by Alicia Korkowski
Eating is one of life's great pleasures. Food provides the fuel our bodies need to function and good nutrition supports better quality of life. The USDA Food Pyramid for young adults recommends 2000-2500 calories daily, while most adults over age 70 require only 1200-1600 calories per day. For older adults every calorie must count for good health. This means eating lots of vegetables, fruits and whole grains along with moderate amounts of dairy, lean meat, fish, legumes and eggs and limited amounts of sweets and other "junk" food. Good nutrition can help increase energy, prevent some chronic illnesses, and maintain overall wellbeing, all of which are particularly important for individuals with dementia and their caregivers.
Variety, color and texture guide us to better nutrition. The more colorful a vegetable, usually the higher the vitamin and mineral content will be. Sweet potatoes, yams or squash have higher food value and more fiber than mashed potatoes or French fries. Spinach or dark greens make a healthier salad than iceberg lettuce, and fresh fruits have more fiber than a glass of high-calorie juice.
Whole grain breads and cereals also provide a healthy combination of nutrients and fiber. Oatmeal, whole grain breads, and brown rice provide better nutrition than processed cereals, breads and rice. Read labels as you shop to see how many grams of fiber the product contains.
When it comes to protein, most of us think of beef or chicken, but there are many other healthy alternatives. Fish is an excellent source of protein and healthy fats. Legumes, like beans or lentils, provide both protein and fiber. And don't forget tofu, which can be added to main dishes, eggs or to a fruit "smoothie".
A major part of any healthy diet is water; yet many people reduce their fluid intake with age. Dehydration poses serious health risks, especially in later life and with increased use of medications and a loss of natural thirst. Restricting liquids to deal with bladder urgency or incontinence is unwise and can lead to constipation, urinary tract infections, imbalance in levels of medications, mental confusion, and the disruption of important systems in the body. Keeping a pitcher or bottle of water close at hand helps people remember to drink. Water is "brain-food" and our bodies need it to function.
When caring for a person with dementia, adjustments to the diet will need to be made over time in response to the person's changing condition. As the disease progresses, mealtimes may become more difficult and confusing. There are many aids to help meet some of these challenges, like specially shaped plates and bowls with suction bottoms, non-spill cups, and utensils designed to be easier to grip and use. Incorporating snacks and finger foods with high nutritive value can improve the diet and lessen frustration and the burden of care. Good choices include peanut butter (or other) sandwiches, pieces of cheese, carrot sticks or other vegetables, apple slices, bananas, or other fresh fruit. Yogurt or milk shakes may also provide needed protein and calcium.
Any sudden change in appetite or weight is cause for concern and merits a call or visit to the doctor, because it may signal an undetected medical problem or illness. Where there are challenges like loss of appetite or trouble chewing, working with a nutritionist or dietary technician may be advised. Swallowing difficulties or choking episodes should also quickly be brought to the doctor's attention.
It's never too late to make small changes in our daily routines that can mean significant improvement over time. A good place to start might be to focus--one week at a time--on more colorful fruit and vegetables, whole grain cereals and breads, more water, and more nutritious snacks. Enjoy!