Seniors are at risk of not having their daily nutritional needs met. This can be a result of many factors such as decreased mobility, medication interactions or side effects, cognitive deficits, isolation, climate barriers and mental health issues.

What are some easy tips that seniors and their caregivers (or concerned family members) can due to minimize the risks of poor senior nutrition?

Make sure that your loved one is eating from each of the four food groups at least three times a day. For example:

Group 1 – Fruits and Vegetables contain natural disease fighting ingredients and can aide in healthy digestion. Try eating some that are dark green, red, orange and yellow such as spinach, oranges, bell peppers, etc.

Group 2 – Grains contain fiber which can aide in digestion. Remember to increase fiber slowly and to increase fluids at the same time. Eat some whole wheat pasta and breads, oatmeal (porridge), etc. Consult a physician if you have any concerns or any digestive problems.

Group 3 – Milk and Milk Alternatives help to prevent osteoporosis and aide in bone development. Additionally, this group gives us vitamin D, which may be less available in the winter months. You can eat milk, cheese or yogurt.

Group 4 – Meat and Meat Alternatives provide us with protein, vitamins and minerals. Enjoy some fish, poultry, lentils, chickpeas, nuts and seeds.

If a senior is not able to shop or to prepare balanced meals, you can try these tips:

• Make a little extra dinner at your house a few nights a week and put one portion in a re-heatable
container with instructions on how to re-heat the meal. Leave this in your loved one’s freezer or refrigerator;

• Invite your loved one over for one meal a week at your house;

• Look into community resources, such as Meals on Wheels, to provide one to three meals a week;

• Hire a neighbor, friend, or home care agency to prepare two-four meals a week at your loved one’s home;

• Hire a teenager in the area to have one meal an evening with your loved one. This is good for social interaction for your loved one and provides the teenager with a “job” that has lifelong learning potential;

• Call your loved one’s friends and ask them to invite your loved one to dinner or lunch once a week.

Never forget how important fluid is to our body since it is made up mostly of water. Without enough water, our body has more difficulty digesting food, transporting medication, and circulating blood to aide in healthy bone and muscle development and maintenance. In the winter time, we can become more dehydrated due to being indoors with heating systems. Add soup to your meal and drink lots of water, fruit juices (100%pure), milk, and herbal teas.

Sometimes seniors are not as active as the general population. This reduction in activity can contribute to a reduced appetite. Even light and consistent exercise such as walking, yoga, stretching and chair aerobics can stimulate one’s appetite. If you find that motivation is lacking, perhaps joining an exercise group or moving into a retirement residence where group exercise activities are organized could help. Exercise also releases chemicals in our brain that help with improving one’s mood and cognitive functioning.

Written by:Sarah Blunden, Registered Dietitian, Certified Diabetes Educator, McGill University Bachelor in Human Nutrition 2003; Stephanie Erickson, MSW, PSW, LCSW

Written by: Stephanie Erickson, MSW, PSW, LCSW

It is very scary to know that our parents are living alone in their home as they begin to lose physical and cognitive functioning.  We want to respect their decision to remain autonomous at home for as long as possible so we search for ways to make this happen.  The following is a complete list of all of the areas in your home that present a danger to your parent or loved one, outlines the factors that increase risk and offers concrete suggestions to reduce the identified risks.

Emergency Preparation:

1. Get the name of neighbor/friend/relative and phone number to contact in the case of an emergency and you are not able to get to your loved one’s home.
2. Post your name and phone number next to every phone AND give this information to AT LEAST one neighbor/friend.
3. Obtain the name of a community member, social worker, other professional to contact in the case of an emergency and/or regular updates.
4. Give an extra key to a neighbor or friend, have an extra key for yourself, and hide one outside the home (if you feel comfortable) so someone can gain access to the home in an emergency.
5. Register with Medic-Alert or LifeLine and get a bracelet for your parent so he/she can access help if there is a fall.  See our website under Resources for a link.
6. Make sure all legal documents (power of attorney, mandates in the case of incapacity, etc. are updated and complete).

Risk Factors for a Fall:

1. Over 75 years old
2. Living alone
3. Housebound
4. Use of cane/walker
5. Previous falls
6. Acute illness, chronic conditions, tremors (neurological disorders)
7. Multiple medications
8. Cognitive impairment
9. Vision and hearing problems
10. Difficulty sitting/standing from a chair/bed
11. Foot problems
12. Alcohol/drug use
13. Poor nutrition
14. Balance/equilibrium problems

Bathroom Safety:

1. Install grab bars in the bathtub or shower and by the toilet
2. Use rubber mats in the bathtub or shower
3. Use a shower chair or bench
4. Take up floor mats when the bathtub or shower is not in use
5. Install a raised toilet seat
6. Remove tub and install a shower with a minimal step-up
7. Place a chair in shower stall
8. Use a telephone shower head

