ENGAGE - ENERGIZE - EMPOWER

Saturday, March 21, 2015

FOOD - taking apart Level 1

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Can't stop thinking about how Maslow's Hierarchy of Needs relates to the elderly.  The levels are the same, the order of importance isn't changed, but the ability to satisfy even the most basic is increasingly difficult as we age.

A harsh fact of life - it's practically impossible to fully meet the physiological needs of the young-old, let alone the old-old.  Unlike kids under fifty, every active & energetic oldster is acutely aware their ability to secure their fundamental needs could change in an instant.  As for those who are getting up there & the flat-out O L D, food, drink, shelter & sleep are not as easily secured as when they were younger.

Consider food.  In spite of a fridge filled with yummy, nutritious food or dining rooms offering balanced meals three times a day, older folks often don't get enough food.  Reality - loss of appetite & changes in eating patterns are natural in Late Adulthood.  

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And just because an elderly relative or friend is eating doesn't mean he or she is eating well.  Too many are like the client who ate the same dinner every time we went out - chicken croquettes & mashed potatoes, with coffee & ice cream for dessert.  Not a single green veggie, no fruit, a few sips if any water.  Her family was okay with it, it wasn't my place to make a fuss.  She was dangerously underweight, had balance problems, difficulty walking, all impaired by her diet.


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I wish all my older friends were like a client who faces serious memory challenges every day, but never skips a meal, always takes care to eat a hearty balanced breakfast, a healthy lunch, and a nutritious dinner.  While it's true she is blessed to live in a senior residence with no less than three dining areas - casual, informal & formal - and generally very good food, many of her fellow residents like sparrows or stick to just cheese steaks & french fries.  

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Helping older family & friends eat nutritious meals every day is no easy thing.  And our body doesn't help.  If it feels like our bodies turn against us as we age, it's because they do! 

As we grow older, many people lose their interest in food. Could be due to changing taste buds (they age, too), depression or simply loneliness, but depressed appetite isn't unusual in the elderly.  The challenge is that while their desire for food might decrease, their need for good nutrition does not. 

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My mother loved good, nutritious food, but as she edged into the mid-80s found she had less & less energy to cook.  Great Grains & yogurt replaced eggs & toast for breakfast, while Progressive Garden Vegetable Soup became her lunchtime staple.  But even fairly robust Mom needed help opening the can - we youngers often don't realize the obstacles that can block the way from an older person eating wholesome meals.


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A lot of older people experience a loss of appetite, due to either a health condition or medications.  A fully stocked pantry & fridge are meaningless to someone who's just not hungry.

One of my clients loves steak - hamburgers for lunch, beef for dinner.  He also has a good breakfast, loves salad & veggies & fresh fruit.  A nutritionist at his assisted living center spoke to the family about doing what they could to get him to eat a wider range of food, to substitute grilled fish for the burger, a piece of salmon for the prime rib.   I am delighted that the kids told her that Dad was going strong at 94 & they saw no reason to bug him about healthier choices.  

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Unfortunately, children & well-meaning caregivers are too often influenced by well-meaning specialists who are more interested in a well-balanced diet than happiness.  Most of us know people in their final weeks who were burdened with restricted diets when it wasn't necessary, when a lovely bite of a favorite dish would at least have raised their spirits.  


My wish for all of us is to be like my dear old Mom, who maintained a healthy appetite to the end of her days.  She had no problem swallowing, no dental problems that limited what she could eat.  During that last week at home, she requested blueberry muffins & thoroughly enjoyed a few bites of bacon.  She savored each meal, however small, to her last day.  Mom taught me that having an appetite for life helped her maintain a keen appetite for food.  Physically emotionally spiritually, she embodied Mame Dennis' admonition...

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suggested reading -  http://www.aplaceformom.com/blog/01-23-2013-loss-of-appetite-in-elderly

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