Encouraging Weight Gain for the Elderly

Nutrition is very important for all of us. Getting a balanced diet which includes a variety of food with nutritional value is beneficial.

Getting the right amount of vitamins, minerals, fibre and fluid help our skin, hair and body.

In the elderly poor nutrition can cause pressure sores, dry skin and mouths and weak bones. Not getting enough food will result in weight loss and link to other medical and physical problems.

Underlying problems could cause weight loss in the elderly. These may include cancer, gastric problems, depression or side effects from medication (such as nausea).

Illness or disease which causes vomiting, diarrhea or malabsorption could also be factors. Not eating enough, not being able to absorb nutrients or not keeping food down will ultimately result in weight loss.

Other reasons may be down to difficulty in chewing or swallowing, distress (especially in dementia sufferers), loss of muscle mass, poverty or neglect.

When you notice that an elderly person has lost their appetite over a period of time, or is losing weight it is important to seek medical advice.

Noticing that clothes are becoming too loose, the body is slimming down or weighing that person regularly will show that weight is definitely coming off.

A doctor may be able to look at the symptoms and medical history of the person concerned to see if there is a more serious issue to be addressed.

Sometimes a care worker or relative is able to notice the changes in eating habits. Talking to the elderly person may simple give the answer. Or just knowing their routine may give an indication of the problem.

Look at the food which is available to the elderly person. If they live in their own home but struggle to prepare meals, or live in a care home and given a limited option of what they can eat then this needs to be discussed.

Some elderly people struggle to chew certain foods or have dysphagia (difficulty in swallowing).

If this is the case then soft or pureed food would be a better option. By blending softened meat and vegetables, the food would be easier to manage.

Other soft foods include:

• Porridge or Ready Brek
• Weetabix with hot milk
• Yogurts
• Semolina pudding
• Mashed fish in a white sauce
• Creamed potatoes and gravy
• Soups
• Scrambled eggs
• Custard

Those with dysphagia tend to find swallowing fluids difficult, resulting in coughing, choking or bringing it back up. There are multiple causes for dysphagia. The muscles in the throat stop working effectively due to esophageal spasm, Parkinson’s disease, multiple sclerosis or they may have had a brain injury.

In this case, a soft diet and fluids thickened with a thickener for medical purposes (such as Thick and Easy) would help.

It is important that the correct foods should be offered and dehydration avoided by thickening drinks to the right consistency for that person.

Elderly people living on their own may need extra help. Personal care and preparing meals may be a struggle if they have physical or mental health problems.

Community care workers can assist those who are able to stay in their homes but need a little bit of help. They come to help with cooking and preparing food as well as with washing and dressing.

Meals on Wheels is a government scheme to provide prepared meals to those who cannot get out of the house to buy their food or unable to cook. Volunteers bring the meals around to the houses, usually free of charge to those who may be house bound.

If an elderly person is still finding it difficult to make meals or remember to eat regularly then a care home to suit would be the best option. Staff in the care home would be able to serve meals or feed those who are unable to eat themselves and prompt them to eat and drink to avoid weight loss.

If their medication has been reviewed, mouth care attended to, full assistance is given during meal times and they are still losing weight there are ways to bulk up the calories.

If large meals are off putting, then offer smaller ones more regularly throughout the day.

Look at the time of day when the person concerned eats well. If it is breakfast, then try to encourage more food then. Take advantage of when the person is hungry by giving bigger or more portions.

If they eat very little, then add calories to their food. Do this by:

• Adding cream to porridge, soup and mashed potato
• Add butter to vegetables, pasta and sandwiches
• Add sugar or honey to drinks (be careful with sugar with diabetics)
• Always offer biscuits and cakes with tea and coffee
• Offer snacks in between meals
• Add Ensure or other build up drinks/powder to food
• Offer Ensure/Fortisip/build up drinks and milkshakes throughout the day
• Use full fat versions of milk/yogurt/cheese
• Leave snacks lying around to tempt the appetite
• Offer their favourite food

When an elderly person begins to lose weight it is important to give them food which is high in calories. The food may not always be healthy, but you may have to prioritise at this time.

One way the elderly start to lose weight is through neglect. Patients left in bed, those who sleep all day or people alone in their own homes can be easily forgotten about.

Ensuring they get regular meals and access to drinks is vital for their health. If they are left alone or left to sleep, they are missing out on important nutrients and calories.

If the elderly person cannot eat because of medical reasons, they may need a PEG feed. This is a tube which is permanently inserted into the stomach. Known as Percutaneous Endoscopic Gastrostomy (PEG) the liquid food which is balanced with vitamins, minerals, fat and calories is administered by a nurse.

If an elderly person will not eat, it is an idea to get anything you can (within reason!) into them.

For dementia sufferers this can be a struggle, especially if they wander off from the dinner table, become aggressive if they don’t want to eat or make a mess with their food.

There are alternative ways to consume healthy food, for example:

• Blend fruit with plain yogurt and fruit juice for an energetic smoothie
• Add fruit compote to ice cream or sorbet
• Juice vegetables for a refreshing drink full of nutrients
• Snack on boiled or scrambled egg with wholemeal toast. This is high in fibre and protein
• Munch on dried fruit such as apricots or raisins. Yogurt coated raisins have even more calories
• Drink a mug of Horlicks before bed, made with whole milk. It is malty and filling
• Make a banana sandwich on brown bread. The sandwich is soft and easy to eat and it is full of vitamins and fibre
• Have a hearty mug of soup. It is easy to drink and good for you

It is important to monitor the weight of the person concerned. Their weight should go up at a steady pace. If it continues to decrease, seek more professional advice.

Don’t over face the person with a lot of food and never force feed them. They are likely to be put off or vomit.

Instead offer small meals or snacks on a regular basis and leave food where it can be easily accessed. For instance, always keep the fruit bowl full of fresh fruit or leave a tin of plain biscuits on the side.

If they cannot feed themselves then always offer to help with meals, snacks and drinks.