Elder Malnutrition: Ensuring They’re Getting Proper Nutritional Care

Good nutrition is good nutrition, regardless of age, physical condition, or overall health.

But when it comes to the elderly, ensuring proper nutritional care can be a difficult proposition. They may not be responsible for feeding themselves, preparing their own meals, or maintaining a balanced diet. It’s up to friends and family to watch out for them. As we get older, the importance of eating right becomes even more paramount to our well being.

Our dietary needs change with age. The caloric requirement may be less (as we tend to participate in fewer physical activities), but we still have the same nutritional demands. If anything, we may have more. Poor nutrition among the elderly can lead to a weak immune system, poor healing of fractures and cuts, and muscle weakness.

Whether you’re personally taking care of an elderly loved one, or you know someone in a nursing home and want to confirm their dietary needs are being met, the key is educating yourself on some of the unique concerns.

As with people of all ages, they need a balanced diet including vegetables (aim for 2-3 cups daily), fruit (2-3 servings daily), proteins, healthy fats, whole grains, water, and all the requisite vitamins and minerals.

But the nutritional demands of the elderly do include some that are particular to the age bracket.

We all need protein. It’s a crucial building block for the body, used in a wide range of repair and maintenance functions. As a rule of thumb, healthy adults over the age of 50 (without diabetes or kidney disease) need about 1.5 grams of protein per kg of bodyweight each day.

Caloric intake tends to come down as we get older. Women over the age of 50 need about 1800 calories per day on average, although that can be as low as 1600 if they get little to no physical activity. Men can get by on as little as 2000 if they are no longer active, but somewhere between 2200-2400 is ideal for those still engaging in an average amount.

There are some vitamins and mineral deficiencies common among the elderly because of changes in behavior, diet, or activity.

• Vitamin B6 helps with proper nerve and brain function. Good sources include fortified cereals, poultry, fish, beans, dark leafy greens, and oranges.
• Vitamin B12 is key to brain and nervous system function, as well as red blood cell formation. A deficiency can lead to anemia among other things. Good sources include fish, meat, poultry, eggs, milk, and milk products.
• Folic acid helps protect against heart disease and some cancers, and aids in cellular growth and regeneration. Good sources include dark leafy greens, broccoli, avocado, lentils, and citrus fruits.
• Vitamin D helps the body absorb calcium, but as we age, our skin does not produce it from sunshine as effectively (not to mention that we spend less time outside). Milk, eggs, oily fish, and fortified juices are all excellent sources. Experts suggest that we get 800-1000 IUs per day.
• Potassium reduces high blood pressure and the risk of kidney stones, as well as being necessary for the heart, kidneys, and other organs. Bananas, prunes, plums, and potatoes with their skin on can help us get the recommended 4700mg/day.
• Calcium is critical to proper bone and teeth maintenance, and the need actually increases with age. The World Health Organization suggests that adults over the age of 50 get 1200mg/day from a variety of sources including milk and dairy products, leafy greens like kale, broccoli, almonds, and tofu.

Our sense of thirst typically diminishes with age, so the elderly often do not realize they’re dehydrated as quickly as younger individuals. Ensure they’re drinking plenty of liquids – especially water – to keep them healthy.

Most adults do not get enough fiber in their diet. It’s responsible for healthy bowel movements, and improves blood sugar control by slowing down how fast food empties from the stomach. It also leaves you feeling full for longer without adding unnecessary calories. Women over 50 should get about 21g/daily, while men should aim for a minimum of 30g/daily. Found in whole grains, wheat cereals, barley, oatmeal, beans, nuts, vegetables such as carrots, celery, tomatoes, and fruit, an increase in fiber has shown a decreased risk of death (anywhere from 12-15% less for every additional 10g of fiber).

A few other “best practices” for elderly nutrition:

• Omega-3 fatty acids reduce the risk of arthritis, heart disease, and some cancers. It’s found in flaxseeds, fish, and walnuts, among other things. 1-2 servings of omega-3 rich fish is recommended.
• Limit both sodium (can lead to high blood pressure) and sugar intake.
• Include healthy fats from nut butters, nuts, seeds, olive oil, and whole grains (brown rice, whole wheat bread, oats, whole grain cereal).

Discuss your nutritional concerns and questions with the director or kitchen manager at your loved one’s nursing home. Ask to see the daily or weekly menu, and remember that variety is good for everyone. Mealtimes should be social – whether in a care facility or private home – to encourage and support healthy eating habits, and eliminate the desire for anyone to eat alone in their room (where it can not be monitored).

Observe their eating habits. Be mindful of weight loss and other warning signs like poor healing, easy bruising, and dental issues. They may indicate malnutrition.

Finally, supplements should only be considered with a doctor’s support, as vitamin toxicity is a potential problem with older individuals.

Proper nutrition will ensure they spend their golden years in the pink of health. Do your part to make it happen.