Nutrition and Hydration

This year’s Nutrition and Hydration week was planned for 16-22 March, but due to the current difficult circumstances, it did not receive the same strong focus as in recent years.  For elderly people in care settings, especially for those living with dementia, good nutrition and hydration is essential for overall well-being and to help fight infection and illness .

Good eating habits for many of us form part of our daily routine.  However, as we age several things change that can have an impact on our diet and for those living with dementia other complexities come into force as well.

Here are some simple hints and tips that everyone can follow to support good health in vulnerable people:

The Food (remember, we use all our senses when we eat)

  • Prepare foods that are easy to chew and swallow
  • Present foods that are pleasing to the eye – good use of colour and shape (there are some excellent moulds available for use with pureed foods)
  • Ensure the aroma of the food can be smelled in the lead up to mealtimes to increase appetite
  • Give a person a limited amount of choice, based on their likes and dislikes. Too many choices can be overwhelming, so two options should be sufficient
  • Although the full dining experience should be encouraged, making finger food available can also help, particularly between meals. Again, food should be based on preferences but could include sandwiches, fish fingers, chicken nuggets, vegetables, fruit segments.  Sweet things such as chocolate can be included but ideally restricted

The environment

  • Protected mealtimes are important to avoid unnecessary distractions
  • Use a quality menu board that includes food images and information of when the next meal will be. This helps with orientation as well as increasing appetite
  • If possible, use a dining room that has no distractions – avoid music and other noises that can take the focus away from the dining experience and potentially cause distress. Our hearing decreases as we age and some sounds can cause agitation, which stops a person from focusing on one task – in this case eating
  • As a person’s cognitive function declines, they may struggle to remember how to use utensils, so ensure appropriate items are available and adapt as necessary. Perhaps using a spoon rather than a fork could be beneficial or a bowl instead of a plate.  Well designed crockery can really help with independence and encourage people to eat, particularly if the design and colour are conducive to encouraging eating – again using all a person’s senses
  • A person may forget how to eat, so sitting with a person enables them to copy your actions. They can see how you hold a fork or put food in your mouth and mimic your actions

Hydration

Hydration is crucial to good health and the impact of not drinking enough can be sudden and severe.  The results can include infections such as UTIs and delirium, both very serious conditions for an elderly person.

  • Ensuring a person can see and hold a suitable mug or glass, are key to continuous drinking. Water in a clear glass is invisible and therefore is unlikely to be used, whereas water in a tinted glass can be seen and will act as a reminder to drink more regularly, Orange in a clear glass works well!
  • A coloured lightweight mug with large handle (and lid if required) can also act as a prompt to drink if the product is dignified. Some products are very childlike and are not easy to hold and therefore not easily recognised by those living with dementia.
  • Hydration Stations around a care home can act as a visible prompt. Ensuring there is a choice of drinks, even different juices and easy to hold glassware or mugs can really promote increased fluid intake.
  • Snacks around the home that can increase thirst can also help with better hydration levels (as well as increased nutrition)

Exercise

Encouraging exercise is a good way of increasing appetite and the environment can play an essential part in people engaging with their surroundings.  Rather than keeping residents in one lounge area, by creating other seating areas such as cafes gives everyone a choice on where to spend their time.  Rather than taking everyone a morning cuppa, encourage them to visit the cafe for a mid morning snack and a chat.  This is a great way of promoting good nutrition and hydration as well as increasing exercise and social interaction.  To create a real cafe area, you may need some help with appropriate murals and decor, but it is also essential that the room is laid out and really is a social space.  We all love going out for a drink and the experience is about much more than a cup of coffee, it is about socialising and sometimes just watching the world go by.