How Can We Improve the Appetite of Seniors?
We chatted with a professional dietitian and self-confessed foodie, to get tips on some frequently asked questions by caregivers.
Ms Chan Sue Mei
Principal Dietitian, Yishun Community Hospital
Armed with a Master’s Degree in Health Sciences, Ms Chan has been a dietitian for over two decades. Finding her true calling when she first started work, Ms Chan saw how she could help patients get better by making changes to their diets. Her work with palliative patients helped her to realise the importance of nutrition and how eating well can nourish the soul.
"1. Some seniors need blended or soft food due to swallowing issues. Can you tell us more about the different types of diet prescribed to seniors and when they will need such diets?"
As we age, saliva production will decrease, causing dry mouths. Dry mouth is common among seniors and may lead to difficulties in chewing and swallowing. Texture-modified diets can be introduced in this case as they are easier to eat and chew. The different levels in a texture-modified diet include:
- Easy to chew
- Soft and bite-sized
- Minced and moist
Caregivers should find out the difficulties their loved one faces, and prepare meals according to the textures that suit them.
"2. People often associate senior-friendly food with being bland and not tasty. With that said, cooking healthy food at home can be demanding for caregivers who are always on the go. Are there any tips you can share with caregivers who prepare meals for seniors?"
We usually eat with our nose first, followed by our eyes, then our mouth. Hence, the food made for seniors should and can look presentable, smell delicious, and taste good as well! Natural herbs and spices can be used to add colour and flavour to foods instead of overusing sugar and salt.
Healthy, tasty food need not be a hassle to prepare; use time-saving methods like 'one pot' meals, or prepare meals in bulk and freeze them. You can reheat the meals when it’s mealtime.
"3. When should a caregiver consult a dietitian for their loved one’s meal plans? What are some health conditions that need particular care in the diet?"
A caregiver may consider seeking help when they notice that their loved one has a loss of appetite, is eating and drinking less, experiencing unintentional weight loss, or when they start to lose interest in eating.
Some health conditions need particular care in the diet itself. For example, people with chronic diseases such as diabetes, high blood pressure, chronic kidney disease will need certain dietary modifications and restrictions. Deficiency conditions such as anaemia and osteoporosis may require a higher intake of certain nutrients. For such patients, caregivers can consider relooking at how they are managing their food intake.
"4. What are some health tips for seniors or older adults so that they can continue to enjoy meals even at an advanced age?"
There are seven Ts that I can recommend:
- Type: Try different types of food (E.g. For proteins, consider various kinds of fish, eggs, plant-based foods)
- Taste: Try different tastes (E.g. Sweet, salty, sour, bitter, umami, savoury and even spicy.)
- Temperature: Hot food should be hot, and cold food should be cold
- Texture: Play with texture. (E.g. Crunchy, soft, mushy or chewy if there are no swallowing issues.)
- Teeth: Brush your teeth or dentures at least twice a day to keep your gums and teeth healthy.
- Try: Try new cuisines and flavours. (E.g. Different cuisines, buying food from a new hawker centre or restaurant.)
- Together: Eat with a friend or family, as eating is also a social event.
"5. What is your advice on dental/oral care?"
It is very important to clean your teeth after eating. Some seniors don't have any teeth, but it is equally important that they rinse their mouth after food, as gum care is essential as well. Don't forget to also go for regular dental check-ups as much as possible.
"6. Is it possible to have a healthy meal plan that consists of our local hawker foods (e.g. curry, laksa)? What are some healthier versions of local foods?"
Of course! Healthy eating is not just about eating salads the whole day. For example, in sliced fish soup, the fish itself is a good source of protein. Also, there is the option of choosing fresh sliced fish (less oily) over fried fish. There are also food stalls that sell curry or laksa using healthier oils, cutting down on coconut milk and replacing it with low-fat milk. Even for Indian cuisines, chapati or naan are much better, lower-fat options than roti prata.
There are many healthy options readily available in hawker centres. You just have to pay attention to all these and make the right choice.
"7. What are two common eating/ nutritional problems faced by seniors? What are your recommendations?"
"I don't need to eat so much because I'm old."
An older person does not necessarily need to eat as many calories because the body's metabolic rate is lower. But other nutrients like protein, vitamins and certain minerals are just as crucial to the body. I would suggest reducing the calories from excessive sugar and fat, and focus more on high-protein foods, fruits and vegetables so that they still get the nutrients but without the additional calories.
Seniors don't drink enough water.
Some seniors find it quite troublesome to drink a lot of water as they see going to the toilet as a hassle, especially when they may need help to move around. Inadequate fluid intake may lead to dehydration and constipation, which in itself may lead to other issues like loss of appetite, altered taste in the mouth, and risk of urinary tract infection.
Remember that liquids are not just about drinking plain water. It could be anything from milk, tea, soups, juices, herbal drinks, etc. A good sign of taking adequate fluid is when your urine is clear or slightly yellow.
"8. How much should seniors eat in a day? Some seniors prefer to eat less, while others have regular meals throughout the day. How can a caregiver manage picky eaters?"
The Health Promotion Board’s 'My Healthy Plate' concept has recommended serving sizes that you can refer to. There are no fixed rules on how many meals a person should eat, as long as they eat and drink enough throughout the day to meet their nutritional and hydration needs.
Caregivers don't have to be too fixated on specific types of food that a patient must eat - because there are so many types of food that they can explore.
Sometimes, patients take cues from family members and caregivers on their attitudes towards food. They may perceive that a food is delicious and exciting because everybody's eating it, in turn, enticing them to eat!
In my line of work, I encounter patients who tend to be a little pickier as they have firm beliefs on how certain foods need to be prepared. I recommend engaging them during the food preparation process, even if it's just plucking the leaves from vegetables or looking through recipes! They are more likely to want to eat the food that they have helped prepare.