Nutrition, Hydration, and Oral Care

We often think of food and drink in terms of mealtimes, making sure our care recipient receives three square meals each day.  But nutrition and hydration needs change as we age or as a medical condition is present, affecting all aspects of health and wellness.

It is difficult to judge how much food and drink is enough, especially as the body of our care recipient is changing.  There are many other factors that influence this including aging, level of physical activity, medication, and digestive system health.  

It is far too common that persons living alone, especially seniors, will skip meals regularly or default to ‘tea and toast’ rather than a well-balanced meal.  If your person is not feeling well, their interest in eating and drinking may decrease further, making the caregiver’s involvement in encouraging and monitoring intake even more vital.

Hydration

Staying hydrated, especially during the hot summer months, is important for everyone. A lack of fluids can lead to serious health problems, especially in older adults. Older adults are particularly susceptible to fluid and electrolyte imbalances because, as we age, our body’s ability to conserve water is reduced. This can make it more difficult to adapt to things like fluctuating temperatures. Our sense of thirst also diminishes with age, which means that dehydration may come on quickly and can begin even before thirst is felt.

Dehydration is a condition of which we all should be aware. Symptoms may include confusion, weakness, darker coloured urine and urinary tract infections (UTIs), dry mouth, headaches, fatigue, cramps, or joint pain.  It may be a best-practice to routinely offer water to your care recipient or an electrolyte replacement.  The following articles on dehydration will give further details on what to look for and how to respond: What is Dehydration? and Dehydration: A Hidden Risk to the Elderly.

Nutrition

Many people may feel unmotivated to cook for themselves, especially if they live alone.  It is a difficult switch from preparing and eating meals with family to "cooking for one".  Some people are no longer able to shop for food, cook for themselves, follow a recipe, or operate kitchen appliances or tools.  

The Statistics Canada’s Nutritional Risk Among Older Canadians tells us about the factors affecting ‘nutritional risk’, which falls between nutritional health and malnutrition.

If you are concerned about your care recipients eating habits, you may be interested in these eight fact sheets from Dieticians Canada.

Calling 2-1-1 or visiting ns.211.ca offers the most current listing of many community resources including Meals on Wheels or Frozen Favourites program, delivering hot meals one or more times weekly.

If you notice your loved one is having difficulty swallowing (this is called dysphagia), the Nova Scotia Speech and Hearing Centres provide useful brochures on how to identify swallowing issues and how to help yourself or a loved one. They also describe the link between swallowing problems and oral care. 

Oral Care

Good oral health is important at every age and can profoundly affect overall health, whether your care recipient has natural teeth, dentures, no teeth, or a combination.  Painful or uncomfortable chewing can be a deterrent to enjoying meals and the embarrassment of poor oral health may prompt a decrease in socializing with others during mealtime.  Statistics Canada reports that people who rated their oral health as fair or poor were more likely to be at nutritional risk.  

Did you know?

  • Your oral health is an indicator of your overall general health.
  • There are over 500 medications that can cause dry mouth.
  • 7 out of 10 Canadians will develop gum disease, which is linked to heart disease, lung infections, and osteoporosis.

There is a short Caregiver’s Guide to Providing Oral Care from the Ontario Dental Hygienists’ Association that provides a good overview and may be helpful.  

Caregivers Nova Scotia offers a two-hour workshop, Brushing Up on Mouth Care, which will help you recognize the importance of good oral care to your care recipient’s ability to eat and to their overall health. Please call Caregivers Nova Scotia for information on a workshop near you.

Caregiver Tips

While our focus is on our care recipient, we may be forgetting our own nutritional needs. In prompting our care recipient to keep hydrated, we may forget to hydrate ourselves.

Perhaps you could set up some good practices –drinking from a large bottle of water so you can track your fluid intake each day, or making healthy snacks easily available for when you are feeling hungry between meals.

And when a thoughtful family member or neighbour asks what they can do to help, suggest they could make an extra serving or two when cooking a casserole, or something that is easily re-heatable. Chances are they will be happy that there is something they can do to be of service.