A guide to elderly nutrition, how to adapt diets and how to meal plan

As we age our nutritional requirements can change. It’s common for older people to begin to eat less or change their meal patterns. In this article, we’ll discuss how changes in patterns can be warning signs for other issues, how getting older can present challenges to diets and how you can achieve healthy elderly nutrition with meal plans.

Chapter 1: Basic Nutrition

Elderly adults are much the same as any other person and should aim for a healthy balanced diet although there are some unique challenges they may face.

What is a healthy balanced diet?

A healthy balanced diet is essential to elderly nutrition

A healthy balanced diet should include a combination of the following six main categories:

Fruit and vegetables

Fruit and vegetables should make up a third of the food we eat each day. Ensuring elderly people are consuming at least five servings of fruits and vegetables in their diet is extremely important. Both are low-calorie food sources, packed with nutrients and fibre.

While we all have our preferences, some of the most beneficial fruit and veg for elderly people include dark-skinned fruits like blackberries, red grapes and plums (all typically full of antioxidants); leafy green vegetables such as kale, broccoli and spinach; and apples. Don’t be scared to stock up on fresh, frozen and even tinned varieties.

Potatoes, Bread, Rice, Pasta and other starchy carbohydrates

Starchy foods are the primary source of carbohydrates for our bodies and typically make up a third of the food we eat-a dietary principal that should remain unchanged for the elderly. Try and include foods that are rich in starch – potatoes, bread, pasta – in lunch and evenings meals, as their fibrous qualities help with digestion and the general health of the intestines. We recommend choosing whole grain varieties where possible.

Beans, pulses, fish, eggs, meat and other proteins

Sources of protein are important for the body. You should try to steer clear of processed meats like bacon and sausages though.

The NHS recommends including fish, especially oily fish, in the diet of elderly people at least twice a week. Research suggests it’s an effective way of reducing the risk of various types of cancer, as well as boosting various cognitive functions and contributing to the health of the eyes. Oily fish such as salmon, sardines and tuna are rich in vital Omega-3 fatty acids as well as being great sources of protein-regardless of whether they’re fresh, frozen or canned.

Dairy and alternatives

Dairy is an important source of protein and calcium that helps to keep our bones healthy. This is especially important for the elderly as it helps to keep bones strong during falls. Falls are the most common reason for the older patients being admitted to hospitals so trying to reduce them should be one of your top priorities. You can read our article on how to deal with falls here.

Oils and spreads

Oils are an essential component of a healthy diet especially for those that are experiencing malnourishment. Try to use healthy fats, specifically unsaturated such as vegetable, olive or rapeseed oils.

Water and other drinks

Water is essential for life and the recommendation is to consume two litres per day. Dehydration can lead to dizziness and falls so making sure you or your loved one is getting enough water should be a top priority.

You can read the full NHS Eat Well guide here.

Common nutrition-related problems in the elderly

There are a number of changes that can affect your eating as you age these include both physical and lifestyle changes and understanding them is important.

Physical Changes

  • Metabolism. Research has shown that after 40 we show a yearly decrease in base metabolic rate. This is the base amount of food/water we need to sustain our bodies when not exercising.
  • Decreased Exercise – In part due to lifestyle and in part due to aches as people grow old, it is common for exercise to reduce as we grow older.
  • Weakened Senses – The elderly have a tendency to lose sensitivity to salty and bitter tastes first so it’s common for them to salt food more heavily than before.
  • Medications and illness – Some medications given to older people can have side effects of appetite and taste. Many drugs can also act as diuretics (increases urine production) or laxatives which can increase the likelihood of dehydration. If you think this might be a problem for yourself or a loved one then you should talk to your GP.
  • Digestion – A slowing of your digestive system as you age can make it harder for your body to process particular vitamins including B12, B6 and folic acid. It may be possible to replace these with supplements but you should talk with your doctor again.

Lifestyle Changes

  • Living on a budget – It’s well documented that dealing with the pressure of limited finances can cause people to make bad decisions with food purchases or seek out easier options but making time to plan food can help to ease this pressure and save money.
  • Loneliness or depression – Feelings of loneliness or depression can cause an elderly person to under or overeat. It can also cause people to sleep for longer and therefore effect when they eat their meals.
  • Death or divorce – Losing a loved one can cause the above depression but it can also have effects on someone’s routines and patterns especially if they weren’t the cook in the relationship. This can lead to a change in diet and mealtimes.

