The silver years can be immensely fulfilling, as seniors discover the joys of pursuing personal interests, developing their social networks, and bonding with grandchildren and other family members. However, advancing years also bring physical inconveniences that are a direct result of ageing. Of the many changes that seniors experience, arguably none has as great an impact on their sense of wellbeing as those that affect their ability to enjoy food.
Digestion slows down with age, causing food to move slowly through the gastrointestinal tract. As a result, more water is absorbed from food waste, leading to constipation. The elderly are also more susceptible to diverticulosis, a condition in which pouches form in the wall of the colon. While many people with diverticulosis experience no symptoms, pain may occur if the pouches become infected.
An elderly person's experience of eating is also affected by changes in sensory perception. A drop in the number and sensitivity of taste buds causes loss of ability to perceive sweetness, saltiness, bitterness and sourness. A decline in the sense of smell also renders an elderly person unable to enjoy the aroma of their favourite foods.
Chewing and swallowing may become difficult as saliva production falls, or if there are dental problems such as tooth loss or poorly-fitted dentures. In addition, the elderly may experience swallowing difficulties due to age-related loss of muscle tone along the food passage, as well as conditions such as stroke and dementia. This condition, called dysphagia, can lead to complications such as pneumonia if choking occurs and food is aspirated into the respiratory tract.
Dysphagia may lead to poor nutrition, especially if the person with dysphagia becomes averse to eating due to these difficulties, or refuses to eat unpalatable food that has had its texture modified to facilitate swallowing. Coupled with the specific nutritional requirements of the elderly, this can be a challenge to manage. While the body requires lower amounts of nutrients such as sodium, it requires more iron, Vitamin D, Vitamin B, folate, and calcium. Deficiencies in these essential nutrients can lead to anaemia, increased risk of stroke and dementia, and osteoporosis.
There are simple steps to make mealtimes more enjoyable if you or your loved one is experiencing age-related physiological changes that make eating well a challenge. Ensuring that your diet is well-balanced and contains the necessary nutrients, fluids, and fibre will minimise the risk of undernourishment and constipation. If chewing is difficult, consult a speech therapist for advice on how to cope. Specific meal textures may be prescribed to make swallowing easier and safer. You should also pay close attention to your oral health by brushing and flossing daily, and going for regular dental check-ups.
Finally, do not hesitate to seek help if you experience problems with eating, digestion, or your oral health. Prompt medical attention can make a difference between continued discomfort and poor health, and thriving dotage filled with meaningful activity, wonderful memories, and continued enjoyment of food.
Texture Modified Meals: An Alternative for People with Swallowing Difficulties
Changi General Hospital (CGH) has put joy back into mealtimes for people with dysphagia by creating the first ready-to-eat texture modified meals in local flavours for people with dysphagia, as well as the elderly who prefer soft meals. The meals present delicious food options that appeal to the Asian palate, and are nutritionally-balanced. They are convenient for caregivers, as only simple heating is required before consumption. Fourteen varieties, including braised ginseng chicken, seafood otak, and kicap fish, are available in three different textures – blended, coarsely minced and finely minced.
It took the CGH Dietetics and Food Services team six months to identify the ideal formula to thicken the food while ensuring acceptable taste and texture. Once the formula was found, the team developed, tested, and refined the first batch of recipes. These recipes have been licensed to local specialist nutrition company Health Food Matters (HFM), which has signed a patent licensing agreement with CGH to produce and market the meals.
"Dysphagia occurs most commonly among the elderly. But there are also young men and women who have the same difficulties, such as those with dental procedures, naso-pharyngeal cancer and people who simply prefer soft food. Regardless of the situation, we hope that our texture modified meals enable people with dysphagia to enjoy meals that meet their nutritional requirements," said Ms Magdalin Cheong, Deputy Director, Department of Food Services, CGH.
The meals are expected to be available for sale at healthfoodmatters.com.sg in early 2017.
This article first appeared in Caring Magazine, issue 145, nov/dec 2016.
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