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If the established food habits of the older person are poor, such habits will undoubtedly have been a long time in the making. These habits will not be easy to change. Poor food habits that begin during old age can also present problems. Decreased income during retirement, lack of transportation, phys-ical disability, and inadequate cooking facilities may cause difficulties in food selection and preparation. Anorexia caused by grief, loneliness, boredom, depression, or difficulty in chewing can decrease food consumption. Dementia and Alzheimer’s may cause the elderly to think they have eaten when they may not have.
Studies indicate that many senior citizens consume diets deficient in protein; vitamins C, D, B6, B12, and folate; and the minerals calcium, zinc, iron, and sometimes calories.
An elderly client’s diet plan should be based on MyPyramid and the nutrients should be checked against the DRIs and AIs. Older persons’ needs can vary considerably, depending on their conditions, so each person should be examined by a physician to determine specific requirements. If the client consumes less that 1,500 calories a day, a multivitamin-mineral supplement is recommended.
Variety and nutrient-dense foods should be encouraged, as should water. Water is important to help prevent constipation, to maintain urinary volume, to prevent dehydration, and to prevent urinary tract infections (UTIs). When there is serious protein and calorie malnutrition (PEM), the reason may be economic or psychosocial. Elderly people who have long hospital stays can develop PEM in the hospital. They may dislike the food, drugs may dull the appetite, and they may be lonely and depressed. Sometimes poor or missingteeth can make eating protein foods difficult (Figure 15-1). In such cases, protein-rich supplements can be used.
If overweight is a problem, it may be caused by overeating, lack of exer-cise, drugs, or alcohol.
Any adjustment in food habits will require great tact, and plans for changes must be based on the individual’s total situation.
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