Support with food can help a lot

This 42kg pile of food waste found in rubbish bins during the audit is a little more than half...
Helen Gibbs offers some advice on how to help older adults keep eating well.

This week is Malnutrition Awareness Week 2021 and the theme is ‘‘Everybody’s business’’.

Malnutrition conjures a certain image for most people but dietitians have a more subtle view of this term. Malnutrition means poorly nourished and there are many forms of malnutrition.

One group which is at high risk of malnutrition is people aged 75 years and older. There are many reasons why, but a major reason is eating alone. Humans enjoy sharing food. When we are eating by ourselves day after day, we get bored with it. We take less care about selecting, preparing, and eating food.

Meals on Wheels is a partial solution. It takes care of the selecting and preparing food. It doesn’t solve the issue of solitary eating. It is important we all support older people we know to keep eating well, especially when we are experiencing disruptions in our usual habits such as Covid-19 restrictions.

Unplanned weight loss

How would you know if someone was at risk of becoming malnourished? Unplanned weight loss is a major indicator of problems. You might see their clothes are not fitting as well, their face looks thin, or they may mention they are not enjoying their food as much. Anyone who has unplanned weight loss should see a doctor. Weight loss could be a sign of other health problems. If the doctor has checked for other health issues and they are healthy, then the problem is not eating well.

Talking about food and what you can do to help them eat better is useful. They might be struggling to get their shopping. It’s possible they are finding it too difficult or tiring to cook. Finding quicker and easier options can help. See below for ideas on quick and nourishing meals.

Share a meal

If you can, making time to eat with them on a regular basis is useful for their wellbeing. Sharing a family meal will give the spice of company to their meal. If we can’t be there, we can plan to share an eating time using technology.

Some older people find it hard to make social connection, especially after retirement and bereavement. Age Concern, Grey Power or the Over 60s Club in Dunedin can help them find new people to enjoy spending time with and these organisations and others do have regular shared meals.

If someone has lost substantial weight or is still losing weight, they will be encouraged to eat more. Many older people have smaller appetites so may be reluctant to have more food or extra snacks. Adding extra energy (calories) to existing meals is far simpler (ideas below).

Some people are concerned that adding fat will damage their health. We need to consider the health risk of low body weight as higher in older people than the risk from elevated cholesterol.

Many older women are delighted to get back to a weight they were when they were younger. Unfortunately, this weight loss increases their risk of falls, hip fractures, and long hospital stays when unwell. Older people are generally healthier a little bit heavier than younger adults.

Sometimes people are prescribed drink powders or small containers of high-energy drink. These should be used between meals as snacks. They can be a useful temporary solution, after surgery or time in hospital but many people find them overly filling and boring.

Weight loss is not inevitable in old age, and unplanned weight loss increases the risk of poor health in old age. Being aware and supporting your kuia and kaumatua to eat well is a way of caring for their health.

Quick meal ideas

  • Eggs (scrambled, boiled, fried, omelettes, et cetera) — there is no limit on the number of eggs per week. Serve with wholegrain or wholemeal toast. Ideally add some vegetables such as onions, mushrooms or tinned tomatoes.
  • Baked beans on toast.
  • Cheese, sweetcorn and onion toastie.
  • Tinned salmon or tuna or sardines or grilled cheese on toast with some vegetable rich soup.
  • Instant noodles with some frozen vegetables and tinned fish (salmon, tuna or sardines).
  • The many ready meals in the supermarket — but add some frozen vegetables for balance.

Adding energy (calories) to everyday food

  • Use full-fat milk and add extra milk powder to the milk for more protein and energy (2 Tbsp milk powder per 1 cup milk).
  • Have milky coffee and milo rather than drinks made with water.
  • Be generous with spread or butter on bread, crackers, scones, pikelets, or crumpets.
  • A dob of spread or butter on vegetables or potato.
  • Have chocolate and cream biscuits rather than plain biscuits.
  • Choose creamy yogurts, ice cream and milk puddings for desserts.
  • Add plenty of mayonnaise and high fat dressings to salads.
  • Have cheese and crackers for snacks, select the crackers with a shine — this means they have more fat in them.

- Helen Gibbs is nutrition development adviser with WellSouth Primary Health Network.

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