Eating well - advice for carers of older people

E for Eating well is in the run up to publication of my new book Carers and Caring; the One Stop Guide; how to care for older relatives and friends . I am sharing some of the practical solutions learned from research and experience. If you think any problems have been missed you can email me and tell me, and I’ll make sure they are covered in the next edition and online on my website at www.juneandrews.net. 

Eating well 

For older people, eating well depends on a range of things including their health, any medication that they must take, any problems with teeth or swallowing that affect what they can have to eat, plus other underlying issues. 

To find out what the person should eat, you may get help from a dietician. You can contact them at a hospital, or via General Practice, and community dieticians are often able to help in care homes or at home. In older people the appetite is often small, and they will require encouragement or even supplements. Sometimes people are a bit quick to reach for supplements. There are things you can do like adding a dollop of cream that will increase the nutritional value of small portions.

It’s important to emphasise the benefit of fibre in meals. Constipation is something that can make life miserable and uncomfortable and spoil anyone’s appetite. It also leads to confusion and illness in very old people. At a time of life when opportunities for fun may be limited, people should be allowed to self-indulge a bit, and so they might not want always to stick to one of those “healthy” Mediterranean diets. However that diet does seem to carry extraordinary health benefits, including fibre from which comes from plants, fruit and vegetables.

Keeping up fluid intake is important, and you can help with that by making sure that all the things that would encourage drinking, such as the teapot and jugs of water, are clearly visible and the person can help themselves. Leaving a flask of tea handy can make things easier. 

Eating in company can make the person who has not been eating enough more likely to take in more food. Eating is an intensely social activity. 

When I would offer a cake to my granny, she would refuse it even if I encouraged her. A few moments later, when she saw everybody else was taking one, she would then take one for herself. In encouraging her to eat I ended up putting on weight. Because I had to eat to keep her company! Another trick was to order a side order of chips for myself when we went to a café. I would then say that I didn’t have room for them, and she would quickly eat them up with ketchup because she couldn’t bear the thought of me ‘wasting’ perfectly good food. (Ailidh, 23)

You can buy crockery and cutlery that helps people with sensory and physical impairments to eat and drink independently. You will find ideas on the AskSARA website or from an occupational therapist (see contact details in Useful Contactsand Resources of the book). Start with establishing the best place to sit up while eating, and the ideal position of the plate, cup and cutlery. Non-slip place mats help stabilise the plates, and plates with a raised edge can prevent food spilling while the person is scooping it up. Angled spoons and forks are great if the person has restricted movement in their shoulder or arm. You can buy an electronic stabilising handle for cups, and attachments that will stabilise a spoon or fork if the person has a marked tremor that makes it hard to eat independently. There are major advances in automated eating devices, and though some of them are hugely expensive they can be rented or leased and may sometimes be provided by the local authority.

Appetite will be stimulated by attractive smells. The right aroma can increase the appetite in people who do not think they are hungry, even if the person does not notice the smell. There have been many attempt to create those attractive odours artificially. You can buy a device that will release food fragrances in the living space, which is meant to get the gastric juices flowing, so the person will anticipate and welcome food. The smell of chocolate, coffee or hot apple pie is used commercially to increase trade in shops and restaurants. Essential oils work in a diffuser machine, just like a domestic air freshener you might use at home to cover other smells and it has been suggested that they can increase appetite, but everyone is different.  If someone has a poor appetite, being around delicious smells coming from the hob or oven and helping with preparations in the kitchen can tempt them to try what you’ve been cooking. 

There is much more about eating and drinking in  Carers and Caring: The One-Stop Guide: How to care for older relatives and friends - with tips for managing finances and accessing the right support  available for pre-order or from all good bookshops from May 2022

Three hints:

1.     Eating alone is hard for some people

2.     The mechanics of eating can be helped with special cutlery

3.     The smell of cooking can improve anyone’s appetite