How To Prevent Malnutrition In The Elderly

What is malnutrition?

Malnutrition occurs when an individual does not meet their nutritional needs. Malnutrition may be either under-nutrition or over-nutrition. In older people malnutrition usually refers to under-nutrition. Under-nutrition results from a decreased intake of protein, energy, vitamins and minerals.

Why are older people susceptible to malnutrition?

As we age the ability to meet nutritional needs can become increasingly difficult. There are a number of factors that influence food intake as we age increasing the risk of malnutrition. These include:

  • Altered taste, smell and sight
  • Dentures and reduced saliva flow resulting in dry mouth
  • Long term illness
  • Dietary restrictions
  • Decreased desire to eat
  • Low income (pension)
  • Living and eating alone, decreased desire to eat
  • Poor mobility and inability to shop/cook food
  • Side effects of medications or many medications

Signs of malnutrition in older people

There are a number of signs that may indicate an older person is malnourished, including:

  • Muscle loss/wasting (sarcopenia)
  • Loss of subcutaneous fat (fat under the skin)
  • Prominent bones (bones stick out)
  • Hollow appearance under the eyes or the eye temple
  • Skin Bruising
  • Flaky dry skin
  • Oedema (build up of fluid under the skin)

Consequences of malnutrition in older people

Some of the consequences of malnutrition in older people include:

  • Increased risk of infection
  • Poor wound healing
  • Skin breakdown with ulceration
  • Impaired immunity
  • Memory loss ad confusion
  • Fatigue
  • Decreased muscle function
  • Breathing and heart difficulties

How to prevent under-nutrition in older people

Listed below are some simple tips to help older people achieve an adequate intake of food to meet their nutritional needs through a well balanced diet:

  • Eat a variety of foods as outlined by the Australian Dietary Guidelines
  • Aim to have small frequent meals each day rather than trying to eat three large meals to increase food intake
  • Eat main and mid meals before filling up on low nutrient dense foods like tea and coffee
  • Add extra energy and protein sources to main meals such as "polyjoule", high protein milk, cheese and margarine on vegetables
  • Aim for nutritious high energy and high protein foods for mid meals such as cheese and biscuits, yoghurt and flavoured milk (Sustagen)
  • It is important to have appropriate meal consistency. If there are problems with chewing certain foods choose soft texture foods such as minced meats with sauces, bread without crusts and pureed fruit with custard.
  • Drink adequate amounts of fluids to keep hydrated
  • Drink alcohol in moderation, limit intake
  • Maintain good oral care and refer to dentist for dental problems affecting food intake
  • Incorporate food preferences into each meal and regularly monitor food intake  
  • Allow enough time to eat meals, especially for slow eaters
  • Consider multivitamin or vitamin/mineral supplement
  • Identify available support systems: family, friends, GP, Aged Care Assessment Team (ACAT), Home Based Therapy (HBT), community day centres and shopping services.
  • Another option is delivered prepared meals: meals on wheels (MOW’s), tender loving cuisine (TLC) or frozen ready-made meals from the supermarket.
  • Family and friend support systems may assist with feeding, cutting up meals, opening packets.
  • Sharing meals with family and friends can also make eating more enjoyable for company to make meal times enjoyable.

The following are simple examples of how to boost your energy intake with a high protein and high energy milk drink (example the Pro-Cal shot 30 to 60 ml):

Stir 30-60ml of Pro-Cal shot into hot tea or coffee (in the morning) and hot chocolate or malt drinks (for supper)

Stir in 30-60ml of Pro-Cal shot in some cold milk, breakfast cereal, porridge or smoothie (200ml milk, 30-60ml Pro-Cal shot with pureed fruit and yoghurt or ice-cream in a milk shake)

Add Pro-Cal shot in soup, creamy pasta sauce, casseroles, stews, gravy or mashed potatoes/sweet potatoes/pumpkins at main meals

Make a delicious summer treat by combining Pro-Cal shot with fruit yoghurt, pour into ice moulds and freezing to make ice-blocks or add Pro-Cal shot into ice-cream dessets and custards.

The Pro-Cal product is available from in Australia.

Article by Kate Flinders