According to one expert on geriatric nutrition, our diet makes a difference in how we live. Proper nutrition can also help us manage common chronic illnesses in our later years.
“In Canada, 45%, and in BC, 55%, of older adults admitted to hospital medical and surgical units are malnourished,” says Jenneke van Hemert. Jenneke is a BC-based dietician and founder of Therapeutic Meals, a technology startup devoted to senior’s nutrition.
“My expertise and passion is in geriatric care, modified diet textures and nutrition therapy,” van Hermert says.
Van Hemert studied Dietetics at the University of British Columbia and has spent most of her career in patient-centered care environments in hospitals and long-term care homes.
Malnourishment increases the length of client’s hospital stay, diet and nutrition can affect every aspect of our lives as we age.
The impact of Geriatric Nutrition
“Close to 90% of Canadian seniors live with at least one chronic condition,” says van Hemert, “Proper nutrition increases quality of life for people living with chronic conditions by improving muscle strength, gait, balance and mobility, for example.”
Nutrition also improves immune system function, van Hemert says, as well as speeding up healing, and increasing the overall perception of wellbeing.
“Nutrition is particularly important when we age because physiological changes make us more vulnerable to malnutrition,” says van Hemert.
Absorption of certain nutrients is compromised, van Hemert says, and appetite tends to decline.
“Even though these changes are common, they are not actually normal or healthy,” says van Hemert. “I have heard this story many times; when a mother or father does not want to bother anyone, and will manage with having tea and toast. Unfortunately, this eating habit excludes protein which is important in maintaining lean muscle mass, balance, strength and gait, and therefore leads to muscle wasting.
Protein deficiency is an independent risk factor for falls, meaning that proper nutrition is a necessary part of fall prevention.
How to ensure you or a loved one is consuming a nutritious diet.
According to van Hemert, offering nutritionally-sound and ready-to-eat meals is a great way of optimizing nutrition, as these meals can easily be heated and enjoyed by both the caregiver and client.
Van Hemert says nutrition and eating habits can either precipitate or prevent serious chronic illnesses in later life.
“Seniors are most likely to move into a caregiving scenario as a result of an incident or exacerbation (worsening) of a chronic condition,” say van Hemert. “There is a wide range of conditions that present with challenges with eating.”
For example, dementia presents a wide range of challenges: the inability to recognize hunger or thirst can result into missed meals or dehydration, which results in frailty, dizziness, weakness, fatigue and confusion.
“These symptoms contribute to increased risk of falls, and urinary tract infection, both of which may result in hospitalization,” says van Hemert. “The best way to encourage healthy eating is to have the meals in a social setting, at the same time every day. Having ready-to-eat meals at hand is also a great tool. The caregiver can heat up the meal and spend time with the client during meal time.”
The importance of nutrition therapy
Van Hemert says it’s possible to use nutrition to mediate or even reverse some complications from common conditions related to aging.
“Nutrition therapy can accelerate recovery from illness or injury, improve management of illness and disability, and decrease risk of illness exacerbation or need for readmission,” she says. “For example: obesity contributes to the development of chronic diseases such as heart disease, diabetes, hypertension, osteoarthritis and certain types of cancer. Weight management, portion control and high fibre intake are a proven nutrition therapy approach.”
To help caregivers be proactive about diet, van Hemert has launched a technology startup to help improve senior nutrition.
“I founded Therapeutic Meals with the purpose of helping people in the community living with chronic disease meet their specific nutritional requirements while providing great tasting meals, variety and quality,” says van Hemert. “I am currently in a startup phase, and have launched our nutrition counseling services. The nutrition counseling aims to support caregivers and their loved ones and clients assess the nutritional needs, helps with the implementation of nutrition therapy, to screen the client for dysphagia or other risk factors for malnutrition and provides a strategy to mediate conditions.
“My expertise and passion is in geriatric care, modified diet textures and nutrition therapy. Modified diet textures are no chew diets, minced diets, soft diets, finger food, cut up and dysphagia diets. Nutrition therapy focuses on restricting certain macro or micronutrients, or the opposite, increasing certain macro or micronutrients, based on the prescribed diet order as part of treatment of a chronic or acute condition.
The meal service component is yet to launch. Once the meal service is online, van Hemert says Therapeutic Meals will provide a full home nutrition care package.
Jenneke van Hemert is busy building her Therapeutic Meals startup in Victoria, BC.
Common Conditions Related to Geriatric Nutrition
Managing Chewing Ability
Poor fitting dentures, mouth sores or other painful mouth related conditions compromise chewing ability. A swollen red tongue, or fissures in the corners of the mouth are signs of nutrient deficiencies or poor fitting dentures. Either one result into insufficient intake of a balanced diet. A temporary modified diet texture such as a no chew diet can greatly improve intake and help the mouth heal, while dentures are being fixed or refitted.
Dysphagia (Difficulty Swallowing)
Difficulty swallowing, or dysphagia, can be present as a result of progressive dementia, stroke, or other neurodegenerative diseases. Dysphagia increases risk of choking and aspiration (food going down the air pipe rather than to the stomach).
Food or fluid particles can provide a nutrient rich environment for bacteria in the lungs, which can lead to aspiration pneumonia. Signs of dysphagia can be elusive, as coughing is not always present.
Pocketing food in the cheeks, sneezing, runny nose, teary eyes or a gurgly voice after consuming fluids are all signs of dysphagia. Pneumonia is a common infection among patients both in the community and in an institutional setting and is a leading cause of morbidity and mortality in Canada.
Modified diet textures, and avoidance of certain high risk foods are key methods in managing dysphagia and lowering risk of aspiration pneumonia.
Chronic Obstructive Pulmonary Disease
Due to the laborious breathing, a client may have trouble eating and breathing at the same time, causing a decreased intake. In addition, the energy required to breathe sufficient air is increased. Both factors put a COPD sufferer at risk for malnutrition and frailty. Nutritionally, COPD is managed with a nutrient dense high protein high calorie diet, making every bite count.
