Dietetic Care Services

Helping You Achieve Better Health

10 Things to Know About Catering for Older Adults


In this Part 5 of a series of articles, Kyann Calvi, Accredited Practicing Dietitian, discusses techniques and strategies for catering to older adults.

When devising a menu for older adults its important to consider the factors that affect their health and nutrition status. A well planned menu can help the client group to achieve their nutrient needs.

See below for handy hints to help you plan your menus.

Malnutrition

Protein energy malnutrition is one the most significant and costly problems faced by aged care facilities. Protein helps to improve nutrition status and decrease recovery time. Include protein such as meat, chicken, fish or eggs in main meals. If your facility offers a continental breakfast consider introducing a high protein hot breakfast such as eggs or baked beans at least 2-3 times a week. Offer nourishing snacks and drinks such as yoghurt and milk drinks between meals and on request and choose desserts based on dairy and fruit rather than low-nutrient options such as mousses.

Dehydration

Fluid intake is usually governed by thirst however older adults can partially lose their sense of thirst. This can result in inadequate fluid intake, leaving this group at higher risk of dehydration, a condition that may require admission to hospital. Offer fluids regularly throughout the day.

Constipation

Poor intakes of fluid and fibre can result in constipation. Offer a variety of smooth (eg: wholemeal not wholegrain) high fibre breads and cereals, fresh fruit and vegetables, and add legumes to soups to ensure adequate fibre is included in the menu.

Chewing and swallowing difficulties

Older adults may have poor dentition, ill fitting dentures (especially if they've recently lost weight) or swallowing difficulties due to medical conditions. Make sure that your menu offers soft foods that are easy to modify (i.e. puree). All meats should be cooked until tender and accompanied by sauces/gravies as this adds moisture making them easier to chew and swallow. Residents with dementia can develop aversions to foods with particular textures. They may hold food in their mouths, spit food out or play with it rather than eating it. In this instance texture modification may help to increase nutrient intake.

Special diets

These are generally not appropriate for this age group, where increasing intake and quality of life are top priorities. Diabetes is managed through medication rather than imposing unnecessary dietary restrictions to control blood glucose levels. There are some instances where dietary modification is imperative and an appropriate diet should be provided from the menu options e.g. low fat for an obese person, or gluten free for a person with Coeliac disease.

Dietary customs

Residents should be assisted to maintain their dietary customs according to their religious and cultural beliefs. Offer alternatives to every main meal to accommodate individual preferences. Minor alterations to meals such as the addition of spices or substitution of meats, may be enough to satisfy residents needs.

Variety

The menu cycle should be 4-6 weeks and contain a wide range of meals that are familiar to residents. Meats, vegetables, cooking methods and accompaniments should vary throughout each week of the cycle and menu items should reflect the season.

Presentation

Older adults have a lessened ability to taste, smell and chew, so make sure the food looks appealing. This can be a little tricky when dealing with modified textures (i.e. pureed meats and vegetables) where the consistency must be right for the foods to hold their shape. Some facilities use food moulds or partitioned plates to improve visual appeal.

Timing

The main meal should be provided at lunch time when residents are more alert. The evening meal still needs to be nutritious but generally older adults are fatigued and prefer a lighter meal such as soups and finger foods like mini quiche/frittata.

Feeding aids

Tools which assist ability to eat and drink, such as plate guards and built up cutlery should be provided to encourage independence at meals. If a resident is capable of eating but experiences difficulties they might eat less due to spillage or feel embarrassed and refuse meals altogether.


Some of the barriers to achieving optimal nutrition have been outlined above. Use this guide to develop or amend your menu to help your facility achieve excellence in nutrition standards. The menu plan and provision of food and fluids should be assessed by an Accredited Practising Dietitian (APD). APDs can also offer clinical services, education sessions and assist with policies and procedures. To find an APD visit the DAA website www.daa.asn.au or call the APD Hotline on 1800 812 942


Kyann Calvi is an Accredited Practising Dietitian (APD) who specialises in Food Allergy/Intolerance, Coeliac Disease and other gastrointestinal disorders such as Irritable Bowel Syndrome. For the past seven years she has helped people with food allergies/intolerance meet their nutrient needs through special diets. Kyann works in private practice locations in the Eastern suburbs of Melbourne.

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