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Eating well and enjoying one’s food is an essential aspect of daily living. Having a balanced diet that meets our individual nutritional needs helps boost our physical and mental health and improve our quality of life. However, as we get older, our appetite and eating habits can change, so achieving the right nutritional balance and maintaining an adequate weight can become a challenge, particularly if we develop health conditions such as diabetes or dementia.
It is a simple fact of life that older people are often less hungry, potentially leading to unintentional weight loss and nutritional deficiencies.
The reasons why are not always obvious but can include changing levels of hunger or fullness hormones, underlying illness or depression, boredom or apathy. Sometimes developing a particular health condition makes us lose our sense of taste or smell, so food becomes less appealing. Loss of appetite can also be caused by medication or a physical issue with teeth or dentures which makes eating tricky or painful.
Most older adults move around less than before and therefore require fewer calories each day, although, interestingly, our need for certain nutrients actually increases. It’s normal to lose muscle mass and strength, too, which can make us prone to serious injuries, such as fractures, from even relatively minor falls.
So it’s important that we eat plenty of healthy staples such as fruit, vegetables, fish and lean meat. These provide important nutrients including protein and fibre, calcium and vitamin D (essential for good bone health) and vitamin B12 for the blood and nervous system.
We understand that meals are an incredibly important aspect of our residents’ day, so it’s all the more important that your eating experience is as nourishing, healthy and enjoyable as possible. Fulfilling your personal eating and nutritional needs forms a major part of our drive to offer the best possible person-centred care.
Just like you and your relatives, our kitchen and catering staff are part of our Canford family and enjoy getting to know you and learning what you most like (and dislike) on your plate as well as details of any special dietary or cultural requirements, food allergies/intolerances or the need for a puréed diet. This will all be recorded in your care plan alongside your medication and other information your care.
Our chef, kitchen staff and dieticians from our partner Caterplus plan and provide home-cooked, nutritionally balanced meals using fresh ingredients. These contain the right mix of protein, carbohydrates (including fibre), healthy oils and fats, vitamins and minerals. Sight and smell can play an important role in stimulating appetite, so we present meals attractively and make them enticing with different flavours, colours and textures. It may sound obvious, but we also ensure that hot food is served hot and cold food has been properly refrigerated!
Our menu changes daily and we offer a choice at every mealtime. If none of the day’s dishes appeal residents can request something else. Lunch is usually the main meal of the day with a lighter evening meal, but you can swap them around if you prefer to have your main meal in the evening. Having some meals in bed (breakfast is a popular choice) is fine too.
Not everyone feels like eating three full meals a day, so we provide a selection of healthy and visually tempting sweet and savoury snacks including fresh fruit and home-made cakes, which are also available as puréed versions. These are popular with residents, especially those who prefer to graze throughout the day (and sometimes the night) to meet their nutritional requirements.
A wide selection of unlimited hot and cold drinks, fruit juices and smoothies is also available 24/7.
We use person-centred portion control to help us meet each resident’s dietary needs. This is as much about ensuring a healthy diet as it is about weight maintenance. Elderly people often lose weight unless they are being cared for in bed, and then they may be at risk from gaining it.
Portion sizes are therefore important. We use a special range of different-sized utensils to serve up the right amount of food for each person, without having to worry about whether it is too much or too little. These work equally well for normally textured food as well as for modified food, such as ‘textured’ or puréed meals for people who have chewing or swallowing difficulties.
We use person-centred software to record what all our residents eat and drink each day, and exactly when. We also closely monitor your weight and dietary needs each month, recording any changes on your care plan.
People with dementia often experience physical, emotional and behavioural changes that can make mealtimes, and receiving the right nutritional balance, more challenging. Even in the early stages, changes in the brain may result in people forgetting to eat or becoming confused mid-meal. They may also become restless, finding it hard to sit down for long enough to finish a full meal. They therefore need a diet high in fat and energy to replace lost calories and help them maintain their weight.
Sometimes, a formerly comfortable chair and table may themselves become unwieldy, the surrounding décor or noise levels may grow uncomfortable or distracting while cutlery may be too difficult to handle.
Our kitchen staff often prepare finger foods for our residents living with dementia. This can be easier to eat without having to worry about trying to use a knife, fork and spoon. Our sweet and savoury snacks are nutritious, too, and designed to appeal to people with dementia.
As the condition progresses, people can have problems with chewing or swallowing, also known as dysphagia, and this can affect how they swallow certain types of food or liquid – or even anything at all. Particularly common in the more advanced stages of dementia, dysphagia increases the risk of choking and repeated chest infections or ‘aspiration pneumonia’, as food or liquid ‘goes down the wrong way’. The added complication is that communication problems may make it hard for someone to indicate that they are having trouble.
Our staff receive regular training in what to do if someone is choking and we base our menus on guidelines provided by the International Dysphagia Diet Standardisation Initiative (IDDS) to ensure safety.
We prepare our meals in a modified format that so that people with swallowing difficulties can still enjoy delicious and appetising meals. This might involve simply mincing food or providing it in smaller bites so that the food doesn’t need to be chewed. Puréed foods might be ‘thin’ or ‘thick’.
Thick puréed foods are of a consistent, soft texture while still being solid enough to eat with a fork. They are created with each element of the meal separate from the other so that the different flavours are still distinct. All meals are served according to the right portion size for each person.
Older people are also more prone to dehydration, largely because they often do not feel thirsty. Water makes up 60% of the human body so staying hydrated is extremely important at any age as our bodies constantly lose water, mainly through sweat and urine. The body detects thirst through receptors in the brain and throughout the body. As we age these may become less able to recognise thirst, while our kidneys (which help the body to conserve water) also lose function. People with dementia, for example, become unable to realise that they are thirsty.
Whatever the reason, it is vital to ensure that older people remain sufficiently hydrated.
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