Kitchen Safety:

1. Use automatic tea pot
2. Remove rugs without a non-stick service
3. Place frequently used pots and pans at waist level to minimize bending and stretching
4. Use a microwave to reduce use of oven/stove
5. Disconnect stove/oven fuses if there are memory impairments and it has been left turned on in the past

Outdoor Safety:

1. Repair cracked sidewalks
2. Install handrails on stairs and steps or install a ramp
3. Trim shrubbery along the pathway to the home
4. Install adequate lighting by doorways and along walkways leading to doors

Living Space Safety:

1. Remove throw rugs, or tape down to secure
2. Secure carpet edges
3. Avoid visually distracting patterns on flooring/carpets
4. Mark transitions from carpet to flooring with a different color paint/stripe
5. Remove low furniture and chairs that are too low to get up/down
6. Remove objects on the floor
7. Reduce clutter
8. Remove cords and wires on the floor
9. Avoid floor wax or use nonskid wax
10. Ensure the telephone can be reach while laying on the floor

Stair Safety:

1. Install hand rails on both sides of staircases at elbow height
2. Make sure an adult can wrap their hand completely around the handrail
3. Attach them securely to walls or posts
4. Secure carpet on treads of stairs
5. Install light switches at the top/bottom of stairways
6. Do not reduce lighting in stairways; in fact, increase the lighting
7. Do not place rugs at the top/bottom of stairs
8. Leave one hand free to hold the handrail when carrying objects
9. Check lighting for adequate illumination at night, especially in the pathway to the bathroom and on stairs

General safety:

1. Wear shoes or slippers that fit properly and have a non-slip sole
2. Remove reading glasses when walking up/down stairs
3. Install a telephone on every level of the home, especially in the bedroom, kitchen, and bathroom
4. Install a bathroom on each floor
5. Understand side-effects of medications, such as dizziness
6. Avoid alcohol
7. Avoid carrying large or heavy objects, such as laundry baskets
8. Get up slowly from a sitting or laying position; sit on the side of the bed before rising
9. Wear clothing with an elastic waistband for easy removal

For further information, please contact Erickson Resource Group at www.ericksonresource.com

Written by Valerie Houghton, RD LD

In the United States, the senior age group accounts for approximately 25% of all prescription drugs being dispensed and according to RX. Magazine, there are more than 140,000 hospital admissions each year in America due to adverse drug reactions.  Taking medication to help control diabetes, high blood pressure and arthritis is quite common but unfortunately, what is not so common is making sure the foods you eat are not negatively affecting how the drug(s) work to control your illness or ease pain and suffering. 

One way to ensure your medications are doing the absolute most for you is to be aware of any food or beverage that may hinder the effectiveness, or in some cases, be a danger, to your health. Being aware of any possible food and medication interaction is essential for effective medication therapy and peace of mind that harm will not result due to improper food consumption.

So who can help you determine if you have any food and medication issues?

Several health professionals should be involved in this process but the best place to start is with your doctor.  Review the list of medications with your physician and ask about any potential food or beverage that might impact the effectiveness of the drug.

Another health professional to consult regarding medications is a registered dietitian. These food and nutrition professionals work alongside medical staff in hospitals and clinics providing nutrition guidance and therapy to  improve health, speed healing and educate patients on how to optimize food and medication for the best possible health outcome.  Many of the patients the registered dietitian interacts with are on multiple medications and the dietitian can advise the doctor and the patient on potential foods that may interfere with the effectiveness of the medication.

The dietitian will often take a diet history from the patient asking specific questions about foods consumed to highlight any potential risk of food and medication interaction. The dietitian can then provide a list of foods to include or exclude from your diet that decrease the risk of food and drug interactions.  For example; foods high in fiber like, bran cereals, can slow the rate of digestion in the stomach. If you take certain medications with high fiber meals it could lower the amount of a medication being absorbed into the system or slow the rate of absorption.

Another source of food and medication information is the local pharmacist who dispenses your medications; they can provide advice on what foods to avoid or incorporate into your diet that allow your medications to work properly. If you are taking more than one medication and seeing more than one doctor, make sure they all know what medications you are taking and inquire about any possible interactions between medicines.

As a reminder; don’t skip mentioning vitamins, supplements or herbal medicines that you may be taking.

The more informed your healthcare providers are about your medications and the foods you normally eat, the less likely you are to incur any negative health consequences from food and drug interactions.

Here is a list of common medications taking by seniors and the foods to avoid and include for each category.

Valerie Houghton is practicing registered dietitian and free lance writer for magazines and websites.

