Beware Nursing Home Nutrition

Hospitals and nursing home dieticians don’t seem to have the recipe for good nutrition. Caregivers don’t know how much of anything patients are really consuming.

Earlier this year, researchers at the University of California measured the total percentage of food and fluid intake of 56 nursing home residents in one facility: the nursing home staff overestimated the total intake levels of residents by 22 per cent. The staff also failed to identify 53 percent of those residents whose intake levels were equal to or below 75 percent for most meals!

The authors of a 1999 study published in the Canadian Medical Association Journal defend the confusion by stating:

"Malnutrition is difficult to define." A surprising statement in the face of diminished muscle mass and mobility, poor immune function and decreased healing ability.

Seniors Need Supplements

In his 13 years of clinical practice, North Vancouver naturopath David Bayley has treated many elderly patients with health problems linked to bad nutrition. These problems can cause impaired mental performance, headaches, lethargy, fatigue and depression, to name a few.

"Nutritional deficiencies are very common," Bayley says. "There are two major reasons. The first is convenience foods–packaged, premade and canned items that are notoriously low in enzymes and biologically inactive."

Patients in hospitals and nursing homes have little control over their meals and even seniors living at home choose to skimp in the kitchen. Daily shopping is a hassle. They bypass fresh produce because it doesn’t keep well.

"The second reason [for] is that the efficiency of our own gut decreases with age," Bayley explains. "It’s difficult to chew. Many people have bad bites or dentures."

At the very least, he suggests a multivitamin/mineral for his elderly patients but because individual requirements vary he may also recommend extra of vitamins E and C, flavonoids, ginkgo biloba or a sublingual vitamin B12/folic acid tablet. His patients are encouraged to try organic home delivery services. When time or energy falls short, many a senior looks forward to drop-off meal services at affordable prices.

Says Bayley, "We should make eating whole food a priority. He explains that the nutrient content of food is lower than it used to be even 60 years ago. Fruits and vegetables are typically grown in poor quality soil and picked too early. A person needs a meticulous diet to ensure proper nutrition–especially the elderly.

Making The Effort for Health

All long-term care facilities are licensed by the Ministry of Health and are supposed to be inspected on a regular basis. In addition to their operating license, a facility may also have been accredited through the Canadian Council on Health Services, Sections 7 through 7.11 of the Community Care Facility Act Adult Care. Regulations lay out what is legally required in terms of nutrition and food planning. Among other things, a food plan should be developed for each new resident within two weeks of arrival; it should be documented, monitored, reviewed and revised if necessary, and any vitamins to be meted out must be ordered by the resident’s primary health care provider.

For one Vancouver family, that was unacceptable. When Charles Gale was admitted to full-time care, his family worked hard to maintain his level of nutrition through natural medicine.

The institutional food was boring and Charles looked forward to occasional meals on the town. The difficulties began when staff discovered that Charles was taking vitamin supplements for a recurring heart problem. The Gales were told they needed a doctor’s permission if Charles wanted to continue taking vitamins. A note from the family naturopath wasn’t good enough.

"Our regular family doctor doesn’t believe in vitamins," son Ron admits, "but I made an appointment anyway."

He returned to the nursing home, with signed permission for his father’s vitamins in hand and the staff conceded. Several months later, the nurses remarked that Charles’ health had improved–dramatically!

Ron remembers how his father refused the flu vaccine and chose elderberry, a more natural alternative, instead. Charles was one of the few patients who remained well during a spring flu epidemic.

By this time the doctors realized they weren’t running the show: they were part of a health team. By reclaiming their right to the health care of their choice, the Gale family beat the odds of institutionalized malnutrition.

Alternative Options

Tracy Dale can’t remember the last time she had the flu. Why? Because she takes extra special care of herself and the residents who thrive in her wholistic retirement home in Lindsay, Ontario.

"It’s extremely difficult to change people’s life habits," Dale admits, but that doesn’t stop her from trying.

This registered nurse, who specializes in therapeutic touch, nutrition and other healing arts, wouldn’t dare microwave a meal. She leads by example: a green drink here, a bulgur and flax seed muffin there.

"Simple things make the difference," she says and indeed, her clients benefit from getting back to the nutritional basics. For more information, contact Tracy Dale at Hope House (705) 328-0404.

Cost-Effective Malnutrition

Hospital and nursing home dieticians are trained to count calories, to provide the cheapest menu and to cook everything in order to avoid food poisoning. For example, you can’t get a soft boiled or poached egg because of the fear of salmonella.

Consequently, the food offered is dead. Pasteurized milk, reconstituted fruit juices, no raw food of any kind because of chewing problems are the norm; whole foods are almost non-existent.

The reason? Care homes are business for profit. They can’t allow any mishap resulting in extra cost. So you have to take the responsibility yourself, like the Gales. The next time you visit your loved one, take her to a salad bar–she’ll be the better for it!