How to Get the Elderly to Eat!

Learning how to get elderly to eat when they refuse can be a difficult task.  There are typically many factors that are causing them to not want to eat and it’s important to find the underlying cause.

As a Registered Dietitian with over a decade of experience working with the elderly, I have found the best techniques that work to get them to eat.

Let me guide you through this difficult journey, because it can get easier.

an elderly lady serving food to three smiling older individuals.

Understanding Appetite Loss

Appetite loss is a big reason that an elderly individual will refuse to eat.  As we age our appetite does naturally decline, it’s something we expect to see.  But appetite loss still does need to be monitored to avoid malnutrition.

Appetite loss in the elderly can be attributed to various factors, including medical conditions and side effects of medications. For instance, conditions like Parkinson’s disease, dementia, and stroke often affect eating habits. 

Similarly, certain medications can diminish appetite or alter the taste of food, impacting the desire to eat.  For a list of medications that cause nutrition implications, check out a list here.

If you want a full article on the many causes of appetite loss in the elderly, I recommend clicking here to read a full article on it!

The question then becomes, well what do you do when an elderly person refuses to eat?

You help them TO eat!  Here is a list of things that you can do that can encourage your loved one to eat and improve their nutrition!

Strategies to Help an Elderly Person Eat

When it comes to the elderly refusing to eat, it may be more than one thing that is causing them to not want to eat.  So be patient and know that you may have to try more than one strategy to encourage them to eat again.  

Below I’ve listed the factors that may be playing a part in them refusing to eat.  But also understand that you may need to consult with a healthcare practitioner if there is an underlying health issue causing it.  

Try these strategies and let me know below what you’ve tried and how they’re working!

Address Underlying Causes

Medical conditions and medication side effects play a significant role. Health issues such as Alzheimer’s, Parkinson’s disease, cancer, or gastrointestinal disorders can directly affect appetite and digestion. 

Many medications prescribed to older adults, including antidepressants, pain relievers, and blood pressure drugs, can lead to reduced appetite or cause nausea. Oral health is another critical factor; issues like ill-fitting dentures, gum disease, or tooth loss can make eating painful or difficult.

Psychological factors also have a profound impact. Depression, anxiety, loneliness, grief, or significant changes in the living environment (like moving to a care facility) can decrease an elderly person’s desire to eat. Reduced physical activity, leading to a lower metabolic rate, can further diminish appetite. Moreover, sensory changes that come with aging, such as alterations in taste and smell, can make food less appealing.

Physical challenges like difficulty swallowing (dysphagia) are common in older adults, making the act of eating uncomfortable or even painful. Cognitive decline, including conditions like dementia, can lead to confusion around meal times or forgetfulness about eating. 

Addressing these issues requires a comprehensive approach, involving medical intervention, dietary adjustments, and environmental changes, to encourage better eating habits in the elderly.

Creating a Routine

Establishing a regular mealtime schedule is crucial for the elderly, as it sets a routine that can enhance their appetite. Consistent dining times align with the body’s internal clock, aiding in better digestion and creating a sense of anticipation for meals.

Offer Multiple Small Meals

Offering five small meals a day can be beneficial for elderly individuals who are reluctant to eat. Smaller meals are less overwhelming than larger ones and easier to digest, making them more appealing to those with decreased appetites and slower digestive systems. 

This approach ensures a steady nutrient intake throughout the day, maintaining energy levels and overall health. It also accommodates dietary needs and preferences, providing variety and helping to stabilize blood sugar levels, which is particularly important for those with or at risk of diabetes.

The routine of frequent, small meals can positively impact mental health. It creates regular intervals of activity and engagement, which can improve mood and cognitive function. This eating pattern is not only nutritionally beneficial but also aligns with the lifestyle and health requirements of the elderly, encouraging better food intake and well-being.

Enhance Flavour

Enhancing flavor and aroma is a key strategy in making meals more appealing to the elderly, whose sense of taste and smell may have diminished. Utilizing herbs and spices is an effective way to boost flavor without relying on excess salt or sugar. 

Options like garlic, ginger, basil, and cinnamon not only enhance taste but also stimulate the appetite through their aromatic qualities. The visual presentation of food plays a crucial role. Attractive, colorful, and neatly arranged dishes can make food more enticing, tapping into the psychological aspect of eating where visually appealing food is more likely to be enjoyed.

