Today is our last installment of our mini-series on Seniors and Nutrition and to finish the series we will be talking about how to prevent and detect malnutrition in the elderly. First, we will discuss what malnutrition is and what it looks like in older adults. Then, we’ll cover some of the factors that contribute to malnutrition. Finally, we’ll end with ways you can help your loved one avoid poor nutrition, and in turn, malnutrition. Now let’s move on to the rest of the show.

 

Good nutrition is important for everyone, regardless of age, but is especially important for older adults. According to the World Health Organization, malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition covers 2 broad groups of conditions, undernutrition and overweight, obesity and diet-related noncommunicable diseases, such as heart disease, stroke, diabetes, and cancer.

 

Undernutrition includes stunting, which is low height for age, wasting, which is low weight for height, underweight, which is low weight for age, and micronutrient deficiencies or insufficiencies, which are a lack of important vitamins and minerals.

 

Approximately 2.4 billion adults worldwide are experiencing malnutrition, with 1.9 billion being overweight and 462 million being underweight. In some cases, people may be overweight and also exhibiting micronutrient deficiencies or may be underweight and have diabetes. Because there are many types of malnutrition, it can be hard to spot if your loved one is experiencing a form of malnutrition or not.

 

But left unchecked, malnutrition can cause a host of other issues. According to the Mayo Clinic, malnutrition in older adults can cause them to have a weakened immune system, which increases the risk of infections. It also can cause poor wound healing, muscle weakness and decreased bone mass, which can lead to falls and fractures, a higher risk of hospitalization, and an increased risk of death.

 

The Alliance for Aging Research has created a pocket film that covers who is at risk for malnutrition, the debilitating impact it can have on older adults, tips for identifying the condition, and how it can be treated and prevented. We’re covering some of the key points of the video, but if you would like to watch the full thing, you can find the link to it in our show notes for today’s episode.

 

According to the Alliance for Aging Research, Malnutrition can happen to anyone, but older adults are particularly at risk, as they are more likely to have chronic conditions that put them at risk for malnutrition. Some illnesses and diseases, like cancer and Alzheimer’s, can change an older adult’s appetite and metabolism and they can also require dietary restrictions that can make eating difficult.

 

When we picture malnutrition, we often picture starving children in third world countries or even the animals on the ASPCA commercials, but malnutrition is everywhere and far more common than we think. Malnutrition doesn’t always look like someone is starving. Actually, most malnutrition cases, at least in the US, tend to look like the opposite. What’s even more concerning about malnutrition, it can be impossible to see until it’s too late.

 

Older adults often experience illnesses, diseases, or accidents that require them to be hospitalized or require them to be in a long-term care facility, both of which lead to a higher risk of malnutrition. As we age, our bodies go through changes that also can lead towards malnutrition, which is another reason that older adults are at a higher risk.

 

As we get older, our sense of smell and taste weakens, and things that we once enjoyed may not taste as good as they once did. Our digestive system can also slow with age, and take longer to digest meals, making us feel fuller throughout the day, but leave us lacking essential calories and nutrients. As we get older, our bodies may not be able to absorb nutrients as well, either. So, your loved one may be eating the same foods that once brought them a lot of energy, but now doesn’t have the same effects.

 

According to the American Society for Prenatal and Enteral Nutrition, or ASPEN, malnutrition in seniors often mirrors the signs of aging. Unplanned weight loss, feeling weak or tired, loss of appetite, swelling or fluid accumulation, and being able to eat only in small amounts are all signs that your loved one is malnourished, but they are also signs of aging. If you suspect your loved one may be malnourished, talk to their doctor immediately so they can get the calories and nutrients their body needs. Now that you know what malnutrition is and what it can look like in older adults, let’s move on to factors that contribute to malnutrition.

 

Cognitive diseases like Alzheimer’s can make it difficult for your loved one to remember to eat. Mobility issues can also make it more difficult for your loved one to shop for their groceries, cook their own meals, and eat on their own. Some treatments and medications can also require dietary restrictions and cause your loved one to have a loss of appetite, leading them to become malnourished.

 

According to ASPEN, the causes of malnutrition in older adults are a complex blend of physical, social, and psychological issues — from the loss of appetite due to depression to the inability to get to the store for groceries. Prompt diagnosis and treatment of malnourished older adults is critical. If it goes on undetected for too long, irreversible damage and even death can occur.

 

Mayo Clinic lists several factors that contribute to malnutrition in older adults. Normal age-related changes in taste, smell and appetite generally decline with age, making it more difficult to enjoy eating and keep regular eating habits. Disease-related inflammation and illnesses can contribute to declines in appetite and changes in how the body processes nutrients. Impairment in ability to eat, like difficulty chewing or swallowing, poor dental health, or limited ability in handling tableware can contribute to malnutrition. Behavioral or memory problems from Alzheimer's disease or a related dementia can result in forgetting to eat, not buying groceries or other irregular food habits.

 

Some medications can affect appetite or the ability to absorb nutrients. Dietary restrictions for managing medical conditions — such as limits on salt, fat or sugar — might also contribute to inadequate eating. Older adults may have trouble affording groceries, especially if they're taking expensive medications. The lack of socialization can also cause malnutrition.

