In this article

Nutritional considerations Nutritional requirements

Foods to choose Store cupboard items

Common problems

To meet your nutritional needs, aim to eat a varied diet including regular meals and snacks, drink enough fluid (at least six to eight glasses or cups every day) and, most importantly, enjoy your food.

Ideas for quick and nourishing snacks:

• Sandwiches filled with cooked meat, bacon, tinned fish, cheese or peanut butter. Use different breads for variety. Add pickles, relish and sauces.
• Toast with pilchards, sardines, beans, cheese, ravioli, tinned spaghetti or eggs (well cooked).
• Crackers or digestive biscuits topped with cheese, toasted crumpets or teacakes, yoghurt and fruit, fruit cake or malt loaf, breakfast cereals, soup.

The following foods should be eaten every day:

If it's difficult to get to the shops, it's useful to have some basic foods stored:

• Milk: long-life, evaporated or dried milk and tinned milky puddings
• Meats and fish: tins of corned beef, stewed meats, ham, sardines, salmon and tuna
• Fruit and vegetables: a variety of tinned fruits and vegetables, beans, pulses, long-life fruit juice, instant mashed potato
• Drinks: cocoa, malted milk and meal-replacement drinks
• Cereals: breakfast cereals, crackers, crispbread, oatcakes, rice, pasta and biscuits
• Other: soups, stock cubes, gravy, honey, jam, pickles and sauces
• Freezer ideas: frozen meals, vegetables, bread or rolls, ice cream, fish, chips and meat dishes

Poor appetite and weight loss

People on a low income, people living in institutions and those without their own teeth are more likely to experience nutritional difficulties. The key nutrition issue for frail older people, whether living in a residential home or in their own homes, is maintaining adequate energy and nutrient intakes.

Tips for a calorie-rich diet:

• Fats and sugars provide energy and help food to taste good. Use generously.
• Have a pudding once or twice a day, such as yoghurt, milky puddings, ice cream, trifle, cake, fruit pie, sponge puddings with custard, ready prepared desserts. Cakes, biscuits, chocolate and crisps provide extra energy when eaten with meals. Take care that they don't spoil the appetite for more nourishing foods, though.
• Enriched nourishing drinks, which are available from pharmacies and supermarkets, may be taken between meals to increase calorie intake, but they shouldn't replace meals.
• Alcohol in small amounts can actually stimulate the appetite. Check with your doctor first if you're taking medication.

If you have an elderly relation in hospital, or living in a nursing or residential home, and you're concerned about their weight loss, speak to the nurse in charge.

Ask about the meals provided and request that food intake and any further weight loss are monitored. If you're still concerned, ask to speak to a doctor or for a referral to a state-registered dietician.

Possible reasons for malnutrition in residential or nursing homes include:

• underlying disease or illness
• loneliness or depression
• monotonous menu
• unfamiliar foods
• inappropriate textures
• inflexible meal times
• lack of snacks and nourishing drinks
• no choice of portion size
• insufficient staffing to help with feeding
• no monitoring of food intake or weight loss
• food provision - general lack of fresh foods, heavy reliance on convenience meals, over-boiled vegetables, lack of fresh fruit, dull and bland food

Obesity

Obesity at any age, including old age, is undesirable because it greatly increases the risk of diabetes, joint disorders, breathing difficulties and can affect mobility.

For those older people who do become overweight, strict dieting is not advised, as this reduces the intake of essential nutrients. Instead, the balance of food intakes should be changed, reducing sugary and fatty foods, while increasing bread, cereals, fruits and vegetables.

Increasing the amount of regular, gentle exercise will also help achieve slow, sensible weight loss.

Swallowing difficulties

If you suspect that an elderly relative is experiencing problems with swallowing, contact your doctor. Such difficulties can arise from neurological disorders, Parkinson's disease, or following head injury or stroke.

A speech and language therapist is often the person to diagnose the severity of the problem. They will offer advice on which types of food texture will be appropriate, whether this be soft foods, thick fluids only or a thin purée.

A dietician should be involved in the care process to ensure the texture-modified diet is high in energy and essential nutrients.

This article was last medically reviewed by Dr Rob Hicks in September 2005.
First published in March 2001.