For more information, contact Valerie Houghton at valerieonperdido@yahoo.com

Guest Writer Article – Ronni Alicea, RD MBA

For most people it is a bittersweet decision to consider a residential living facility and for others it is a necessity. While the social life, meal service, housekeeping and nursing assistance are key benefits of choosing this lifestyle, for people with celiac disease it can be a stressful decision.  Here is a review to help assure your diet and medical care will be managed properly while you enjoy your new friends.

Choosing a Facility:

Ideally, there will be a few facilities to interview that offer the services you need. Although the admissions office will encourage you to speak with the dietary manager and the dietitian regarding your gluten-free needs, my advice is to ask to speak with the facility administrator, director of nursing and the activities director as well.  Confidence that meals and snacks are prepared correctly is paramount.  However, these other departments need up-to-date information about celiac disease too.

There are times when arrangements have to be made quickly.   Even if you are the first gluten-free diet in a facility, do not despair!  The staff wants to do the right thing.  Facilities are in the business of providing the best quality of care possible for people.  Facilities have an obligation to provide a gluten-free lifestyle as prescribed by your physician. That includes meals, activities and medical care.  All facilities are audited by state and federal agencies and every community has an ombudsman to help.

The following recommendations are for people seeking long-term living arrangement or short term stays to recuperate.  Managing Gluten-Free diets, like other food allergies, depends on facility wide awareness.

For the Administrator

1.  Ask if they have experience with providing a gluten-free environment.  Whatever the answer, yes or no, express your thanks that they are proactive!  A gentle reminder of how many people with Celiac Disease will be looking for facilities that are competent will perk up their ears.  One of an Administrators functions is marketing the facility.

2.   Administrators have to approve purchases and prepare budgets.  Food Service Directors will have to purchase gluten-free foods outside their normal supplier.  They will appreciate you reminding their boss why.

3.  Ask the Administrator to introduce you to the Director of Nursing, Director of Dietary and the Activities Director.  The personal introduction will help underline the importance of a team approach needed to assure a proper gluten free life.

For the Food Service Director and Dietitian

1:  Ask if they have recent experience preparing meals for a gluten free diet.

Key Points:

1. Use the term cross-contact when discussing meal preparation. Cross-contamination is a term food service workers have learned to associate with food borne illness like salmonella and E. coli.
2. Prepare gluten-free work area by using a fresh clean cloth, spray cleaner and rinse with clean hot water. Facilities will have a red sanitizing bucket that is refilled several times a day however sanitized crumbs in the bucket are still toxic!
3. The most difficult item for the kitchen to make is gluten-free toast.   Cooks should know how to make toast in the oven however a dedicated gluten-free toaster may be appropriate. Request Grilled Sandwiches when possible.
4. Review label reading and the need to read labels each time.

2:  Residential facilities have a menu that repeats every three to five weeks.  Ask if they need help with their gluten-free diet extension.

3.  Ask who coordinates the between meal snacks.

4.  Many facilities have food delivery once or twice a week.  Please check out www.celinalfoods.com for information about this inexpensive way to always have meal essentials available.

Conversation with Director of Nursing and Dietitian (and Doctor)

1.  Ask if the facility has recent experience with a gluten-free resident.  Ask that resident care staff be given an in-service on gluten-free diets.

2.  Remind them that you will always need a gluten-free multivitamin, even if you eat 100% of your meal.  Many gluten-free foods are not fortified with the B vitamins and Iron found in wheat containing products.

3.  State you will need your tissue transglutaminase antibody titer done annually.

4.  Remind them that although most medications are gluten-free they should be checked by the facility pharmacist.

Talk with the Activities Director

The activity director is a very important person for you to know.  They are very interested in your well-being at the facility and will want to interview you.  Be prepared to discuss:

1.  Your favorite foods.

2.  Your religious needs.

3.  Gluten Free craft supplies.   Prepare the activity director now with this resource: www.discountschoolsupply.com.

Attend the Care Planning Meetings and Resident Council

If you find that the facility is just not getting the diet correct and are inflexible to learning, please alert your local ombudsman.  Every state has trained professionals that will investigate your complaints and be your advocate.   Facilities should have the local phone number posted in plain view.  Visit www.ltcombudsman.org and jot the number down or call the Ombudsman Resource Center at 202-332-2275, but I sincerely hope you never need it.

In our busy life we can all use more friends.  If you have a few hours please consider volunteering in a residential facility.  There is always need for someone to call bingo numbers or read to the visually impaired.  Maybe they have a resident with Celiac Disease?   You will feel great and will learn how to be a better advocate for yourself.

For more information please contact:

Celinal Foods
Ronni Alicea, RD, MBA
www.celinalfoods.com
ronni@celinalfoods.com
689 Talamini Road Bridgewater NJ  08807

Telephone: 908-704-7017

——

Erickson Resource Group are always looking for guest writers to feature on this website. If you are a health professional and would like to contribute, please get in touch with us through our Contact page.