The mission: nutrition

It’s been 25 years since Arlene Peterson’s husband died suddenly of a heart attack. His death came as a shock and required an adjustment in nearly every area of Peterson’s life, including at the dinner table.

“I didn’t have anybody to cook for anymore,” Peterson said last week, before lunch at the Southside Senior Activity Center. “You’re used to cooking for more people.”

Peterson eventually got used to making dinners and freezing what she couldn’t finish to eat later.

But for many older people, the death of a spouse can trigger a downward spiral of poor nutrition habits. It’s just one of many things — from illness to economics — that can leave the elderly malnourished and at greater risk of infections, falls and other problems.

“When it gets bad, it often gets really bad,” says Dr. Barry Barnes, a geriatric specialist who teaches and practices at Family Medicine of Spokane.

There are many reasons that getting adequate nutrition becomes increasingly difficult as we age.

The first comes down to dollars. The fixed-income budgets of many seniors are already stretched by many things, including increasingly costly medications. They may not have the resources to get to the grocery store for shopping and, once there, they may not have the money to buy nutritious food.

“A lot of them eat instant things, these TV dinners and stuff like that,” says Dr. Leonard Vanderbosch of the Hillyard Medical Clinic. “They don’t get the balance of fruits and vegetables.”

Low-cost lunches are available at nearly two dozen senior centers and adult day centers around Eastern Washington and North Idaho. Plus, a variety of agencies deliver meals to people who aren’t able to leave their homes.

The Spokane Regional Health District serves about 400 home-delivered meals and about 300 meals in group settings each day, says Lynne Quimby, Senior Nutrition program manager.

Chronic illness can limit peoples’ ability to prepare healthy meals. Plus, physical problems can cause a loss of appetite and decrease the ability to chew and swallow food, says Dr. Bruce Dentler, a geriatric specialist.

“One of the things that contributes to our appetite is we enjoy the taste and the smells of good food,” Dentler says. “As you lose that, particularly the sense of smell, people sometimes lose part of their interest in food because it’s not as enjoyable.”

Poor oral health, along with neuromuscular conditions such as Parkinson’s disease and stroke, can make it difficult to chew and swallow food, increasing the risk of choking and making some people wary of eating, Dentler says.

The sense of thirst also declines as we age, so seniors should be sure to drink plenty of water. In addition, incontinence can make people less interested in drinking, Vanderbosch says. Dehydration can cause blood pressure to dip, he says.

“Fluids are very important,” he says.

Eating healthily is important, of course. But it’s not always the most important thing, Dentler says.

“For most people over 75 or 85, you’re much less concerned about what they eat rather than whether they eat,” Dentler says.

Dentler visited a 90-year-old man in a nursing home the other day who had lost 20 pounds. His weight dropped to 112 pounds and he was too weak to walk.

The man said he just wasn’t interested in food anymore, but he admitted that he liked root beer floats and a glass of red wine before dinner.

If that would get him to eat more, Dentler said he would make sure the man got his ice cream treat and glass of wine.

“It really behooves those of us who are concerned because we see someone who may not be eating well to really find out what that person likes,” he says.

Seniors also need to be particularly vigilant about food safety.

“As we age, our ability to fight off infection is weakened,” increasing the risk of contracting food-borne illness, says Keri Lindquist, a health educator with the Spokane Regional Health District.

Lindquist visited the Southside Senior Activity Center last week to teach a class on food safety. She stressed the importance of keeping foods at the proper temperature and the benefits of using the freezer to store unfinished food. Lindquist will be at the senior center every Wednesday through October with a different seminar on nutrition.

Even if they’re eating well-balanced meals, older people may also want to consider taking a vitamin supplement, Barnes says. As we age, Vitamins E, D, B12 and folic acid aren’t absorbed in the body as well.

An inexpensive, generic multivitamin formulated for older adults should help fill in the gaps, he says.

So, how can you tell if you or an elderly loved one is getting adequate nourishment?

Be concerned if someone loses more than five pounds in a two-week period or is consistently losing weight without dieting, Barnes says. Also, be wary of cuts, scrapes and bruises that seem to take a long time to heal; that can be a sign of poor nutrition.

A loss of energy or persistent falling can also signal dietary problems.

But those who work with the elderly repeatedly return to the loss of a spouse as a major red flag for dietary problems.

“We see a lot of isolation. … We see a lot of loneliness,” Quimby says. “A lot of people that are isolated, they don’t think about eating. … It’s hard to cook for yourself, and it’s not very much fun to eat by yourself.”