Special Diets and Feeding Assistance in Senior Living

Stacey Burke
By Stacey BurkeJuly 13, 2021
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Dietary needs can shift considerably with age, and the physical and cognitive limitations that can develop in later years may interfere with your loved one’s ability to maintain a healthy diet. Perhaps the simple process of shopping for, preparing, and eating a meal has become an obstacle for them. Or, maybe they’re intimidated by a new therapeutic diet for a chronic condition like diabetes or high blood pressure.

With nutrition being a cornerstone of overall health and wellness, dietary concerns are among the top reasons caregivers consider senior living arrangements for their aging loved ones. Many senior living communities employ culinary teams who develop well-rounded menus that maintain high nutritional standards and support a variety of dietary needs while delivering quality taste.

Learn more about how senior living communities plan menus that cater to diverse dietary needs, plus how communities’ feeding assistance practices help residents maintain a happy, healthy lifestyle.

Special diets in senior living

Seniors instructed to follow a special diet — and their caregivers who help implement it — may find it overwhelming at first. Between knowing what to buy and how to cook potentially unfamiliar ingredients, creating well-balanced meals that are nourishing and delicious can suddenly seem like a challenge. Fortunately, many senior living facilities recognize the importance of elevating their dining experience and have professional chefs and culinary teams dedicated to the cause.

How do communities accommodate special diets and dietary preferences?

Senior living communities rely heavily on strong communication between all members of the care team to fulfill needs and preferences.

“We have a spreadsheet with all of our residents’ dietary needs listed on it that we check daily,” says American House Sarasota’s Culinary Director Tim Laielli, or “Chef Tim” to residents. “I’ve got a fantastic restaurant manager that helps keep us in the loop when new residents arrive or changes need to be made as well. Overall, there’s an excellent line of communication from the front of the house to the back.”

Communication between the culinary teams and fellow staff members can look quite different depending on the community. Some communities use a color-coded cup and plate system, while others implement a seating chart to help the wait staff place the appropriate meals in front of residents. For American House Sarasota residents who must follow specific diets, the culinary team and wait staff use cards with residents’ photos on them to make sure everyone receives the appropriate meal.

For loved ones dealing with severe allergies, it’s crucial they join a community with a clear communication plan regarding special diets.

What are some of the special diets and dietary options senior living communities offer?

Whether it’s preparing low-sodium snacks or plant-based meals, many communities provide a range of choices for all residents. Chef Tim and his team use a hands-on approach to make sure their residents enjoy delicious, nourishing food.

“We recently had a vegan resident join us, so I went and chatted with him about the food that he likes,” he says. “I gave him a list of items we could prepare for him and let him know I’d follow up in two weeks to get his feedback. This resident had been in several other communities that didn’t take the time to hear him out and weren’t willing to accommodate a vegan diet. He was really appreciative.”

A vegan diet is just one of the many dietary options residents look for when considering a community. While not all communities are equipped to accommodate the same dietary preferences and needs, common diets and options may include:

Allergy-friendly and food-sensitive diets

The availability of nut-, gluten-, and dairy-free options is a common concern, and more communities offer special menus developed to accommodate residents with specific intolerances. Culinary teams take food allergies and sensitivities very seriously and follow additional precautions to limit cross contamination. In communities such as American House Sarasota — where the culinary team makes meals and desserts from scratch — purchasing prepackaged, gluten-free meals is necessary to make sure a meal is safe for residents with gluten allergies.

Diabetic/low-sugar diet

Roughly 27% of Americans age 65 and older have diabetes, according to a 2020 report from the Centers for Disease Control and Prevention. For diabetic residents, a controlled-but-diverse meal plan rich in diabetic-friendly foods can help ensure their nutrition needs are met while also providing sufficient variety. Providing ongoing diabetes education can play a key role in helping residents manage their symptoms and make healthy food choices.

Low-sodium diet

Sodium plays an important role in the body’s ability to maintain proper hydration, but for residents with chronic conditions such as high blood pressure or kidney disease, too much salt can be harmful. Low-sodium diets often focus on fresh, whole foods, and they try to restrict commercially prepared foods like canned soups and vegetables.