What are the risks to an elderly person?

Increase in fatty tissue

The combination of reduced base metabolic rate and decrease in activity can lead to a build-up of fat which puts an elderly person at increased risk of heart disease, certain cancers, diabetes and breathing problems.

Undernourishment

In contrast to the above point, undernourishment and weight loss as a result of lack of food or vitamins can cause a weakened immune system and make it harder to absorb medication in the elderly. It can also hinder wound healing and make bones more brittle or frail. This can make it harder for elderly patients to recover from even minor accidents.

Dehydration

Dehydration is often called a silent killer. Older people are especially at risk, as, with ages, comes a host of diseases that make dehydration more likely. Reduced sensations like thirst, poor renal function and simply forgetfulness can lead to the elderly not drinking enough. This is compounded by the side effects of many medications, that often act as diuretics (increase urine production) or laxatives.

Mild dehydration can increase feelings of tiredness and affect concentration. Common complications include weakness, low blood pressure, dizziness and increased risk of falls. It also leaves elderly people at increased risk of sores and skin conditions.

Chapter 2: Adapting diets for the elderly

Diets need to be adapted to meet elderly nutrition requirements.

Now that we know about the typical healthy diet and the challenges that older people face, we begin to look at how to adapt a diet to suit their needs specifically.

What if my loved one doesn’t want to make changes?

Making suggestions to your loved one can be a tricky process. It’s often hard to take advice from others on something that most people assume should be obvious. It’s also possible that as someone ages, the food they eat can be one of the increasingly fewer things they control and the suggestion they should change it can be upsetting.

Often if your parent won’t listen to your advice you can try to ask someone they respect to steer them in the right direction. It might be a friend of theirs or their doctor but usually, there is someone that can help.

Dehydration in the elderly

Symptoms of dehydration in the elderly

The first thing to do is to spot it. Dry-mouth, lips and tongue, inelastic skin, drowsiness, low blood pressure, dizziness, disorientation and strong urine can all be signs of dehydration.

At the simplest level, reminding them to drink enough water can be very effective.

It can also help to have them take a full glass of water with their medication and to have a glass or jug of water by their chair or on the side in the kitchen at all times. It may help to have squash or juice in the house to make drinking more palatable.

Beyond that, monitoring and correction is the only real way to ensure they have taken enough fluids. Below is an example of a Fluids and Solids monitoring sheet, that you can download or create yourself, that will allow you to record it all more closely:

A monitoring sheet to helptrack how much water your loved one is consuming

Tips to counteract undernourishment

We know the causes of malnutrition are related to changes in lifestyle, tastes and medication in older adults. Here are some things you can do to try to improve undernourishment.

  • Focus on flavourful foods – Due to the effects of reduced taste as we age making food less interesting, you should look to introduce flavourful food into your diet.
  • Eat with other people – When people eat with others it can be a more sociable and enjoyable activity. It also provides some positive peer pressure to finish the food with the others at the table.
  • Snack between meals – Another way to get some extra calories is to stop for snacks during the day. Eating some fruit or biscuits during the day can put less pressure on big meals.
  • Eat nutrient-packed healthy food – If the quantity of food being consumed is low then ensuring the food that you do eat is nutrient-packed is even more important.
  • Speak with your doctor about medication – It is possible for medication that you are on to affect your appetite so if you believe that it could be causing issues for you then your doctor may be able to suggest some changes.

Tips to counteract overeating/obesity

  • Exercise – Getting you or your loved one out and about will help burn more calories and keep weight down. It also helps your body in general.
  • Entertainment – As with people of all ages, boredom eating can set in when people don’t have enough social or stimulating activities to perform. You can read our article on activities to do with an elderly person.
  • Reduce pre-made meals – If you or a loved one lacks skills or energy in the kitchen then they may be falling back to unhealthier ready meals or frozen foods. You can try and help them to cook fresher food with fewer calories or ask a carer to come in for an hour a few times a week to cook them a meal.

