By Elizabeth Libby Smoot -- email@example.com
Andrea Wickham has spent her career as a dietitian helping senior citizens eat properly, a daily task that for the young and healthy happens without much thought. But for the older person suffering deteriorating health, taking dozens of medications every day or living with dementia, the seemingly easy task of eating becomes a hurdle that challenges not only the senior but the caregiver as well.
Home Instead Senior Care found that 83 percent of family caregivers in the U.S. assist with groceries and are challenged to provide a balanced diet for those they care for. The national provider of non-medical care and companionship services for seniors, with an office in Winchester, recently published a booklet titled "Cooking Under Pressure." The free booklet identifies the warning signs of poor nutrition, what foods should be staples in the diet and provides shopping tips and recipes.
While good nutrition is vital at any age, for seniors poor nutrition has devastating effects.
"When you get to that advanced age, you have physical problems that affect eating," said Wickham, a Front Royal resident who works for Home Instead Senior Care. Oftentimes, she added, family members are too slow to notice the decline.
"They see them every day and they don't recognize the signs. They don't see the dryness around the mouth and nose, or that their hair is brittle or their skin" is dehydrated, she said.
The dominos easily fall for an older person who already doesn't feel well and finds eating to be one more difficult task amongst many. Seniors with mobility issues may dread grocery shopping or navigating around the kitchen. Arthritis makes food preparation and using equipment such as can openers taxing. Eye trouble or clouded memory may cause difficulty following recipes. Dentures that no longer fit make it impossible to eat certain foods, and less-efficient taste buds can make food bland and unappealing.
Poor nutrition can quickly lead to weakness, dehydration, accelerated disease and depression. It's difficult for someone suffering a poor diet to find the energy to move, maintain mental acuity, fight off infection and diseases. Oftentimes, a life span is cut short by an inadequate diet.
The pressures on caregivers, many of whom have children of their own, jobs and other commitments, make ensuring their loved ones are eating correctly that much more of a challenge. Home Instead Senior Care reports that 67 percent of caregivers who rated their lives as "extremely stressful" were caring for loved ones with three or more nutritional risk factors, such as illness, multiple medications or unexplained weight loss/gain.
Jan Ricketts of Winchester helps her elderly parents who, a few years ago, began suffering various ailments that required a change in diet. Over time, Ricketts' mother became less inclined to cook. Ricketts then began to notice her parents, age 79 and 73, were dining out more often, eating more snack foods and were sometimes sitting down to dinner at 9 o'clock at night. She and her four sisters turned to Home Instead Senior Care to provide meals for their parents right in their own home. The move has brought considerable peace of mind.
"I know they're getting a nutritional meal that's being prepared," just for them, Mrs. Ricketts said. "That has taken off a big weight."
Adding to the stress for caregivers is coming to grips with the fact that the parents who once lovingly provided their meals can no longer do the same for themselves.
"You just take it for granted that mom has always known how to cook and then lo and behold there's a concern," said Aaron C. Blight, owner of the Winchester Home Instead Senior Care franchise. "Sometimes children are the last to notice the symptoms in their parents."
Blight employs 200 caregivers who perform a variety of functions all in an effort to keep seniors in their homes. He notes many clients forget to check expiration dates on food, putting them at risk for food poisoning. One client made hamburger patties and stored them for days in the cabinet instead of the refrigerator. Another exploded food in a microwave that then caught fire.
Caregivers can expect a struggle as they intercede with seniors in their care. "There is resistance as their functional capacity decreases," Blight said. "They don't want to acknowledge that they're not as efficient as they used to be. There's a mental adjustment that has to be made."
The parent-child dynamic can also contribute to a rocky experience. "Some have better relationships with parents than others," Wickham said. "Some people won't do anything their children suggest."
The booklet was created in part to make this process easier.
Ricketts said her parents now look forward to the companionship the nightly caregivers provide. Her parents' health has also improved with lower cholesterol, needed weight gain and a general overall feeling of well-being.
Blight, who relates firsthand to the stress caregivers feel, having taken care of his mother-in-law during her five-year battle with cancer, hopes his company's new booklet will encourage caregivers to be proactive about meeting the needs of their loved ones.
"We find people don't call until there's a crisis. About 25 percent of people who contact us do it in a planned way that involves foresight.
"We hope this book will provide some information and education to family members who are looking at parents and loved ones and their nutritional status. Hopefully, this will help them to know what to look for."
For Ricketts, focusing on her parents' nutrition and getting help from experts has brought her relationship with her parents back where she wanted it.
"I feel like now I can actually go up and visit" and be a daughter and not a caregiver.
Warning signs that older adults are not eating properly
1. Loss of appetite
2. Little or no interest in eating out
4. Sudden weight fluctuation
5. Expired or spoiled food
6. Skin tone
8. Cognitive problems
9. More than three medications
10. A recent illness
-- Source: "Cooking Under Pressure," a booklet created by Home Instead Senior Care, which is free of charge and can be obtained by calling 722-8750 or toll-free at 877-650-3800.
Web sites helpful for caregivers
www.foodsforseniors.com (the Home Instead Senior Care site)
eatright.org (the American Dietetic Association)
-- Source: caregiverstress.com
Recipes suitable for seniors
1 bunch fresh broccoli (bite size pieces)
1 medium purple onion, chopped
8 slices bacon, fried and crumbled
1 cup sharp cheese, shredded
1/4 cup sugar
3 tablespoons white wine vinegar
1 cup Miracle Whip Salad Dressing
Wash and cut broccoli stems and buds less than 1/2 inch in diameter. Add onions, cheese and bacon.
Mix remaining ingredients for dressing and pour over broccoli mixture. Marinate several hours.
-- Source: Home Instead Senior Care via Blue Ridge Hospice
Lemon Rosemary Chicken
2.5 oz. lemon juice
2.5 oz. olive oil
1 tsp. ground rosemary
3 lb. chicken, cut up and skin removed
Mix first three ingredients. Marinate chicken overnight in the mixture in refrigerator. Drain chicken from marinade and place on baking sheet. Bake at 375 degrees for 30 minutes or until temperature reaches 165 degrees.
-- Source: Home Instead Senior Care via the Shenandoah Area Agency on Aging