Older adults

  Population considerations

  • Changes in nutritional needs. As people age, energy needs decline and the digestion and absorption of nutrients changes. This results in higher vitamin and mineral needs and lower energy needs. Studies show that adults take in less energy-rich foods as they age, which makes it more difficult to achieve nutritional balance (Wahlqvist, 2000). 
  • Sensory Changes. Loss of smell and taste can make food less appealing and less enjoyable to eat (Brownie, 2006).
  • Changes in fluid intake. It has been suggested that older adults have a decreased ability to sense thirst. This can result in dehydration as well as other more severe conditions (Brownie, 2006).
  • Physical mobility. As adults age, physical limitations can make it more difficult to shop for foods and prepare meals. This could lead to increased consumption of pre-packaged, boxed or frozen foods that have a higher calorie and lower nutrient content (Brownie, 2006).  Overall food intake often decreases resulting in malnutrition.
  • Chronic illness. Individuals living to older ages are more likely to have at least one chronic disease (Brownie, 2006). Chronic disease conditions often require special dietary restrictions that may be difficult for older individuals to follow (Wahlqvist, 2000).
  • Medication. Older adults often take multiple medications that may interact with digestion and absorption of nutrients or cause side effects that make eating less desirable, such as altered taste (Brownie, 2006).
  • Isolation.  Living alone can result in poor nutrition. Barriers to good nutrition when living alone at an older age include: transportation and money to purchase healthy items at a food store, energy and physical ability to prepare foods, as well as loneliness or depression (Brownie, 2006).         
  • Institutionalized individuals.  Under-nutrition is a major problem among individuals living in assisted living and skilled nursing facilities. A contributing factor to under-nutrition is the lack of control over what food is being served to them (Wahlqvist, 2000).   
  • Misunderstanding.  Older adults may become confused or receive untruthful nutrition information due to the fact nutrition information is typically easily accessible from a variety of sources, some of which may not be credible (Higgins, 2004).
  • Food preference and habits. Food habits and preferences can be difficult to change. The familiarity and enjoyment of certain foods and cooking methods could reduce an older adult’s willingness to adopt healthier options (Wahlqvist, 2000).

  Strategies to address these considerations

  • Work with local decision makers to ensure programs aimed at elderly populations, such as the Older Americans Act Nutrition Program, are fully implemented.  Support existing food and nutrition services that promote health, functional independence, and manage chronic disease (Kuczmarski, 2005).
  • Identify changes in nutrient needs. Combining efforts of services or organizations that work with seniors with the expertise of registered dietitians and healthcare providers, can ensure that older individuals are receiving current and accurate information, as well as appropriate foods for their changing nutritional needs (Kuczmarski, 2005). 
  • Enhance flavors. Experiment with ethnic foods, different herbs and spices, or vegetarian meals to increase the intensity of flavors.  Adults may enjoy the taste of foods and actually eat more (Mathey, 2001). Cooking classes or demonstrations are a great way to involve older adults and have them practice cooking and sample nutritious foods (Higgins, 2004).
  • Promote hydration. Providing adults with education, a graduated cup, and their preferred beverages at the preferred temperature can increase fluid intake (Mentes, 2006). Individuals may also need reminders or frequent offers of drinks and invitations to social events that include and encourage beverage intake.
  • Address physical mobility. Work with individual seniors as well as agencies and organizations that work with seniors to identify strategies to increase the ability of individuals to continue to prepare foods as they age. Nutrition education that combines lectures with hands on cooking demos, recipes, and food testing can be successful (Higgins, 2004).  The Meals-on-Wheels program or food delivery programs offer another option to reach those who may be unable to prepare their own foods.  
  • Address chronic diseases and medications. Teach older adults how to communicate with their healthcare provider.  This will help individuals address issues such as undesirable side effects of medication related to eating and personal care needs or concerns related to chronic disease care (Teutsch, 2003). Likewise, utilize strategies that assist practitioners to become more alert to changes in an older adult’s nutritional status and general nutritional needs in relation to chronic disease and medications to help improve or maintain the health of older individuals (Levine, 1993).
  • Build and/or maintain social support. Community-based interventions, such as Senior or Community Centers, can serve as a social setting for individuals to eat. Interventions providing the company of others to older adults have proven successful in increasing food intake (Wahlqvist, 2000).
  • Nutrition promotion in institutionalized settings. Interventions within nursing or assisted living facilities should be directed at ensuring a variety of nutritious options are available as well as oral supplements. 
  • Provide nutrition education. Educating older adults on the importance of eating a variety of foods can improve total food intake, health outcomes, and survival (Higgins, 2004). Interventions targeting older adults must be implemented with empathy and mutual respect, helping individuals apply knowledge to daily nutritional behaviors (Higgins, 2004).

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