Nutrition in Long-Term Care – The System Needs to Change

Why Focus on Nutrition?

Proper nutrition is essential for maintaining a strong and healthy body. It provides energy, aids in weight management, and enhances resistance to illness. Additionally, good nutrition is associated with a lower risk of diseases such as osteoporosis, high blood pressure, heart disease, type 2 diabetes, and certain cancers. In individuals with Alzheimer’s or dementia, poor nutrition can exacerbate behavioural symptoms. Research indicates that managing high blood pressure may also be beneficial in reducing the risk of dementia.

How can you help your loved one in long-term care?

Advocating for someone in long-term care can start with reviewing their menus and discussing nutrition and feeding with the care home administrator. A willingness to engage in this discussion reflects the administrator’s commitment to patient care. They may involve a dietician or other staff members to explore the details further. It is helpful to bring any dietary information provided by the patient’s doctor or a qualified nutrition professional.

Many long-term care homes can provide detailed nutritional information including calories, fat content (saturated vs. unsaturated), salt, sugar, servings of fruits and vegetables, fiber content, vitamins, and minerals. They should also indicate whether specialized menu options, such as gluten-free, vegetarian, or lactose-free, are available. Additional considerations, such as religious or physical dietary requirements and personal taste preferences, may also need to be discussed to ensure all specific needs are met.

4 Tips for Meeting Nutrition Needs in Long-Term Care

Here are some questions to ask regarding nutrition that can help boost a senior’s health, which are also useful to discuss with a dietician when deciding on a long-term care home:

3. Have they cut down on refined sugars?
Refined sugars, often found in processed foods, provide calories but lack vitamins, minerals, and fiber. Are healthier options like fruit or juice-sweetened baked goods available? For those with a loss of appetite, do they add sugar to foods to encourage eating?

4. Do they limit foods with high sodium and use less salt
High sodium intake affects blood pressure. It’s beneficial to use spices or herbs to season food as an alternative to salt whenever possible.

Some seniors, especially those with dementia, may experience loss of appetite and weight loss. In such cases, ask if the doctor recommends supplements between meals to increase calorie intake and whether these supplements can be provided by the care home or if residents should keep a supply in their apartment or room.

Understanding Senior Nutrition Needs in Long-Term Care

How different is nutrition for seniors compared to the general population?

Staying hydrated can be a significant challenge for seniors. It is crucial for care homes to encourage fluid intake by offering small cups of water or other liquids throughout the day, as well as foods with high water content such as fruit, soups, milkshakes, and smoothies.

In addition to knowing what to offer seniors to eat, other factors must be considered, including budget constraints, safety concerns, and resource allocation. Currently, all long-term care homes in Canada receive funding from the federal government, including both for-profit and non-profit homes. Of this funding, $9 per day is allocated for food ingredients per resident. This limited budget makes it challenging to provide high-quality ingredients necessary for maintaining good health in elderly residents. When evaluating a care home, it is important to ask how they manage to make their food both interesting and healthy.

In Ontario, 64% of the 77,000 adults living in 626 long-term care homes have some form of dementia, further complicating the provision of food and nutrition. Between 2018 and 2019, long-term care homes reported over 660 incidents involving food and nutrition issues, leading to 1,121 food-related emergency room visits. Additionally, residents wait an average of 43 minutes to receive their meals. A recent study by the Dietitians of Canada found that dehydration is present in nearly half of long-term care residents and that residents consumed 40% to 93% more sugar than recommended.

When considering a long-term care home for a loved one, inquire about their strategies for managing these challenges to ensure that residents receive proper nutrition and hydration.

The Mental and Physical Health Benefits of Food in Long-Term Care

Food is intimately linked to feelings of comfort, home, and ease. It serves as a means for socializing, connecting, finding purpose, staying energized, and maintaining a rhythm of activities that foster a sense of normalcy. For many seniors, food may represent one of the last areas where they have control over their choices. Just as children may resist eating what’s on their plate due to a sense of powerlessness, seniors who have lived productive, independent lives may struggle with losing the ability to make decisions for themselves in their later years.

Food is deeply rooted in our culture, identity, and overall well-being. Emphasizing the quality of food and the processes around serving it in long-term care homes is crucial. Nutrition care and dietary services significantly enhance residents’ quality of life. Ensuring adequate staffing for feeding, with staff properly trained on feeding techniques and food-related hazards, is essential. Care homes should provide residents with a variety of food choices, ensuring all meals are fresh, nutritionally excellent, flavourful, culturally sensitive, and tailored to each resident’s unique dietary needs and preferences.

Ensuring proper nutrition in long-term care homes is vital for the physical and mental well-being of residents. By focusing on balanced diets, limiting harmful ingredients, and addressing hydration needs, care homes can significantly enhance the quality of life for seniors. Advocating for transparent and high-quality dietary practices, understanding the unique challenges faced by seniors, and prioritizing personalized, culturally sensitive meal options are essential steps in providing compassionate and effective care. In this way, nutrition becomes not just a matter of sustenance but a key component in maintaining dignity, health, and happiness for our beloved seniors.

Don’t forget to check out our Concerned Friends Additional Resources page for links you may find helpful in all aspects of the long-term care and aging experience. 

Isabell Berry, Concerned Friends Volunteer

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