How To Recognize Eating Issues in an Older Adult (and what you can do about it)

As people age, their nutritional needs change too. There are many factors that may cause the changes such as scheduled medications, daily activity level or if they are overweight or underweight.

Each older adult has varying nutritional needs, but all seniors have a baseline of certain vitamins they should be getting to be considered healthy. Calcium, vitamin D, vitamin B12, and Potassium are important to include in the older adult’s diet. Without adequate amounts of these vitamins, often determined by lab values, older adults should be prescribed supplements by their doctor. It is also important for older adults to include fiber in their daily diet. It is key to remember to always chase fiber with water.

As memory begins to decline, Caregivers may notice changes in eating habits that are signs their loved ones may or may not be getting the nutrition they need to stay healthy and strong. Some  signs the caregiver may want to look for are:

• Their loved one often says they are “not hungry.”
• When given a plate of food they pick at it or eat small, infrequent bites
• They are turning down their favorite foods
• The home is full of moldy or expired food
• Noticing their clothes are fitting more loosely

When an older adult’s appetite decreases, the causes range from an unexplained loss of taste, cooking skills or lack thereof, forgetfulness of how to cook or read recipes, difficulty with mobility, or how the food smells or looks even though the dish is familiar to them.

It’s important to know that a decrease in appetite may also be a symptom your loved one is depressed. We often think indications of depression are feelings of sadness, loneliness, a loss of interest or hope but when it comes to depression, changes in appetite are also common.

Consequences of not eating are obvious: weight loss, muscle loss, vitamin, and mineral deficits. Other not-so-obvious consequences are dehydration, increased risk for infection, increased risk for falls, exaggerated confusion, and even an increased chance of seizures.

Bringing up the subject of not eating to any loved one is difficult. Many elderly individuals deny losing their appetite or not eating simply because they do not realize it. Family often does not want to bring up the subject just to avoid adding more stress and anxiety onto their parents or loved ones.

Families sometimes want to avoid conflict and confrontation at all costs. The conversation about eating needs to be direct, serious, and questions should be asked in simple yes/no format or able to be answered with simple answers. It is important to get the whole truth about eating habits because nutrition is essential to life and answers may even save your loved one from an unnecessary test. Examples of questions to ask an older adult directly are:

• Are you eating?
• How many times are you eating a day?
• Are you cooking meals every day? Do you have leftovers?
• Are your clothes fitting differently?
• Who is doing your grocery shopping?

There is technology available for families to check in with their loved one if they feel any line questioning is too invasive. Video calling is a great way to see and talk to them regularly and notice any changes to their appearance, environment or behavior. Livindi offers video calling that is designed for seniors with little to no experience with technology. If you believe your loved one might benefit from therapy, teletherapy with Livindi is HIPPA compliant and covered by Medicare. What’s even better is that therapy can be delivered right in the comfort of their home with licensed, professional therapists.

What’s Happening in the Bathroom?

One of the most common illnesses that can result occur from not getting optimal nutrition, especially fluids for the older adult, is a Urinary Tract Infection (UTI). If not caught early, it could lead to a bladder infection, kidney infection or even sepsis. Early signs and symptoms to watch for if your loved one has a UTI are:

• Urinary urgency/frequency
• Pain or burning during urination
• Pain or tenderness in the pelvis, lower back or abdomen
• Fever
• Nausea
• Fatigue
• Hesitation with urinating
• Feeling as though they are not emptying all the way
• Dark/cloudy urine
• Foul smelling urine

More advanced symptoms of a UTI include:

• A fever of 100.5℉ or greater
• Specifically in older adults: confusion, increased anxiousness/agitation, decreased appetite, fatigue, unsteadiness on feet
• Any combination of these symptoms may be seen, it could be only a few or many

It’s difficult to know if an older adult is experiencing any of these symptoms, especially if they live alone. There is available sensor technology that inexpensive and helpful in determining changes in bathroom habits that might indicate a problem. Placing a sensors such as Livindi door sensor on the bathroom, a refrigerator, or entry door, can track when that door has been opened. A regular opening of a refrigerator door means there is a good possibility the person has grabbed something to eat. If, however, there is an increased frequency of the bathroom door being opened, that might indicate they may have a UTI or other medical issue. Regardless,  Livindi will alert the family through a Helper App that there might be an issue. Family can check in with each other through the App to discuss any other indicators of a potential problem and make an action plan together.

After determining an older adult has a UTI, they may need antibiotics. If this happens, it is important they finish the entire course of the antibiotics. It is also encouraged to increase their cranberry juice and water intake. Cranberries or cranberry juice lowers the pH of urine, causing it to be more acidic which makes it more difficult for bacteria to grow.

After treating a UTI, it is important to prevent reoccurrence because for every UTI that occurs, it increases the risk even more for that person to continually keep getting them. Prevention of a UTI can be done by drinking cranberry juice (8 ounces daily), or if physician approved take cranberry capsules (supplements) daily. Older adults should also make sure that their water intake and nutrition is adequate. Another important prevention measure is to make sure that the older adult is staying clean and hygienic, especially in their perineal area.

Managing Issues with Eating

Caregivers may be wondering at what point should a meal delivery service be considered for a senior loved one with an eating problem. If you have even an inkling that they are not getting the nutrition that they need or are seeing any of the signs listed above, it is time to start looking at the community resources that are offered. Seniors may need help with grocery shopping because they are not able to get to the grocery store or would have difficulty walking around the store. During the COVID pandemic, most stores added grocery ordering and delivery services to their list of offerings. Another resource is a service like Meals-on-Wheels, a volunteer service that delivers fully cooked meals to the disabled and elderly. If looking into a service like this it is important for the meals to be well-rounded (include foods from all the food groups), easy to heat up in the microwave, easy to keep in the fridge if they are not eaten right away. Make sure to ask if beverages are included. The best contact for setting up a program like Meals-on-Wheels would be the area hospital or clinic Social Worker or contact the Department of Human Services Office for the city they belong to. When setting up the program, they gather all the information that is needed to delivery healthy and safe meals to your loved one (such as allergy information, special textures, likes/dislikes etc.).

Whether your senior lives with you or If you are a long distance caregiver, taking advantage of available technology is an effective way to measure your loved one’s eating habits to determine if a service such as a meal delivery is needed. Caregiver stress is real but the importance of providing good nutrition for the older adult cannot be understated. Malnutrition will only aggravate many conditions commonly seen in the senior population. Getting help with optimizing your loved one’s nutrition will be essential to taking care of them and you.

If you’d like to learn more about Livindi or our Livindi Behavioral Health services, give us a call at (508) 416-6030.