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We have a lot in common with those of you out there providing at-home assisted living services or memory care services in and around Bethlehem. For instance, the challenges related to loss of appetite within our aging loved ones is common to both professional and at-home care givers alike. We believe you’ll find this blog post both educational and actionable in addressing the loss of appetite within the loved one under your care.

A Loss of Appetite in a Parent or Senior Loved One

A loss and changes in appetite are a natural part of aging. Although poor appetite doesn’t necessarily indicate a serious health problem such as dementia in the elderly, it is still critical to make sure seniors get enough nutrients. Along with some warning signs to be mindful of, there are some easy ways you can help your senior loved ones get the right nutrition.

Although it’s normal for our appetites to change with age, several different factors can also cause a loss of appetite in the elderly:

• Lack of energy to cook and tiredness from lack of sleep
• Lack of interest in food due to changing taste buds, depression or loneliness
• Loss of appetite due to health conditions and dementia symptoms
• Depression
• Medication side effects

“I remind my clients often that a loss of appetite (and thirst) is a normal part of aging and doesn’t always mean something is wrong,” says Heather Schwartz, RD, at Stanford Hospital and Clinics. “However, minimizing the detrimental effects of poor nutrient intake is always important, no matter from where the low appetite stems.”

It is also critical to rule out any underlying health problems or symptoms. If your loved ones aren’t eating well, a good first step is always to consult a physician.

What Should I Be Concerned About?

The aging process brings with it many perceptual, physiological and other changes that can lead to decreased appetite in the elderly patient, including:

1. A lower metabolic rate and lessened physical activity mean seniors need fewer calories.
2. Changes to the sense of smell and taste can affect the enjoyment of food.
3. Dental problems or gastrointestinal changes (like lactose intolerance) that go along with age can affect the appetite.

However, if your parents or senior loved ones are making poor food choices because of their changing tastes, or if they aren’t getting enough to eat, then that’s cause for concern. Seniors must get the right nutrition for their changing dietary needs. Vitamin or nutrient deficiencies can cause significant health problems for vulnerable groups, especially the elderly. Changes to taste or appetite also occur in conjunction with some serious illnesses, including:

• Alzheimer’s disease and dementia or Parkinson’s disease
• Head and neck cancers
• Mouth and throat infections or periodontal disease
• Salivary gland dysfunction
• Thyroid disorders

Any unexplained changes to your loved ones’ dietary health, including unexpected weight gain, loss or general malaise, should be checked out with a physician so you can rule out or confirm symptoms of dementia.

How Can I Stimulate an Appetite in the Elderly?

If you’re concerned about a lack of appetite in your elderly loved ones, whether dementia is a concern or not, there are a few practical things you can do to help them get enough nutrition:

Be aware of medication side effects.

If the problem is dry mouth, Schwartz says, “Chewing sugarless gum, brushing often or using an oral rinse before meals can improve taste sensation, and ultimately nutrient intake.” If meat is tasting “off” — and a common complaint is that some medications make foods taste metallic — then try other sources of protein like dairy or beans. If water doesn’t taste right, try adding herbs, or sliced fruits or veggies like lemon or cucumber.

Consider using an appetite stimulant.

Some seniors have had success with prescription appetite stimulants. A healthcare provider must be consulted to inform the patient and caregiver of the side effects of the stimulant and to also make sure it is appropriate for your loved one.

Encourage social meals.

People of all ages may experience a reduced appetite when the thought of eating alone comes to mind. For seniors, accessibility and availability of social contact can be even more of a problem, especially if they suffer from dementia. Schwartz suggests checking out the meal options at senior centers, temples or churches, and community centers. Additionally, meal “dates” with friends, family or caregivers and even meal delivery services can help.

Increase nutrient density, not portion size.

“I ask caregivers not to increase the volume of food they serve to seniors who may have low appetites,” says Schwartz. “Rather, increase the nutrient density of the foods they serve.” In other words, don’t intimidate them with a huge helping. Alternatively, add healthy extra calories in the form of avocado, olive oil or a little peanut butter.

Set a regular eating schedule.

“Our bodies tend to thrive off regularity, as do our hunger and thirst signals, so when we stray from our usual patterns, so does our appetite,” says Schwartz. She suggests starting slowly by adding a small beverage and/or snack during a normal mealtime. This can help stimulate the body’s hunger signals.

Eating to Encourage a Good Night’s Sleep

In addition to experiencing serious changes in appetite, older adults and individuals with dementia often experience changes in their sleeping patterns. Such changes may be as a result of sleep disorders, such as insomnia or sleep apnea.3 They may also be related to pain or discomfort. It is not uncommon for people to be uncertain when addressing their elderly loved ones’ lack of eating and sleeping. However, both adequate sleep and nutrient consumption are critical for promoting optimal health.

Not eating during the day and feeling hungry at night can make sleeping even more difficult. Such unhealthy patterns increase the frequency of night awakenings. If dementia is involved, this can be very disorienting. Alternatively, chronic fatigue can make elderly adults less likely to finish meals. Consistent sleep deprivation can contribute to feelings of depression and a lack of physical activity, which can also negatively impact the senior’s appetite.

Foods To Eat for Better Sleep

In addition to getting enough to eat throughout the day, it is important that caregivers pay special attention to what is on a senior’s plate during the hours directly preceding bedtime. Try encouraging the following items for dinner and nighttime snacks:

• Moderate Amounts of Lean Protein: While consuming too much protein can be hard on the digestive system late at night, adding some protein to a late-night snack can help promote sleep due to high levels of tryptophan.
• Warm Drinks: Drinking a glass of warm milk or a caffeine-free herbal tea at night can help relax seniors and boost the production of melatonin. Stay away from drinks with caffeine and avoid putting too much sugar in drinks right before bed. It’s also a good idea to finish drinking approximately 90 minutes before going to sleep to limit middle-of-the-night bathroom trips.
• Healthy, Complex Carbs: Carbohydrates paired with tryptophan-containing protein sources can help tryptophan make it into the brain where it is converted into serotonin. However, it’s a good idea to grab whole wheat toast or sweet potatoes over white bread, cookies, or other unhealthy carbs.
• Fruit: Some fruits such as cherries, kiwis, bananas, and pineapples contain melatonin, which can help seniors get to sleep sooner and stay that way longer.

Make sure to limit meal sizes late at night and avoid overly greasy or spicy foods. Such foods may irritate the stomach and cause difficulty falling asleep. As a result, the patient might avoid future evening meals. Also, older adults should avoid alcohol before bed since it affects normal sleeping patterns.

We want you to know that we are here to help. Contact Gateway Gardens Assisted Living and Memory Care in Bethlehem today.

Credit: Heather Schwartz, RD