Eating Problems of the Geriatric Client and Ways to Improve Nutrition

Problem	Cause	Dietary Interventions
Within the mouth	Impaired taste buds Dental caries Chewing difficulty due to: Poorly fitting dentures No dentures No saliva Paralysis Metallic taste from medications	Referral for correction of dental problems Mouthwash/oral care before meals Food prepared to meet client’s needs (chopped, pureed, soft)
In the upper GI tract	Swallowing difficulty Paralysis due to stroke Food causing GI distress	Thickened and jellied liquids Soft, chopped foods Small, frequent meals Presentation important (how food looks on serving plate) Avoid expression such as “baby food” (negative connotation)
In the lower GI tract	Constipation Diarrhea Bloating	Add fruits/liquids to restore bowel function (see Table 11-12. Bowel Training,Reduction of Risk Potential) Avoid foods that cause diarrhea Plan meals at appropriate times for ease of digestion Avoid salt
Psychosocial	Loneliness Meals no longer social event Depression Anorexia	Encourage attendance at meal program if available Arrange group meals/activities when possible Emphasize best nutrition when appetite is at peak (breakfast) Allow time to complete meal Interact with others whenever possible
In the environment	Inability to shop for, prepare, or cook food Impaired vision Lack of resources Difficulty in feeding self Acute or chronic illnesses present (e.g., arthritis, stroke)	Refer to Meals-on-Wheels Encourage family involvement; describe how food is arranged on plate Refer to social services Assess need for assistive devices Assess ability to grasp utensils and guide food to mouth Open packages and milk cartons; butter the bread; cut meat and vegetables

From Thomas, CL (ed): Taber’s Cyclopedic Medical Dictionary, ed 18. FA Davis, Philadelphia, 1997.

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Table 9-2