By LoRayne Haye M.S.C.N.
The “Grey Tsunami,’ is the nom de plume that gerontologists have given the current state of our aging population. According to the U.S. Census Report “The older population—persons 65 years or older—numbered 46.2 million in 2014 (the latest year for which data is available), representing 14.5% of the U.S. population, about one in every seven Americans. By 2060, there will be about 98 million older persons, more than twice their number in 2014.” (1)
In 2009 on the heels of the economic down slide, I found myself taking care of both my aging parents whose health at 83 years of age was declining. Although, I had over a decade working within hospitals, and skilled nursing facilities with dementia and Alzheimer's patients. Little of my professional background seemed to prepare me for the intimate responsibility of care taking my mom and step-dad within their home.
The following are recommendations for people 80 years and above who are still living at home, and for those who have dementia or Alzheimer's.
There’s numerous factors which can lead to weight reduction in the elderly population, such as grieving the loss of a significant other, living alone and isolated, as well as depression, which commonly accompanies the aforementioned. I chose to address the food end of the equation regarding weight loss. If your loved one loses 5% of their weight within a 6 month period--that is definitely significant, and should be considered a red flag. Even though, most research indicates 5% weight loss in one year, I beg to differ, as once an elderly person loses weight, it can be difficult for them to gain it back. Additionally significant weight loss is a risk factor, that comes with a high price tag. Such as weakness within the muscles, which can contribute to falls, and fractured bones. Do follow up and get them to make an appointment with their physician, or make it for them. (2)
Appetite Decline due to Aging
Numerous studies have documented appetite decline in the aging population, which can range from prescription meds that inhibit appetite, to low nutrient status such as vitamin B-12, and the consort of B-Vitamins, as well as Zinc.Between 15-30% of the older generation experience 'anorexia of aging.' Needless to say there's a host of reasons as to why this occurs, as I mentioned before. Yet, the commonality among of these is the decline in weight, with all of these reasons leading to nutritional deficiencies as well as loss of energy. (3).
Food Containers: With age comes frailty—although they’d never admit it—being part of the ‘greatest generation’ and all. Take a look at what resides in their cupboard and refrigerator. If there’s a multitude of cans and containers, and they’ve been there since the last time you visited. More than likely they haven’t been able to open them. Even small yogurt containers can be challenging for an elderly person to open, due to arthritis and vision challenges. I chose to handle this with my parents by saying, ‘hey would you like some yogurt?’ If they said yes, I would place said container on the table and wait………… If they asked me to open it—well that says it all. Clearly, they have to rely on another to get to said food. So what are the options? You can go to smaller containers, which might work. However, what I found to work best was removing the contents into a small dish, covering it and placing it at a level they can reach in the refrigerator. Arthritis runs rampant in this age group, and many have it in their hands. Which makes opening just about anything difficult or impossible. Those with Rheumatoid Arthritis will have an even tougher go of it, even when using a 'grip assist' for opening jars. Do make a mental note of what their hands look like, and if needed, have them assessed by a professional who may be able to offer up exercises as well as various therapies for their hands. Additionally, many of these professionals can provide guidance in how best to set up their kitchen, pantry and refrigerator to specifically meet your elderly parent’s needs.
Dentures: Although, it’s not always visibly apparent. A telltale sign of not being able to eat, is ill fitting dentures. Observation is key here; Are they able to chew their food? If not then it’s time to get the dentures checked and time to get a base line weight. Their doctor should have their last weight on hand, and I would recommend keeping a note of their weight and date it's taken in your smart phone. Then follow up with weekly weighing. If you get their weight from a scale they have at home, and compare it to the one their physician has, there may be a significant variation. Since scales vary and most physicians’ offices have their scales calibrated annually or more often. If your parents haven’t had an annual exam, now would be a good time to schedule one..
Dementia: It creeps in quickly. Again, observation is key here. Although memory loss is what’s discussed most often, it’s far from the only item that can head south. The ability to chew and swallow is initiated and coordinated by the Central Nervous System (CNS). Taking note of consistent coughing or throat clearing while eating or drinking, is a red flag. Do schedule a doctors appoint ASAP and an evaluation by a qualified Speech Therapist (SLP), who can make recommendations for various textures of foods and liquids. This will save your loved one the angst of experiencing a trip to the E.R for a choking episode, or what often comes in the after math a case of pneumonia. Since particles food that are choked on can end up in the lungs, which results in infection. This can be a tricky area, since as I mentioned prior that ill-fitting dentures can lead to these symptoms. Needless to say, asses the dentures first.
LoRayne Haye M.S.C.N. is the Founder & CEO of Eating-4-Energy a nutrition consulting company based in Carlsbad, California. She has a diverse background which spans over 20 years in the industry, which includes being a nutrition manager and auditor for the health care and restaurant industry, as well as building world class nutrition departments for luxury spas, natural food stores, and gyms. She holds a M.S in Human Nutrition, an A.A. in Applied Health Nutrition & Kinesiology, and an A.A. in Gerontology.
For more information or to book a class, workshop or in-home assessment please contact LoRayne at:
1. U.S. Census Report 2017: Aging Population https://www.census.gov/newsroom/facts-for-features/2016/cb16-ff08.html
2. Shabbir,A. et al. "An Approach to the Management of Unintentional Weight Loss in Older People." (2005) Canadian Medical Association Journal.2005 Mar 15; 172(6): 773–780. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC552892/
3. Pilgrim,A. et al. " An Overview of Appetite Decline in Older People." (2015), European Journal of Nursing and Older People: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/