Different cooking methods can also bring out unique flavors and aromas. Techniques like roasting or grilling intensify flavors, while slow cooking makes dishes more aromatic and tender, which is beneficial for those with dental issues. 

Using fresh, high-quality ingredients can significantly improve the taste and aroma of meals. Considering the texture of food is important; a mix of textures, such as adding a crunchy element to a smooth dish, can make eating more interesting and enjoyable.

Pleasant Dining Environment

The environment where meals are served also plays a significant role. A calm and visually appealing setting can make meal times more enjoyable and less stressful. 

Simple touches like a well-set table or a quiet, comfortable room can make a considerable difference. These factors are especially important for those facing challenges such as dementia or sensory impairments, where a serene environment can help in focusing on the meal and eating better.

Dining Room Table Setting

Contrasting colours in meals are crucial for the elderly primarily due to visual and cognitive reasons. As people age, their vision can decline, making it harder to distinguish between foods and plates if the colours are too similar. This can lead to reduced appetite and decreased food intake.

Elderly individuals who are served food on plates with high colour contrast (like white rice on a dark plate), eat more compared to when the food and plate were of similar colours. 

This is because the high contrast makes the food more visually appealing and easier to identify, which can be particularly important for those with diminished sight or cognitive issues.

Colourful meals can also provide a variety of nutrients. Different coloured foods often contain different nutrients, so a visually diverse plate can also be nutritionally diverse, contributing to a better overall diet. This aspect is especially important for the elderly, who may have specific nutritional needs or deficiencies.

Importance of Social Interaction

Social interaction is intimately linked with improved appetite in the elderly. Sharing meals can transform eating from a mundane task to an enjoyable and communal experience. 

Engaging in conversation during meal times not only provides a warm and inviting atmosphere but also encourages the elderly to eat more. Discussing topics like daily events or reminiscing about past experiences can significantly enhance their dining experience .

Inviting family members or friends to join meals or even involving the elderly in meal planning and preparation can make food-related activities more stimulating. 

This approach not only boosts their appetite but also provides a sense of involvement and importance, contributing positively to their overall well-being.

Food Safety and Nutritional Needs

Food safety is KEY for the elderly!  They are more susceptible to foodborne illnesses. Paying attention to expiration dates, practising good hygiene, and ensuring proper cooking of foods like meat and eggs are essential steps.

Also, refrigerating leftovers promptly and avoiding high-risk foods like soft cheeses and unpasteurized milk products can prevent health issues.

Nutritionally, older adults should focus on a balanced diet rich in fiber, healthy fats, and vitamins while reducing salt and “white foods” like white bread and rice. Incorporating whole grains, fruits, vegetables, and lean proteins ensures a nutritious diet. 

Hydration is a Focus!

Hydration is vital for the elderly due to their increased risk of dehydration. As we age, our body’s ability to conserve water decreases, and the sense of thirst becomes less acute. These changes can lead to a reduced intake of fluids, making dehydration a common issue among older adults. 

Dehydration in the elderly can lead to serious health complications, including urinary tract infections, kidney stones, constipation, and even hospitalization due to severe cases.

Proper hydration is essential for maintaining bodily functions. It helps in regulating body temperature, transporting nutrients, and eliminating waste. For the elderly, staying well-hydrated is also crucial for cognitive health, as dehydration can lead to confusion, drowsiness, and memory problems. 

Ensuring adequate fluid intake is a key aspect of maintaining overall health and well-being in older adults.

Shopping and Meal Planning Tips

Effective shopping and meal planning are key to ensuring the elderly maintain a balanced and appealing diet. Planning meals in advance helps to ensure a variety of nutritious foods are included in the daily diet. 

Creating a shopping list based on this plan can aid in sticking to a budget and avoiding impulse purchases of less healthy options  .

When shopping, focusing on whole foods found in the perimeter of the grocery store, such as fresh produce, meat, and dairy, is beneficial. Processed foods, often high in fat, sugars, and sodium, should be limited. 

Reading Nutrition Facts labels helps in selecting items that are lower in these undesirable ingredients and higher in beneficial nutrients like fiber and vitamins.

