When a relative doesn't eat enough

Good nutrition is critical to senior health, but many older adults do not eat right. Older people are more likely to have inadequate nutrition than younger adults are — and are more susceptible to numerous health problems related to an inadequate diet. Many older adults in long term care facilities have poor nutrition. While seniors cared for at home or living independently generally fare better, patterns leading to inadequate nutrition — also called malnutrition — often begin at home. Knowing the causes and danger signs of nutrition problems, as well as taking steps to ensure a diet rich in protein and other necessary nutrients, is critical in maintaining senior health and strength.
Problems caused by malnutrition
Over time, malnutrition in older adults can lead to fatigue and increase the risk of digestive, lung and heart problems. Malnourished seniors are at increased risk of death. Malnutrition weakens the immune system, increasing the risk of pneumonia and other serious infections. It can worsen existing health conditions and mental confusion. Over time, poor nutrition can lead to a low red blood cell count (anemia) and muscle weakness leading to falls and fractures. Poor nutrition can also cause blood clots, bed sores, and depression and other senior health problems.
Good nutrition is especially important for the very ill or seniors who have dementia. These older adults are more likely to be admitted to a hospital or long term care facility — and are vulnerable to post-surgical complications and other problems linked to poor nutrition. Healthy, independent seniors need good nutrition too — often, nutrition problems develop gradually. Identifying dietary problems as early as possible and taking steps to eat well can make a big difference later.
Malnutrition in seniors: A web of factors
At first glance, the causes of malnutrition seem straightforward: too little food, a diet lacking in nutrients or absorption, eating or digestion problems related to getting older. But the causes of malnutrition are often more complex. For instance, older single adults, even those who are energetic and self-sufficient, often do not cook for themselves. Their typical dinner may be nothing more than a handful of popcorn or a cup of tea.
Carried on for a long time, a nutrient-poor diet accelerates the loss of muscle mass and strength that normally comes with aging. Shopping and preparing food become more difficult, which reinforces the tendency to subsist on easy but empty fare — such as toast, cold cereal or saltine crackers. Eventually, the chronic lack of nourishment leads to increased frailty, dependence and illness, which in turn can trigger depression — itself a major drain on appetite.
When does malnutrition begin?
Often, the cause of malnutrition is not a single event, but a cascade of difficulties that can include physical, social and psychological issues.
Physical causes of malnutrition: Older adults often have health issues that can lead to decreased appetite or trouble eating. These include chronic illness, trouble chewing and swallowing, a recent hospitalisation or nursing home stay, trouble absorbing nutrients (malabsorption), medications, diminished taste and smell, frailty and so on.
Social and psychological causes: Sometimes social factors and other factors are linked to malnutrition. These include limited income, depression, alcoholism, reduced social contact, restricted diets etc.
What to look for
The signs of malnutrition in older adults are often hidden, especially in people who do not seem at risk. To help uncover problems before they become more serious:
* Ask an older loved one about eating habits, but do not rely on self-reports alone
* Look for physical problems such as poor wound healing, easy bruising and dental difficulties
* Know what drugs an older loved one takes, and how they affect appetite and digestion
* Ask an older loved one's doctor to check certain protein levels (serum albumin, prealbumin or retinol binding protein levels)
What you can do
Malnutrition is a complex problem, but even small changes make a big difference in an older person's health and well-being:
* Enrich diets
* Restore life to bland food
* Plan between-meal snacks
* Use nutritional supplements
* Consider outside help
* Engage doctors
* Make meals social events
* Encourage regular exercise
Treating nutrition problems: Critical to senior health
Aging-related changes, health conditions and medical treatments can affect appetite, chewing, swallowing and digestion — and can cause other problems that make eating well a challenge for older adults. Overcoming these problems can be difficult. But identifying and treating nutrition problems as soon as possible is critical to senior health, longevity, independence and well-being. Take steps to ensure adequate nutrition in an older loved one, Look for signs of poor nutrition and discuss any concerns with doctors and other care providers.