Plant-based diet

Plant-based diets can vary. The typical plant-based diet eliminates most, if not all, meat and animal by-products. Studies have shown that some variations of vegan and plant-based diets may help lower cholesterol levels and reduce the risk of heart disease and certain types of cancer.

Texture-modified diet

This type of diet, also called a pureed or mechanical soft diet, requires all foods to have a texture that eases chewing and swallowing. For residents with conditions that interfere with their ability to swallow (known as dysphagia), a consistent diet of pureed solids and thick, nutrient-dense liquids can help maintain proper levels of nutrition.

Feeding assistance in senior living

For many older adults, independent feeding can become quite challenging. There are many factors that contribute to this, such as ill-fitting dentures, declining muscle mass and cognitive abilities, as well as chronic illnesses including Parkinson’s disease. Without proper accommodations, discomfort during mealtimes can lead to unintentional weight loss, dehydration, and malnutrition.

The staff at your loved one’s senior living community should closely monitor residents’ weight and eating habits, and they should coordinate with physicians and speech therapists to assess community members’ abilities when changes occur. Timely intervention can have a profound effect on a resident’s quality of life, and with the guidance of specialists, the staff can then make the proper arrangements.

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Common mealtime assistance strategies

Many senior living communities employ mealtime feeding assistants. These assistants help ensure residents receive adequate nutrition, eat enough, and stay safe during meals. Their goal is to help only as much as the resident requires while encouraging resident independence through active participation.

Feeding assistants strive to set residents up for success during mealtimes by supplying altered utensils, pre-cutting food, and eliminating excess packaging, among other duties. Assistants may also employ specific feeding methods — some of which are more hands-on than others — which can be combined to meet each individual’s unique needs. Methods may range from physical guidance, such as spoon feeding, to verbal encouragements and directions.

Referring to foods by name or taste, and identifying which items are where on the plate, can help residents who have vision challenges. Other practices like providing direction (such as which item to eat next), addressing the resident by name, and offering praise can help residents finish their meals.

Does mealtime assistance qualify seniors for different levels of care?

The number of activities of daily living (ADLs) your aging loved one needs assistance with — and to what degree they need assistance with each activity — plays a role in determining which level of care is most appropriate. The ability to feed oneself is an ADL that health care professionals consider when assessing a patient’s needs, but it’s not a defining factor.

Generally speaking, if your loved is relatively self-sufficient and can eat independently but needs a little assistance with grocery shopping and meal preparation, home care or an independent living community may be the right fit. If they require consistent assistance with eating and other ADLs, their physician may recommend an assisted living community or nursing home.

Questions to ask regarding nutrition and mealtimes when touring communities

With so many options available, finding a community that can meet your loved one’s dietary needs while catering to the overall sensory experience is crucial in maintaining their health and wellness.

When exploring options, consider the following questions regarding special diets and assistance at mealtimes:

  • Can the culinary staff adjust meals to meet dietary needs?
  • Is there a dedicated culinary team? Does the team include a dietitian?
  • Can you review recent menus?
  • Can you sample a meal during a regular mealtime?
  • How can community members provide feedback on the dining experience?
  • How do staff members keep track of allergies, intolerances, and dietary preferences?
  • Do staff members receive feeding assistance training?
  • How does the staff handle problems with eating and nutrition?
  • Does the community offer meal plans? What are the costs?
  • Are snacks available between meal times? Are they included in the meal plan?
  • Is there a speech or swallow therapist on-site?

Sources

A Place for Mom. Caregiver Survey, December 2020.

Bridgepoint Active Healthcare. Mealtime Assistance Program Handbook.

Clinical Nutrition. Older adults and patients in need of nutritional support: Review of current treatment options and factors influencing nutritional intake.

Clinical Nutrition. Undernutrition and associated factors among hospitalized patients.

Journal of the American Geriatrics Society. Prevention of Unintentional Weight Loss in Nursing Home Residents: A Controlled Trial of Feeding Assistance.

Journal of Unexplored Medical Data. The role of plant-based nutrition in cancer prevention.

The Permanente Journal. Nutritional Update for Physicians: Plant-Based Diets.

Stacey Burke
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Stacey Burke

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