort. In some cases, the individual will go off their food completely due to the silent pain it causes. This is worth bearing in mind if you have noticed a sudden decrease in appetite or if the elderly person finds it hard to open their mouth.
10. Issues with medication and undetected illness
Some medications such as antibiotics have side effects including nausea and loss of appetite. If you suspect that medication is the cause of an eating disorder, seek medical attention and discuss all options with your doctor. There might be another reason why the individual is feeling unwell so it is important to tackle the problem by a process of elimination.
If the individual has swallowing problems for instance, your doctor will quite often refer to the SALT team (Speech and language therapists) who will then offer comprehensive, specialist guidance to make drinking and eating easier.
From one carer to another, I can only offer you the very best of luck. The fact you have read my guide proves that you have an interest in helping another person in need. Other than educating yourself, you can only try your very best. Be realistic of your limitations and accept the help of professionals whenever you need additional support or advice. It is better to seek help than to live a life full of regret if something goes wrong.
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Van on February 26, 2016:
This article and more like it are of critical importance because we have elderly people starving at an alarming rate. Simple lack of communication and understanding are at the heart of it. Caregivers have to fight for the elderly when this sets it because many times they are too weak to fight for themselves. Lead with love and if there are issues, step aside and ask for help, but get them nurished. Death from starvation is a lonely, painful, panic filled passing. Don't stand by and let it happen.
Laura (author) from West Sussex on July 30, 2014:
Hi Suzan! Thanks for your comment.
Due to your father's specific dietary needs, I highly recommend visiting a dietitian (or getting one to visit you and your father at home) for specific foods that benefit his needs. We hired one for an hour to visit my partner who has a digestive disorder and it was well worth the £60. She went through all the foods to have and which ones to avoid.
Has your father seen a Speech and Language therapist at all? They are also excellent and they will do a thing called a swallowing assessment to find out what textures and consistencies are most tolerated by your father. Sometimes they will suggest adding a special thickening powder to drinks and puddings so that they go down easier.
Regarding the limited fluids, some doctors will tell you to include soup/gravy in that allowance and others will say that it doesn't matter. It all depends how strict the fluid allowance is. It might be an idea to find out what their views are on the matter. If they don't count soup as part of the fluid intake, this definitely gives you more flexibility in terms of meal preparation.
If your father is having problems with his current medication, it sounds like a trip to the GP is in order. If the side effects outweigh the benefits, his doctor may try him on another drug or make adjustments to the doses. Hopefully this will bring some equilibrium to his system and maybe his appetite will increase?
In the NHS, patients are given 3 square meals a day, which a lot of people find too much with poor appetite. If a patient is unable to eat a meal, a high calorie supplementary drink/pudding/soup is offered in its place, which I believe you can get on prescription.
The last piece of advice I can give is to create a food diary. If your father is able to, get him to write down everything he is eating and drinking. It can be shown to various medical professionals and they will take his situation a lot more seriously, since they have quality information to go by.
I hope this helps and I wish you and your father the best of luck!
Suzan Thornberg on July 29, 2014:
What foods and how much should my 94 year old Father be encouraged to eat taking into account : he has congestive heart failure (told to limit fluids ), stage three renal disease ( told to severely limit potassium ) , recent myocardial infarction and some slight swallowing problems. Dad has had a great appetite and always loved food until about two months ago when he began a medication ( the same as the " old procardia ) which was highly toxic to him. He recovered from that and then had a mild heart attack. He has a strong will to live but has little appetite and seems to force food as he knows he should eat.
Laura (author) from West Sussex on April 13, 2014:
Thanks Donna :-) wishing you all the best!
Donna on April 12, 2014:
Thank you for sharing this information with all. I found it extremely useful for my therapy
Stephen on May 04, 2013:
This is very helpful. Thanks for putting your thoughts online.
Laura (author) from West Sussex on December 22, 2012:
Hello there Mattieg, thanks so much for your feedback, you have really inspired me to create a follow up article containing the information you require, regarding small meals.
I would like to point out that I am not a nutritionist, nor do I claim to be but I do on the other hand have a decade of experience in feeding the elderly since it is part of my job as a healthcare worker. My mother is also a qualified, head chef at a reputable nursing home where she creates customised meals for individuals with poor appetites and special dietary needs. Maybe we should club together and make an article. Would this be helpful to you?
If you are interested in good quality nutrition, I highly recommend nutritional expert, David Wolfe - he is known for his extensive knowledge in super foods. In one of his videos, he makes a single smoothie that contains more nutrition than what the average American eats in an entire month!
Here is a link to David's video http://www.youtube.com/watch?v=s1RuaqbtuHE
He goes to explain that by juicing and blending your food, you receive high quality nutrition without having to eat lots of heavy meals. This could be really useful if you are looking for ways to consume a well balanced diet, without spending hours in the kitchen.
If you like drinking tea, he has made a video explaining how to make a warming Energy Elixir for better health:
Hope my information proves useful to you. All the best!
mattieg on December 20, 2012:
At last! Someone can talk about feeding the elderly without turning us all into invalids with alzheimers. Thank you. Now, please, can you either illustrate or refer to a page that does illustrate those simple meals that we with smaller capacity for food can eat? I have often thought about six meals a day instead of three large meals but I can't seem to create them so that they add up to a healthy menu. Can you? And, please, with recognizable foods. Whatever are Goji berries? Maca powder? Thank you again.