In a care setting, mealtimes create a rhythm and structure to the day. Breakfast, lunch, teatime and supper can be precious moments of connection between caregivers and residents, and in the community of people who gather around the table.
Mealtimes also provide a valuable opportunity to check that those we look after really are receiving the nourishment they need. Older people admitted to hospital from a residential care setting have been found to be 10 times more likely to be dehydrated than those admitted to hospital from their own home, for example. Staying alert for signs of under-nutrition and dehydration is crucial, as both can impact hugely on day-to-day wellbeing and lead to serious health consequences.
The importance of good nutrition & hydration
The body needs a regular supply of essential nutrients, including protein, healthy fats, carbohydrates, vitamins and minerals, in order to maintain a healthy immune system. This will help protect from chronic diseases but also improve resilience to minor illnesses, from colds to urinary tract infections, and improve wound healing and recovery from surgery – all key issues for the elderly and vulnerable. A lack of nutrients can also lead to feelings of weakness and fatigue, confusion and depression.
Dehydration can be a problem particularly among older residents, as the sense of thirst diminishes with age, reducing the desire to drink. Certain diseases and medication, reduced renal function, diabetes, mental and physical frailty, and swallowing difficulties, also increase risk of dehydration.
Lack of fluids can lead to disorientation and confusion, dizziness (leading to falls), urinary tract infections and constipation, muscle weakness and fatigue, and increase risk of pressure sores and skin conditions.
The ingredients of better wellbeing
Serving food and drinks that residents actually want to consume is the first step – and that means making meals a sensory experience. The look, aroma, textures and taste of meals and drinks stimulate sensory receptors in the mouth and trigger the brain to anticipate food, meaning a person is more likely to take those vital sips and mouthfuls. As carers, we provide the support that means mealtimes truly nourish – whether that’s by helping to cut up food, lift a cup to lips, or be there to provide companionship and encouragement.
By being actively involved in mealtimes, we are also able to monitor and record what a person has had to eat and drink. That way, we can learn the foods and drinks they enjoy, so that we can offer more of what brings a person pleasure and nourishment. And we will be aware when eating and drinking is a challenge, so that we can try different ways to ensure individuals receive the nutrients they need for wellbeing. The tips below can help.
When someone isn’t eating enough…
Check for practical issues. Do they have a sore mouth, badly fitted dentures, chewing and swallowing difficulties?
Are they unhappy? Some of us don’t like to eat on our own, so having someone to sit and chat with during mealtimes can help. If someone is feeling low or angry, they may not feel like eating – can you encourage them to have just a little? Having just a couple of mouthfuls can ‘wake up’ the appetite and distract from difficult emotions.
Ask what foods they enjoy. Are there dishes they loved in the past, favourite family recipes, easy-to-eat alternatives to tried-and-trusted meals?
Use memories to trigger appetite. Often, memories are linked to foods we loved eating at a precise moment. A great project is to make a personal food moodboard, using photos of favourite dishes, people and places. Talking about these moments and referring to them with this visual prompt can help ignite the appetite.
Be flexible. Eating three full meals a day can be overwhelming for some people. Instead, offer smaller snacks, or food they can ‘pick at’. Just be sure that they receive the nutrients they need overall.
When someone isn’t drinking enough…
Agree a daily fluid intake. Knowing how much someone needs to drink, and keeping a track of their intake, will give you confidence as a carer that you are meeting their hydration needs.
Ask what drinks they enjoy. Diluted fruit juices or cordials, tea and herbal teas (not too hot) and thicker liquids such as smoothies or one of my all-natural, meal supplement Nourish Drinks, made with organic ingredients, are all good alternatives to plain water.
Offer regular sips. Have fluids available throughout the day and encourage regular small sips rather than expecting the person to drink an entire glass.
Alternative ways to hydrate. As well as liquids, offer hydrating foods such as fresh fruit, soups, jellies, yoghurt and custard.
Raspberry & peach Nourish Smoothie
1 carton Raspberry Nourish Drink
5-6 peach segments
Blend all the ingredients together and adjust the thickness by adding milk to your taste.
For more tips, meal and drinks recipes, and Nourish Drinks, see www.nourishbyjaneclarke.com