Nutrient Requirements for the Elderly

The nutritional requirements of elderly individuals are certainly different from the younger generation.  Here is a summary of the nutritional requirements to focus on when helping the elderly eat.

Caloric Requirements

The caloric requirements for elderly individuals typically range around 30-35 kilocalories per kilogram of body weight daily. This range is adjusted to meet the changing metabolic needs of older adults, who often have a lower basal metabolic rate compared to younger individuals. 

The decreased caloric need reflects their reduced physical activity levels and lean muscle mass. But these requirements can vary based on individual health conditions, activity levels, and specific nutritional needs. It’s important to balance these caloric needs with a diet rich in nutrients to support overall health, taking into account any chronic conditions or dietary restrictions the individual may have.

Macronutrient Requirements

An important aspect of elderly nutrition is ensuring adequate protein intake to combat “anabolic resistance,” a common issue where the body’s efficiency in using protein diminishes. 

Healthy older adults should aim for 1.0 to 1.2 grams of protein per kilogram of body weight per day. For someone weighing 68kg (150lbs), this translates to about 80-100g of protein daily, which can be obtained from sources like stewed meats, soft-cooked fish, and well-cooked legumes .

Carbohydrates are also essential, particularly for their fiber content, which helps prevent constipation. Seniors should aim for about 25-30 grams of fiber a day, choosing soft, easily digestible carbohydrate sources. 

Healthy fats are important too, for maintaining overall health and providing energy. Incorporating sources like olive oil and avocados into the diet can offer the necessary fats without the adverse effects of saturated fats.

If you want a full list of nutrients to focus on for the elderly, check out this article by clicking here.

Vitamins and Minerals

Vitamins and minerals play a crucial role in the health of older adults. Vitamin D is key for bone health and may protect against chronic conditions like type 2 diabetes and some cancers. It can be synthesized by the body through sunlight exposure and is also found in foods like eggs and certain fish.

Vitamin C, an essential antioxidant, aids in infection recovery, wound healing, and skin elasticity. It’s abundant in citrus fruits and peppers .

Vitamin B12, important for nerve function and red blood cell production, becomes harder to absorb from food with age. It’s present in dairy, meat, and poultry, but supplements may be necessary for some seniors. Iron, vital for preventing anemia, is found in red meat and is crucial for oxygen transport in the body.

Final Thoughts

Encouraging the elderly to eat involves more than just offering nutritious food. Serving smaller portions can be more appealing and less overwhelming, especially if their appetite has diminished. 

This approach makes it easier for them to consume the entire meal, ensuring they get the nutrients they need. Offering five smaller meals throughout the day, instead of three large ones, might better align with their reduced appetite.

Enhancing the flavor of meals is also important. As the sense of taste often diminishes with age, preparing meals with a variety of tastes and textures can stimulate appetite and make eating more enjoyable. 

This can include using herbs and spices for seasoning, which also offers the added benefit of reducing salt intake.

I know that an elderly loved one refusing to eat can be quite stressful, but I recommend staying patient.  Respect them when they say they do not want to eat, and try to offer gentle encouragement where you can.

If you need to seek help, speak with their Doctor and see if they can refer you to a Registered Dietitian.  A Dietitian can be a great asset to get to the root cause, and help you develop nutrition strategies that will promote optimal nutrition!

If you have any question about someone who refuses to eat, drop them in the comments below!  I’m always happy to answer questions.

Frequently Asked Questions

Why do elderly people lose their appetite?

Elderly individuals may experience appetite loss due to various reasons including medical conditions, effects of medications, changes in taste and smell, and psychological factors like depression or loneliness.

How can I encourage my elderly loved one to eat more?

Offering smaller, more frequent meals, enhancing the flavor of food with spices and herbs, and creating a pleasant and social mealtime environment can help stimulate appetite. Involving them in meal planning and preparation can also be beneficial.

What are some nutritious foods that are easy for seniors to eat?

Soft, easy-to-digest foods like stewed meats, soft-cooked fish, well-cooked legumes, scrambled eggs, and whole grains are good options. Foods high in fiber and low in sodium are also recommended.

Michelle saari dietitian
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Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.

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