Common elderly vitamin deficiencies

Vitamin D

While small traces of Vitamin D can be found in different foods, its most commonly produced (naturally) by our bodies when the skin is directly exposed to sunlight. It’s essential for keeping the bones healthy, and a general reluctance amongst elderly people to spend time out in the sun can often mean they’re not producing enough of it.

If getting the person you’re caring out in direct sunlight a little more isn’t possible, then we recommend you find a Vitamin D supplement. A daily 10mcg tablet should be ample but always consult with a GP first as this may vary from person-to-person.

Vitamin C

Vitamin C is commonly supplemented alongside diet plans for people of all ages. However, a healthy, well-balanced diet should supply the body with all the Vitamin C it requires. It helps keep your cells healthy, battles high blood pressure and provides immune system support.

We find Vitamin C in a wide range of vegetable and fruits (citrus fruits in particular) and ensuring the person you’re caring for is getting their five or more portions that we recommend above, then a nutritional supplement shouldn’t be required.

Iron

We need Iron in our diets as it helps to produce haemoglobin – a key component of the circulatory system that helps the blood to transport oxygen. Elderly people actually require less iron in their diets than those under the age of 50, and the chance of an iron deficiency, in fact, decreases as we get older.

However, it’s still important to look out for the symptoms of iron deficiency in your role as a carer. It can lead to depleted energy levels, and the potential symptoms might include tiredness, muscle weakness and shortness of breath. If the person you’re caring for is displaying these symptoms then you should consult a GP.

Calcium

Like Vitamin D, Calcium is an extremely important contributor to bone health. The daily recommended calcium intake is higher for over 70’s as the body struggles to process and digest it as efficiently in older age – the intestines don’t absorb it as proficiently and the kidneys struggle to retain it.

If you’re caring for somebody over the age of 70, it’s important to see that they’re consuming around 1,200mg of calcium per day to achieve healthy bones. While it can be found naturally in dairy products such as milk and yoghurt, a nutritional supplement of around 800 IU/day will help strengthen the bones of the person you’re caring for.

Chapter 3: Elderly meal planning

A meal plan can be a good way to help your loved one manage their nutrition

Meal planning can feel like an unnecessary or overwhelming task but it doesn’t need to be. Here we’ll show you a system of meal planning that doesn’t need to be admin intensive. A meal plan is a great way to make sure that your diet balances all the correct food groups, is cost-effective and isn’t wasteful of food so it’s well worth giving it a go.

What is a meal plan?

Meal planning is about deciding what food you want to eat at the start of the week instead of day by day. For a live-in carer, this can be very important so that they don’t need to be going out to the shops all the time.

  1. Select your dinners and their recipes, if needed.
  2. Shop for ingredients.
  3. Prepare those ingredients.

A meal plan doesn’t need to be entirely home-cooked, inflexible or expensive. You can adapt it to however your life works.

Why should you meal plan?

  • Eat better – Making conscious decisions about your meals usually leads to making better choices. Healthy eating is easier when not making decisions as you walk the supermarket.
  • Add more variety to your meals – Trying new recipes isn’t always easy when you don’t have the right ingredients. Meal planning helps you to decide ahead of time so that you can try new things.
  • Save money – Planning ahead helps you to select recipes that rely on the same base ingredients to allow you to save money by buying in bulk.
  • Prevent food waste – Not knowing what’s in your cupboards and what you want to eat inevitably leads to more food waste than is necessary. Only buying what we need is also a good way to stay on top of overeating.

A simple way to meal plan

  1. Look at your calendar, decide how many nights in the next week you need to make dinner at home. You might want to order in some takeaway one night or have Sunday lunch at a family members house.
  2. For the nights that you know you want to eat at home then select what you would like to cook. We recommend selecting a ratio of 4 recipes you already know and 1 new recipe you’ve not tried before. This can mix things up and make your meals more interesting.
  3. Write down all the ingredients you’ll need to complete those recipes and check for existing ingredients in the house. You can now also re-write the grocery list to group ingredients into supermarket categories. This will make it easier when doing shopping.
  4. Set aside time at the weekend to perform some basic meal prep to take the strain off during the week. You can enlist the help of family at the weekends when they have the most time to help. Prep includes chopping vegetables, washing lettuce, pre-cooking some chicken.

