When you notice that your elder parent, grandparent or loved one is starting to look frail or thin, what is the first thing that comes to mind? Often we think of nutritional health and start planning to add calories and protein to the diet. A common quick and easy solution is to buy liquid nutritional supplements such as Boost or Ensure. But are these the answer?
Not always. In fact, lately health care professionals have become concerned with the over-use of liquid nutritional supplements for our seniors because they can too easily take the place of healthier foods due to convenience.
As a concerned family member or care provider, what can you do to best support your loved one? As part of my own practice in long-term care, there are three key questions that I aim to address during a nutrition assessment before setting therapeutic goals and creating the nutrition plan. They are questions you too can ask with the help of health care providers.
What is the root cause?
Before discussing possible changes to diet and seeking quick solutions, it is important to address the root cause of the issue. Weight changes suggest that something more is going on; there is often a bigger picture to consider. It is important to look at all aspects of the individual's physical, emotional, nutritional and mental health status aside from unplanned weight loss. For example, I look to see if my patients have difficulty chewing or swallowing, or if they are experiencing pain from pressure sores or wounds. I consider potential side effects from certain medications including drowsiness or reduced appetite. Signs of depression, changes in cognitive or physical function, underlying chronic issues and bowel issues can also affect nutrition intake or weight. Think beyond weight and ask questions about potential root causes.
What are the short and long-term goals?
Next, set specific nutrition goals with your loved one if possible. Include them in decision-making and aim for a realistic plan that meets the needs and preferences of the individual (and care provider as appropriate). Specific goals may be directly or indirectly related to food and nutrition. For example, he or she may benefit from batch meals that are easy to re-heat or may require one-on-one assistance during meals if they struggle to use utensils. Either way, ensure they are part of the planning process.
Can we optimize the diet with favourite and nutritionally dense foods?
Finally, look to certain foods or mealtime strategies to boost protein, fat and nutritional value of the diet. Preferably, we want most of those calories to come from nutritionally dense foods as opposed to less nourishing options such as cookies, pastries or potato chips. As a dietitian, I assist families with ways to incorporate safe, quality foods that also meet the needs and preferences of their loved ones.
While liquid nutritional supplements continue to play a role in optimizing nutrient intake for our elders, they may not be effective strategies for every situation if the cause of the issue has not been addressed. We should also consider that they might not even enjoy the taste of these supplements. Get to the root cause of the issue, make a plan, and add quality fat and protein from favourite foods that enhance nutritional status and quality of life.
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Brooke Bulloch is a registered dietitian and spokesperson for Dietitians on Canada. She owns Food To Fit, a private nutrition practice in Saskatoon, SK, and supports the areas of long term care, chronic disease prevention, weight loss through whole foods and healthy behaviours, vegetarian diet planning, and sport performance.