How to cope with difficult eating issues in elders: some tips
Often, whether from physical problems or lack of appetite, eating loses its appeal to frail elders. Regardless of the reason their loved one has for not eating well, caregivers can be stressed by the situation. We know the value of nutrition. We know the feeling of hunger. We want to help them stay nourished.
Professional caregivers, such as those in nursing homes, also struggle with the issue. However, nourishment needs to be provided in the right way, which often depends on why the person has trouble eating.
Following a stroke, many people can have problems properly chewing food and/or swallowing. The same thing can happen in mid-to later stages of Alzheimer’s and Parkinson’s disease. Even if the person wants to eat and feels hungry, the physical effort may seem too much trouble. It’s up to the caregiver to help by providing meals that are as appealing as possible, which is, of course a challenge in itself. Some advice:
- According to an article in Nursing Times, food should have fragrance and flavor, and as much texture and density as the person can physically handle. Even if the food must be pureed, it should have texture to stimulate appetite.
- Liquids often need thickening to keep the person from aspirating liquids into the lungs, which can cause pneumonia. Tilting the person’s head forward can help, as well.
- Temperature is important for stimulating appetite, as well as not injuring the person if food is too hot.
- When feeding someone who needs help transferring the food to his or her mouth, engage with the person directly and lovingly.
- Move slowly and allow him or her to swallow each bite or sip.
- Give liquids in between bites if that helps. Prompt gently when needed.
- Portion size may need to be adjusted. Many elders need smaller, more frequent meals.
- Stay calm and don’t let your worry about the person not eating make matters worse. If they don’t want to eat at a planned meal, you can try again later.
Lack of appetite
End stage dementia leads to problems that are physical and often the ability to chew or swallow is lost. However, lack of appetite can also stem from lack of interest, depression or a failing digestive system. It’s difficult for a reasonably healthy family member who gets hungry when the body needs food to understand that a loved one who is beginning the death process may not want food because he or she can’t digest it. Both of my parents suffered weight loss from lack of appetite and interest in food during their last months of life. During that time, I discovered a few things.
- My mother generally preferred cold foods to hot. She loved fresh fruit. Think about what would “go down easy” if you were recovering from stomach flu. Nice, cool pieces of apple? Juicy strawberries? Pitted cherries? These foods aren’t going to put weight on a person, but discovering the kinds of food the person will eat, and maybe even enjoy, is important. For mom it was fruit. For your elder it may be other types of food. Maybe Jello or yogurt will do the trick. Experiment without always worrying about balanced nutrition or a food battle, and see what happens.
- Good teeth or properly fitting dentures are ideal. The reality is that many elders either have decaying teeth, or they have ill fitting dentures, like my dad. Do what you can to remedy problem teeth.
- Keep portions small. When my mother saw a loaded plate of food, she’d immediately turn away. A small dish of fruit, followed by a piece of toast and later by a nutritional drink could generally be managed.
- The advice of a dietitian is recommended in any case where a person is not getting adequate nutrition. He or she may have sound ideas that you can experiment with.
Remind yourself that your elder will not likely have the appetite you have. Respecting the person you are trying to nourish is important. Don’t let your worry make matters worse. Be helpful, encouraging and offer choices. Ask for professional advice. If a person is nearing the end of life, hunger many not be present for good reason. A medical person can help you understand this process. It’s tough knowing that our loved one no longer wants or even needs food, but understanding the reasons can help with acceptance.