What’s cooking? Family caregivers under pressure

By Naomi Creason, Sentinel Reporter

Adult children find difficulties in making meals for senior parents, especially those with medical and nutritional needs.

It will be 2011 when the first wave of baby boomers hit 65.

The number of people 65 and older has leveled off since 1990, but in a June study, Pew Research Center said that age group will start rising again when the first of 76 million baby boomers become senior citizens.

The research center projects that by 2050, 1 in 5 Americans will be over the age of 65 and about 5 percent will be older than 85 – up from 2 percent now.

The increase in those numbers means an increase in the number of adult children who are taking care of both their kids and their parents, according to Pew Research. Though the number of aging parents receiving financial aid from their adult children is fairly low – 14 percent compared to the 51 percent who still give money to their children – the help that these parents seem to seek from their kids revolves around household chores and errands.

Kurt Kay found that one of the tasks families need the most help with is preparing meals.

“For our caregivers, a lot of (the work) is cooking meals for them,” Kay said of his business, Home Instead Senior Care, which focuses on care-giving services for seniors who try to live independently at homes or in residential facilities in Cumberland and Perry counties.

“Family members are very concerned about the food their seniors eat,” Kay said.

Home Instead, located at 5002 Lenker St., Mechanicsburg, estimates that 83 percent of its caregivers help with groceries or other errands and 65 percent assist with meal preparation.

But according to directors from area senior residential facilities, cooking for a parent does not have to be an unrewarding job. The key is to keep things interesting.

Know their tastes

Jeremy Fry has worked in the senior care industry for six years. Now the director of dining services at The Woods at Cedar Run in Lower Allen Township, Fry believes that to get a good handle on how to prepare meals is to get a good handle on who you’re cooking for.

“I think the best thing you could do is get to know what the resident likes to eat,” Fry said. “It’s not just about what they’re allergic to, but it’s also about what they just don’t like to eat.”

It’s a simple but important question to ask for Fry, who serves

about 135 residents more than 10,000 meals a month. Personal taste, however, isn’t always cut and dried.

“It’s hard cooking for someone who remembers what his or her mom’s cooking used to taste like,” Fry said. “Especially with them aging, their taste buds disappearing and the medications that make food taste differently, the food won’t always taste the same way, and everyone is always very critical about food.”

Much as his residents want the same food from their childhoods, they also keep the same eating habits they had as a child.

That’s one of the reasons why John Bowen, director of social services at Bethany Village, is intent on keeping portion sizes healthy.

“One thing the residents hate is wasting food,” he said. “A lot of them grew up in the Great Depression, so they want to clear their plates. Plus they’re paying for the food, too. So we control portion size. We do ask them when they get here if they prefer small, medium or large portions.”

Portion sizes may be a bit of a change to what seniors are used to, according to Fry, who took note of what portion sizes are like now at a lot of restaurants.

“I think the biggest challenge for them is the portion size,” Fry said. “You go to a restaurant and order a New York strip and you get 12 ounces of beef, but we have guidelines for our portions. Our beef and chicken is 3 to 4 ounces – that’s the biggest size for them.

“At first they think it’s too small, but eating it, they realize it’s the size they can eat. We don’t want to waste anything, and they don’t want to waste anything – it’s their money that we’re spending.”

Take control

That kind of control over food intake is important for both the directors and individual adult children trying to take care of their loved ones. Portion size is just one area that can lead to healthier diets.

Fry found that controlling the ingredients in the food can also help seniors eat healthier.

“I think when you make it yourself, you know what you’re putting into it,” he said. “We don’t add any salt here, unless we’re baking and the recipe calls for it. We use a low sodium base. Salt isn’t supposed to be the flavoring.

“If I’m making a cream of broccoli soup,” he said, “I want the first thing they taste to be broccoli, not salt. If you buy raw items and make it yourself, you can control what goes into it.

“There’s an old saying to shop around the outer edge of the grocery store, because that’s where the produce, meats and dairy products are,” he added. “Get the vegetables and fruits that are in season – they’re usually better and cheaper than frozen vegetables.

“If you get a whole chicken, you can make two or three meals at home from that. You can eat some of the chicken and then use the legs for another meal. It’s cheaper to buy the whole chicken than to buy the sliced portions at the grocery store.”

Creativity is also a crucial component in keeping loved ones interested in what they’re eating.

“We try to show our creative side,” Fry said. “When you have a captive audience like this, you don’t want to keep doing the same thing over and over. But they do want consistency.”

Warning signs of poor eating

So how do you know if someone isn’t eating right? These 10 warning signs are red flags that may signal a potential problem in senior citizens:

1. Loss of appetite.

If the person has always been a hearty eater but no longer eats as he or she used to, it’s time to find out why. Underlying illness could be the root cause.

