Nutrition It is important to stay on top of
hydration, and drinking fluids steadily throughout the day is to be encouraged to prevent feelings of thirst. Guidance suggests aiming for 1.5-2 litres per day, and all fluids (except alcohol) can be included, such as water, tea, coffee, and flavoured drinks. Drinks without added sugar are preferable for health. Older adults often experience a
reduction in appetite and their associated desire for fluids. Additionally, those with mental and physical health conditions such as dementia and Parkinson’s disease may be reliant on carers to recognise signals and to support their hydration. The whole team can play a part in
encouraging and supporting fluid intake throughout the day by: n A range of enticing different juices. n Daily ‘happy hour’ with mocktails to encourage fluid intake.
n Symbols on menus indicating higher fluid content meals, snacks, and puddings, such as jelly, yoghurt, or soups and stews.
n Healthy fruit and/or vegetable-based ice lollies for hot days.
n Ensuring that fresh, cool drinking water is always available and regularly topped up.
n Remembering milk is a refreshing source of hydration.
n Offering a variety of comforting hot drinks too, especially in the mornings and evenings.
n Providing smoothies and milkshakes as alternatives at mid-morning or mid-afternoon teatimes … these can also be great as snacks!
n Putting up hydration posters, like the one above.
Symptoms of dehydration can vary from tiredness and headaches to poor concentration and slow reaction times. Constipation is also common in those with a low fluid intake. This is particularly true in older adults. If someone is vulnerable, they may not be able to recognise signs of dehydration or be able to respond to them. And this is where carers can provide support. We can live for up to two months without food but only three days without water. That is how incredibly important staying hydrated is!
Nutrition
Nutrition in care home environments requires a focus on foods that are nutrient
January 2025
www.thecarehomeenvironment.com
dense instead of calorie dense (sugar/ fat), which can help the consumption of a wider range of nutrients including energy, protein, vitamin, minerals, and fibre. A simple way to identify if a food is nutrient dense’ is whether it is something designed by nature to support a new life. For example, egg (which could potentially ‘grow’ a baby bird), whole seeds or nuts (from which a new plant could potentially grow) or milk (which would potentially ‘grow’ a baby animal). If the answer is yes, then this is likely to be a nutrient-dense ingredient.
Foods to include for those who may be at risk of malnutrition include nut butters, skimmed milk powder, ground almonds, olive oil, and Greek yoghurt. The latter has the added benefit of being a good source of protein, essential for older individuals. As well as protein, fibre is incredibly important, too. It helps to regulate the body’s use of sugars, keeping blood sugar and hunger in check. Fibre helps regulation of bowels, encouraging peristalsis (movement of the bowels) and helping to prevent constipation.
Fibre can bind to other compounds. These compounds include cholesterol, so fibre can therefore help reduce cholesterol levels. What is more, studies have shown whole grains, which are high in fibre, reduce the chance of developing diabetes and heart disease as well as some cancers. It is possible to increase fibre and maintain or enhance protein intake, through switches and additions to recipes on your menu: Adding cooked barley or legumes to
soup can increase the fibre and the protein content. This also adds flavour and texture (but you can blend or puree, if required). When making a stew or sauce, try switching out half the meat for beans or lentils, boosting the fibre and also reducing the cost of the dish. Do not peel fruit and vegetables – not only does this save time and reduce waste, it also increases the fibre content, as this is mostly found in the skins. Sprinkle seeds or granola over yoghurt for a crunchy high fibre dessert (be careful if preparing food for texture modified requirements, though). Choose granary over white bread. Top tip: encourage drinking more water alongside these higher fibre meals, as fibre needs water. An extra glass will help it work its magic!
Do take care to increase fibre slowly, though. Too much of an increase all of a sudden can cause bloating.
Reducing cardiovascular risk We have touched on the importance of fibre in supporting cholesterol levels and heart health. We will now look at other nutritional considerations, modifications, and tips for reducing cardiovascular risk, which increases as we age. Mediterranean diets have been proven time and time again to be beneficial for many aspects of health, including the heart. A traditional Mediterranean diet includes plenty of fresh fruit and vegetables, both white and oily fish such as salmon, kippers, and mackerel, wholegrains, unsalted nuts and seeds, lean meat and chicken, low-fat dairy products, and unsaturated fats such as olive and vegetable oils. It also means a reduced intake of saturated fat such as butter, lard, and ghee, and other animal products such as cream and red meat. There are some specific foods which
have been found to either increase or decrease cholesterol levels which, if high, demonstrate an increased risk of heart disease, heart attacks, and strokes. Foods that can increase cardiovascular
risk: n Saturated fat e.g. butter, full-fat dairy products, and visible fat on meat.
n High fat, high sugar foods such as biscuits, cakes, chocolate, ice cream, and sweet pastries.
n Foods high in trans fats such as margarines and fast foods, as well as those listed above in the high fat, high sugar foods list.
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