 

Older adults who eat alone might not enjoy meals as before and lose interest in cooking and eating. Adults with limited mobility may not have access to food or the right types of food. Grief, loneliness, failing health, lack of mobility and other factors might contribute to depression — causing loss of appetite. Older adults that suffer from Alcoholism are also at a higher risk of malnutrition, in addition to numerous other health problems. Too much alcohol can interfere with the digestion and absorption of nutrients. Misuse of alcohol may also result in poor eating habits and poor decisions about nutrition.

 

There are several factors that can contribute to malnutrition, as you have just seen, but the list goes on and on. Knowing some of these factors to look out for can make malnutrition easier to spot in your loved one. And it is important to know that just because they are eating, does not mean they are eating well or eating enough. If your loved one seems to be eating regularly, but is losing weight or experiencing low energy levels, they may have a nutrient deficiency and need to be on a special diet, so it is important that you talk to their doctor about any changes in their behavior, and their diet, that you notice, especially if your loved one is unable to notice it on their own.

 

Now that we have discussed what malnutrition is, what it looks like in older adults, and the factors that contribute to malnutrition, we can move on to our final section, how to help your elderly loved one avoid poor nutrition.

 

Mayo Clinic says that as a caregiver or adult child of an older adult, you can take steps to monitor nutritional health, watch for weight loss and address risk factors of malnutrition. You can monitor your loved one’s weight by checking their weight at home and keeping a weekly record of it. You can also do a visual check of how their clothes fit, as it can indicate weight loss, as well.

 

Observing their habits is another good way to keep track of their nutrition. You can spend mealtimes together at home — or during mealtime in a hospital or care facility — to observe eating habits and note what kinds of food are eaten and how much. Keeping a record of all medications, the reason for each medication, dosages, treatment schedules and possible side effects can also help your loved one avoid poor nutrition. As we age, many people need medication every day, and those medications can come with side effects that involve loss of appetite or other things that make eating more difficult. When consulting a doctor about poor nutrition, having all of this information on hand can help them determine if your loved one is malnourished faster, resulting in faster treatment that could potentially save their life.

 

Helping your loved one plan healthy meals or preparing meals ahead of time for them can help ensure that they have access to the nutrients they need. Helping them prepare a shopping list or shopping together can also help them make sure that they always have the items they need to make healthy choices at mealtimes.

 

There are many agencies and organizations that exist just to ensure that seniors have access to nutritional meals. Contact your local service agencies that provide at-home meal deliveries, in-home visits from nurses or dieticians, access to food pantries, or other nutrition services to see what help your loved one can be receiving. The local Area Agency on Aging or a county social worker can provide more information about services in your area.

 

If your loved one lives alone and is having trouble eating, they may benefit from social interactions during meals. You could try dropping by during mealtime or invite your loved one to your home for an occasional meal. Going out to eat at a restaurant can be a special treat for them, and they can use their senior discounts.

 

Lastly, daily exercise — even if it's light — can stimulate appetite and strengthen bones and muscles. Encourage your loved one to go on walks if they are able to. Not only can it help stimulate their appetite, but it can help improve their mood. If they are suffering from depression, even a slight mood improvement can increase their appetite, as well.

 

If your loved one needs help improving their nutrition, there are a few things you can do. Before starting anything new, always make sure you discuss the change with their doctor first. When planning meals for your loved, make sure you are including a variety of nutrient-rich foods. A good rule of thumb is to include the rainbow on their plate. Really, all that means is make sure you are including a variety of colored foods, as they all contain different nutrients.

 

Using different herbs and spiced to add flavor to meals can help your loved one improve their interest in eating. Experimenting with these things can help your loved one find a new favorite and cause them to be excited for their next meal.

 

If eating on their own is not enough, you can use supplemental nutrition drinks to help with calorie intake and you can add things like egg whites or whey powder to meals to increase proteins without adding saturated fats.

 

Observing your loved one during mealtimes is the best way for you to prevent and detect malnutrition in your loved one. Actually, being able to see what they eat and don’t eat and being able to witness any problems they have with eating can help you determine if your loved one has any problems that their doctor should be aware of. If you notice they are coughing a lot when they are eating and having trouble swallowing, they may have a medical condition that is causing that that if their doctor was aware of, could be fixed.

 

Knowing your loved one’s eating habits can also help when shopping or cooking. If your loved one is unable to go to the store or cook their own meals, know what they like and what they are able to eat can help ensure that they eat more, or less if that is the problem. Now, you don’t want to make your loved one feel like they have no control over their eating time or like they have lost their independence. We are not suggesting that you stand over them at mealtime. When you take them out to dinner or come visit for lunch, just be aware while you are with them and take note of their habits. It may be useful in the future, and it may not, but it is always better to be safe than sorry.

 

If your loved one is having difficulty eating or you notice any changes in their diet or weight, even if you don’t think they are malnourished, talk to their doctor. Malnutrition often goes undetected and undiagnosed until it is too late, so if you have any suspicions, it is always better to tell your doctor sooner rather than later. You may also find you need the help of a nutritionist when figure out what your loved one should be and needs to be eating. Your doctor or your local senior center can give you resources and referrals for nutritionists in your area. Your local senior center may even have a nutritionist on staff that you can meet with.

 

We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate these long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone who could benefit from this episode, please make sure to share it with them.

 

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Sources:

https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/senior-health/art-20044699

 

https://www.who.int/news-room/q-a-detail/malnutrition

 

https://www.agingresearch.org/campaign/malnutrition/

 

https://www.nutritioncare.org/Guidelines_and_Clinical_Resources/Spotting_Malnutrition_in_Seniors/