2. Little to no interest in eating out.

If your loved one has always loved eating out at a favorite restaurant but no longer shows interest, lack of nutrition may be the problem.

3. Depression.

Change in appetite is a classic sign of depression. Be sure to follow up with a physician if you suspect depression may be a problem.

4. Sudden weight fluctuation.

A weight change — losing or gaining 10 pounds in six months — is another sign that something could be amiss.

5. Expired or spoiled food.

Check the refrigerator for expired or spoiled food. Older people could be saving food until it’s no longer safe. Make sure that all food is labeled with the date, in large letters and numbers.

6. Skin tone.

Observe the person’s skin tone. If they are eating properly, the skin should look healthy and well-hydrated.

7. Lethargy.

If your loved one has regularly been active and enjoyed taking walks but suddenly becomes lethargic, encourage him or her to see a doctor. Poor nutrition could be to blame.

8. Cognitive problems.

Seniors who live alone might forget to eat. Dementia and cognitive problems can lead to nutritional deficiencies. Quick intervention is vital.

9. More than three medications.

Medication can influence both appetite and weight. Check with the person’s doctor to find out if the medications could be the culprit.

10. A recent illness.

Illness or a hospital stay could make a senior stop eating. Keep tabs on your loved one’s recovery, making sure he or she has reliable help at home.

Senior shopping list

They may seem like common staples for any healthy diet, but the following 12 foods hold special nutritional value for senior citizens.

These items were developed by Home Instead Senior Care in cooperation with nutrition experts at Duke University Medical Center and the University of Maryland.

Seniors are asked to consult a doctor before beginning any diet or nutrition program.

1. Oatmeal

A great source of soluble fiber, oatmeal has been shown to help lower blood cholesterol and may reduce the risk of heart disease and stroke.

2. Eggs

With only 75 calories per serving, eggs contain 13 essential vitamins and minerals, including vitamin D, which is important in absorbing calcium needed for bone strength. Lutein and zeaxanthin found in egg yolks may reduce the risk of cataracts and help prevent macular degeneration.

3. Yogurt

Rich in calcium, yogurt can contribute to the calcium requirement needed to prevent osteoporosis. Good bacteria is added to some yogurt, which may help people with digestive problems that often accompany aging. Mixing yogurt with fortified cereal provides added vitamins, including vitamin B12, which many seniors have difficulty absorbing from foods that naturally contain that vitamin.

4. Blueberries

These blue beauties are among the top fruits and vegetables for antioxidants. Research on aging and Alzheimer’s disease reveals that blueberries may also improve memory and coordination.

5. Apples

The benefits of apples are too numerous to name. The pectin in apples supplies galacturonic acid to the body, which lowers the body’s need for insulin and may help in the management of diabetes.

6. Fish

Bluefish, mackerel, salmon, sardines, trout and tuna (bluefin and albacore) are a low-fat, high-protein source of nutrients. The American Heart Association recommends fatty fish twice a week to improve heart health.

7. Chicken

Poultry is an excellent source of protein that contains less fat than most meats. Chicken, especially breast meat, contains half the fat of a steak. Chicken also has niacin and selenium, which possess cancer-fighting properties.

8. Broccoli

A good source of multiple nutrients including vitamins K, C, E, B, and calcium and iron, broccoli has been found to protect against cancer, heart disease, stroke and macular degeneration.

9. Soy (edamame)

Nutritionists recommend consuming up to one serving a day of soy as a replacement for foods high in saturated fats. Some studies have shown that soy improves bone health. Be sure to consult your doctor before adding soy to a senior’s diet.

10. Sweet potatoes and squash

Sweet potatoes provide beta carotene and vitamins C and E, all of which promote healthy skin, hair and eyesight. Squash is a good source of beta carotene and vitamin C.

11. Rice

As a complex carbohydrate, rice digests slowly, allowing the body to utilize the energy released over a longer period, which is nutritionally efficient. Rice has low sodium content and contains useful quantities of potassium, the B vitamins, thiamin and niacin. Rice contains only a trace of fat, no cholesterol and is gluten free, so it’s suitable for people with celiac disease.

12. Dark chocolate

Consumed in moderation, this high-calorie, high-fat food has been found to boost HDL cholesterol (known as good cholesterol) and lower blood pressure.

As a result of the study showing the stress on family caregivers to provide and cook food for their loved ones, Home Instead Senior Care has developed a “Cooking Under Pressure” handbook, promoting healthy, stress-free grocery shopping and meal preparation tips and recipes.

Some of the tips include creating a shopping list so seniors regularly have healthy ingredients, collecting interesting recipes and making sure seniors have the companionship they need to make mealtimes and shopping enjoyable.

The handbooks are free through the Mechanicsburg Home Instead office by calling 582-2734, and are also available on the Web site www.foodsforseniors.com.