Overview for Caregivers - Nutrition & Hydration

Nutrition

As older adults age, their nutritional requirements change. Malnutrition is any disruption to a healthy nutritional status. (2)

Why is it important?

  • 34% of older Canadians are at nutritional risk.  Women are more at risk than men (1)
  • Older adults are at risk for under-nutrition due to dietary, economic, psychosocial, and physiological factors (2)
  • Proper nutrition can lower  the risk for diseases: high blood pressure, osteoporosis, obesity, certain cancers, type 2 diabetes, heart disease (3)

Common Causes

  • Increased sedentary lifestyle (4)
  • Increased deficiency in key vitamins and minerals from a combination of factors: a reduced sense of taste and smell; difficulty chewing or swallowing;  a restricted diet for a health condition; eating alone; loss of appetite; and medication consumption that may prevent absorption of vitamins and minerals (4)
  • Limited income or lack of transportation may affect  access to quality food and the number of meals per day (2)
  • Chronic conditions or disability may affect ability to cook (2)
  • Poor oral hygiene (2)

Key Considerations

  • Follow Canada’s Food Guide
  • Ask for a consultation with a dietitian

References

1. Dieticians of Canada. (2013). Online nutrition screening tool helps older adults identify if they have risk factors
    leading to poor nutrition
. Retrieved March 12, 2014 
2. DiMaria-Ghalili, R. (2012). Nutrition in the Elderly, Nursing Standard of Practice Protocol: Nutrition in Aging.
    Retrieved March 12, 2014 from:
    http://consultgerirn.org/topics/nutrition_in_the_elderly/want_to_know_more

3. FDA.  (2014). Why Nutrition Matter for You. Retrieved March 12, 2014 from:
    http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm267499.htm

4. University of Rochester Medical Center. (2014).  Nutrition Needs in Older Adults. Retrieved March 12, 2014 from:
    http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=2321

Hydration

Drinking liquids throughout the day is especially important for older adults. Dehydration can lead to dizziness, fainting and
low blood pressure.  Dehydration can make constipation worse. (1)

Why is it important?

  • Older adults are vulnerable to shifts in water balance- in both over hydration and dehydration
  • Serious problems can occur:
      • heat injury
      • swelling of the brain
      • seizures
      • shock
      • dizziness/fainting and risk of falls
      • kidney failure
      • constipation
      • coma
      • death (2) (1)

Common Causes

  • Age-related changes in body composition resulting in depletion of total body water (3)
  • Decreased renal function (3)
  • Thirst sense becomes less accurate (3)
  • Poor tolerance for hot weather (3)
  • Intense vomiting and diarrhea (2)
  • Vigorous exercise and not drinking enough water
  • Inadequate nutrition intake
  • ncreased urination

Key Considerations

  • Risk factors: 85+, female, dementia,  multiple chronic diseases, medications, fever, dehydration history , use of diuretics (water pills) (3)
  • Parkinson’s disease or stroke may cause swallowing difficulties (4)
  • Signs of dehydration: little or no urination, sunken eyes, skin lacking elasticity and resilience, low blood pressure, increased heart rate, dry mouth, dizziness/sudden confusion, weakness (2) (4)
  • Common signs: thirsty or dry mouth; urine is dark yellow with a strong smell; feeling light-headed, headache (1)
  • Seek medical attention if symptoms persist, if  swallowing difficulties/excessive choking or coughing after ingestion of food (4)
  • Treatment usually involves replacing lost fluids through increased oral intake
  • Eat Right Ontario recommends if able:  women drink 9 cups (250mL) a day and men-12 cups (1)
  • Certain liquids, such as fruit juices, coffee, or carbonated drinks can make diarrhea worse (2)
  • Keep beverages available (safe for specific diets, e.g., diabetes);  foods containing water (e.g., fresh fruits and vegetables, yogurt) (4)
  • Drink  frequently throughout the day instead of drinking large amounts in one sitting (4)
  • Limit drinks with caffeine to 3 cups per day (1)
  • Certain circumstances require more fluid intake (e.g. illness, when exercising, hot/humid weather, when staying in heated buildings) (2)

References

1. Dieticians of Canada. (2014). Facts on Fluids- How to Stay Hydrated. Retrieved February 19, 2014 from:
    http://www.eatrightontario.ca/en/Articles/Water/Facts-on-Fluids---How-to-stay-hydrated#.UwYiMRbnL7I

2. MAYO CLINIC. (2014).  Diseases and Conditions: Dehydration. Retrieved February 19, 2014 from:
    http://www.mayoclinic.org/diseases-conditions/dehydration/basics/definition/con-20030056

3. Mentes, J. (2012).  Hydration Management. Nursing Standard of Practice Protocol: Managing Oral Hydration.
    Retrieved February 19, 2014 from:
    http://consultgerirn.org/topics/hydration_management/want_to_know_more#item_2

4. Alberta Caregiver College. (2014). Support for Caregivers of Older Adults: Hydration.
    Retrieved February 20, 2014 from:
    http://www.caregivercollege.org/scoa/?Hydration.html

Issue/Condition - Problème / état: 
Resource Type - Type de Ressources: 
Author/Publisher - Auteur/Éditeur: 
Centre for Studies in Aging and Health
Date Published: 
2014-01