14 Mar Malnutrition and Dehydration in Older People
Combating malnutrition and dehydration is a priority concern for carers of older people. Poor health and disease is often a direct result of people not having the right foods to eat and drink. By the same token, emergency hospital visits, treatment delays for other conditions, and reduced recovery outcomes are all linked to malnutrition and dehydration.
To ensure good health outcomes for older people, we must be alert to the factors involved and active to support healthy eating and drinking.
Malnutrition Risk Factors
People are more prone to eating and drinking issues leading to malnutrition if their situation involves particular known social, medical and physical factors. Carers need to know these factors which increase the malnutrition risks, and then take appropriate action to support older people.
For example, the known Social Factors linked to malnutrition include:
- Living alone with little or no support
- Cooking skills or knowledge of nutrition
- Drug or alcohol dependency
- Living in poverty
In addition, the identified Medical factors which contribute to malnutrition are:
- Dementia and other mental health conditions
- Dysphagia – difficulties with swallow
- Conditions causing a lack of appetite – stomach ulcers, cancers
- Diarrhoea or vomiting
- Eating disorders
- Inadequate ability to absorb sufficient nutrients from foods due to other reasons
Lastly, there are known Physical Factors which cause problems around nutrition and eating such as, mobility issues which are preventing the ability to cook or shop, if someone has loss of appetite due to loss of smell or taste, or if there are problems with teeth/dentures.
If any of the above factors apply carers should realise the risks around lack of nutrition, and the connection with serious health problems. For instance, we know that malnutrition causes:
- Increased risk of Pressure Ulcers
- Reduced ability to fight off infections or to heal wounds
- Increased Falls Risk due to decreased muscle mass
- Effects on the heart, brain etc
- Self-neglect, reduced mood, reduced social situation
- Emergency A&E visits
- Delays in scheduled operations
Hydration – essential to life
Water and good hydration is essential to keeping healthy and preventing or treating common conditions for older people. For instance constipation, incontinence, and urinary tract infections are all complications of dehydration. We must help vulnerable older people maintain adequate hydration as without it leads to acute problems for them such as:
- Dizziness and confusion increasing fall risk
- Low blood pressure
- Management of Diabetes
- Pressure Ulcers
- Kidney stones
- Heart disease
- Mental and cognitive impairment
- Dental infections
People must have access and be encouraged to consume regular hot and cold drinks throughout the day. If water is boring for people we can use cordial to add a taste to make it nicer for them. Coffee should be avoided as it is a diuretic.
We support older people to get proper nutrition and hydration by way of the types of food and drinks we make available to them. Talk to people about their preferences and take into account their specific needs and preferences.
- How many meals do they prefer?
- When do they prefer the main meal to be?
- Are there cultural or religious requirements to be observed?
- Foods to be avoided because they are not liked?
- Any known allergies?
What we can do
We can ensure people reach the daily recommendations for protein, minerals and nutrients by way of the food we offer across the day. Older people need access to a variety of small and frequent meal opportunities and drinks throughout the day. For instance, across the breakfast, lunch, evening meals and two snacks during the day we should aim for:
- Fruit and Vegetables – 5 servings
- Bread, rice, potatoes, pasta- starchy food – 5 servings
- Milk and Dairy – 3 servings
- Meat, Fish and protein alternatives – 2 servings
- High fat or sugar content foods may be offered – this depends on individual needs
See here for an example of a balanced menu for age 70 female. If you need support to care for an older person at home contact 4992201 for info on how we can help.