Meal planning tips

  • Ingredient Crossover – Pick recipes that have a lot of ingredient crossover, it will help to reduce the shopping list and you can benefit from buying in bulk. For example:
    • Caesar salad, chicken curry, micro roast
    • Spaghetti Bolognese, Chilli, Cottage pie
  • Online Shopping – Make use of online shopping services if you aren’t able to get out to the shops. It can also be a good way to stay organised and stick to the shopping list instead of being distracted by the interesting offers.
  • Switch things up – If you think you’re in a rut with your eating then take a stroll to a local market or greengrocers. Read a cooking magazine or buy some food or spices you’ve not tried before.

Elderly meal plan samples

Here are some example meal plans for the elderly that aim to reduce cost, food waste and cooking times.

Chicken breast base

This meal plan focuses on using a packet of chicken breasts to provide healthy meals throughout the week. You can pre-cook the chicken and pre-chop the veg at the start of the week to ease the burden throughout.

Monday – Chicken Ceasar Salad

  • Pre-cooked chicken breast
  • Caesar dressing
  • Lettuce leaves
  • Whole wheat croutons
  • Parmesan Cheese
  • Tomatoes, onions, cucumber etc.

Tuesday – Chicken stir fry

  • Pre-cooked chicken breast
  • Whole wheat noodles
  • Thinly sliced carrots, onions, broccoli, spinach or beansprouts (always ensure beansprouts are thoroughly cooked).
  • Soy sauce or pre-made seasoning

Wednesday – Mini Roast dinner

  • Pre-cooked chicken breast re-heated
  • Roast Potatoes
  • Carrots
  • Peas
  • Parsnips
  • Gravy Granules

Thursday – Chicken Curry

  • Pre-cooked chicken breast
  • Whole grain rice
  • Curry seasoning
  • Tinned tomatoes
  • Coconut Milk (optional)
  • Cheddar Cheese
  • Lettuce / Tomatoes

Friday – Leftovers day

Previous days leftovers

Minced beef base

This meal plan focuses on re-using a base minced beef multiple times throughout the week to create different dishes. This allows us to buy a bulk amount of minced beef at the start of the week and means less cooking during the week. You can also swap out the minced beef for minced turkey to make this lighter.

Monday – Spaghetti Bolognese

  • Base mince mix
  • Whole wheat pasta
  • Peppers
  • Carrots
  • Parmesan Cheese

Tuesday – Chilli

  • Base mince mix
  • Whole grain rice
  • Red kidney beans
  • Chillis

Wednesday – Cottage Pie

  • Base mince mix
  • Potatoes
  • Carrots
  • Peas
  • Cheddar cheese

Thursday – Lasagne

  • Base mince mix
  • Whole wheat lasagne sheets
  • Milk
  • Flour
  • Butter
  • Cheddar Cheese
  • Lettuce / Tomatoes

Friday – Leftovers day

Previous days leftovers

Chapter 4: Other elderly nutrition questions answered

If you are struggling eith elderly nutrition then a carer might be able to help

What if my loved one can’t prepare meals anymore?

Depending on what capabilities your loved one has there are a number of options:

  • Meals on wheels – If your loved one is otherwise doing ok then a meal on wheels service might be a good solution to help them keep on top of their elderly nutrition.
  • Move your loved one closer – Moving your loved one closer to you or even into a granny annexe or similar can be a great way to keep an eye on their food intake and provide home-cooked meals from your own kitchen.
  • Hourly carers – If your loved one needs some extra help around the house anyway then an hourly carer could prepare breakfast and dinner for your loved one and leave a cold lunch behind.
  • Live-in carers – If your loved one is requiring additional help anyway then a live-in carer could move into your loved one’s house to cook and eat with your loved one. This can be an excellent way to help those not eating enough to have more encouragement to eat. You can read our live-in care guide here.

What are good snacks for the elderly?

  • Granola Bar
  • Trail Mix
  • Pre-cut Veggies
  • Natural Ice Lollies
  • Fruit Salad
  • Dried Fruit

Chapter 5: Conclusion

I hope this guide has been useful in helping you decide what steps you should take to improve you or your loved ones elderly nutrition.

Author: James

I founded and manage PrimeCarers, a Platform that connects Private Clients with Private Carers near them.