Nutritional Issues for Older People and Older People with Dementia in Institutional Environments

Abstract

The purposes of meals cover physiological needs and social interactions. Mealtimes can be a forum for communication within a family or social unit and food can be seen as a gift; a form of invitation to join in to share the prepared offerings of a host. The manner and way in which food is presented can enhance nutritional status, yet when food is used purely to meet physiological needs, the social meaning of meals become devalued and ultimately a less enjoyable experience. Once a ‘meal’ becomes a routine task and not sociable, the individual may lose their appetite for both the sense of occasion and for the food. Standards on good nutritional care cover the physical and psychosocial aspects of care. Recommendations come from international sources, European sources, British sources and from the four countries of the UK. Age Concern and Alzheimer Scotland have also addressed the issues. Yet the problem of malnutrition in institutional settings persists. Frail older people and older people with dementia are those most likely to be in institutions and those most likely to have a poor nutritional status. This chapter looks at the standards available and the issues involved. It goes on to highlight evidence that shows that those who are dealing directly with providing nutritional care are often care assistants who have little or no knowledge of evidence-based practice on maintaining and improving an individual’s nutritional status.