Updated January 2023
There are so many factors that can influence our relationship with food as we age. For example, while caring for seniors after PSW training, you will meet patients who have lost their sense of smell and taste, making mealtime far less appealing.
Others will be impacted by medication side effects that reduce appetite. In some cases, an illness or disease will make eating painful or unpleasant—and certain patients will make poor food choices that result in weight gain and a host of related health problems.
Poor nutrition is a far more serious issue in Canada than many PSWs realize. A Stats Canada report reveals that one-third of Canadian seniors suffer from malnutrition. That's 34 per cent of Canadians age 65 and over at risk of malnourishment.
How can personal support workers help ensure the seniors they care for eat a balanced diet? What should you know about tailoring diets to common issues among older patients?
Read on for practical tips, food suggestions, and helpful meal-planning advice.
1. Dealing with sudden weight loss/patients who don't eat well
Sudden senior weight loss is fairly common among people age 65 and over. Experts estimate at least 1 in 5 older patients suffer from this problem, often without realizing the serious impact on their overall health.
What should students in PSW training know about dealing with sudden weight loss in an older patient? First of all, be aware of the most likely causes, including:
- Cancer
- Gastrointestinal disease, such as celiac disease and ulcerative colitis
- Depression and other mental health disorders (this is a common cause of rapid weight loss cases in nursing homes)
- Poorly fitted dentures that make eating painful
- Mobility issues (simply walking to the kitchen/dining hall may be difficult, so the patient skips meals)
- Hyperthyroidism
- Diabetes
It's crucial to report significant and sudden changes in weight to your supervisor right away, so the patient can be assessed by a physician.
Once any serious physical or mental health conditions have been ruled out or treated, PSWs can try several techniques to ensure reluctant patients get the daily nutrition they need. These include:
- Serving smoothies that pack in healthy ingredients, like blended protein shakes with fresh fruit, veggies, flax seed oil, and wheat germ
- Mashing or pureeing solid foods so they're easier to eat—or adding gravy and sauces to soften meals
- Serving more naturally soft foods, such as oatmeal, cream of wheat, boiled potato, steamed veggies, soup, quinoa, pasta, etc.
- Suggesting the patient eat smaller meals, more often (such as every two or three hours)
- Setting aside extra snacks that will be easy for your home-care patient to eat on their own (trail mix, Greek yogurt, cheese slices with whole grain crackers, fruits, apple sauce, protein shakes, etc.)
2. Ideal diet for patients with osteoarthritis AND/or weight gain
It is very likely that the older patients you work with after PSW training will have some degree of osteoarthritis (OA). Statistics Canada reports that in 2017, roughly four million Canadians were suffering from OA. Rates were highest among seniors, particularly women in their 80s.
What is the greatest, manageable risk factor for OA? Obesity. Nutrition can play a key role in lowering weight, reducing painful OA symptoms, and protecting against other weight-related conditions like diabetes and cardiovascular disease.
Dietary suggestions for weight management and OA pain reduction include:
1. Incorporating seven to 10 servings of fruits and vegetables each day, with a special focus on orange and green options, like broccoli, cantaloupes, and carrots (try blending into soups and smoothies to pack more of these into your patient's diet). The antioxidants found in these foods may help reduce inflammation and decrease the breakdown of cartilage in the joint.
2. Swapping white bread and white rice for whole grains—like brown rice, barley, oats, and whole wheat bread. These foods also contain higher levels of antioxidants.
3. Avoiding saturated and trans fats, like butter, lard, cream, fried foods, and baked goods. Instead, opt for healthy unsaturated fats, like nuts, salmon, and olive oil.
3. Protecting your patients from dehydration
Did you know that as we age, we don't feel thirsty as often, even though our bodies still need the same amount of liquids? This is why many seniors don't drink enough water and often suffer from dehydration. They simply don't realize they're thirsty.
It's important for PSWs to remind patients to drink often throughout the day, and keep an eye out for symptoms of dehydration—such as dark yellow urine. If your patient is well hydrated, their urine will be almost clear.
Suggestions to encourage your patients to drink more liquids include:
- Keeping a bottle of water next to them at all times
- Reminding them to consume nine to 12 cups of liquid each day (this includes water, tea, milk, soup, and juice)
- Ensuring they have a drink with every snack and meal you serve
Well-balanced nutrition is absolutely central to effective senior care. You'll learn the fundamentals of meal planning in PSW training, but throughout your career, it will be important to stay on top of new research on diet, aging, and disease prevention.
Remember: PSWs play a key role in ensuring patients eat well. They understand the value of good nutrition, each and every day.
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