NUTRITIONAL NEEDS OF THE OLDER ADULT

  1. Calories - 1500-2000 kcal/day to maintain ideal weight; 12% of calories from protein sources; 50-60% of calories from carbohydrates; 20-30% of calories from fats.

  2. High fiber - prevent or alleviate constipation and dependence on laxatives.

  3. Sodium - 3-4 g/day according to cardiac and renal status.

  4. Fats - limit to help retard the development of cancer, atherosclerosis, obesity, and other diseases.

  5. Fluids - 6-8 glasses/day.

  6. Common deficiencies: calories; calcium; folic acid; iron; thiamine; vitamins A, B12, C, and D; niacin; zinc.

  7. Factors contributing to food preferences:
    1. Physical ability to prepare, shop for, and eat food.
    2. Income.
    3. Availability of food if dependent on others.
    4. Food intolerances.

  8. Nutrional table provides interventions for common eating problems in the older adult.
Problem Cause Dietary Interventions

Within the mouth.
Impaired taste buds.
Dental caries.
Chewing difficulty due to:
  • Poorly fitting dentures
  • No dentures
  • No saliva
Paralysis
Metallic taste from medications
Referral for correction of dental problems.
Mouthwash/oral care before meals.
Food prepared to meet patient’s needs (chopped, pureed, soft).

In the upper GI tract.
Swallowing difficulty.
Paralysis due to stroke.
Food causing GI distress.
Thickened and jellied liquids.
Soft, chopped foods.
Small, frequent meals.
Presentation important (how food looks on serving plate).
Avoid expressions such as ‘’baby food” (negative connotation).

In the upper GI tract.
Constipation.
Diarrhea.
Bloating.
Add fruits/liquids to restore bowel function (see bowel training).
Avoid foods that cause diarrhea.
Plan meals at appropriate times for ease of digestion.
Avoid salt.

Psychosocial.
Loneliness.
Meals no longer social event.
Depression.
Anorexia.
Encourage attendance at meal program if available.
Arrange group meals/activities when possible.
Emphasize best nutrition when appetite is al peak (breakfast).
Allow time to complete meal.
Interact with others whenever possible.

In the environment.
Inability to shop for, prepare, or cook food.
Impaired vision.
Lack of resources.
Difficulty in feeding self.
Acute or chronic illnesses present (arthritis, stroke).
Refer to Meals-on-Wheels.
Encourage family involvement; describe how food is arranged on plate.
Refer to social services.
Assess need for assistive devices.
Assess ability to grasp utensils and guide food to mouth.
Open packages and milk cartons; butter the bread; cut meat and vegetables.