Nutrition and Hydration Inservice
Written by Amber Jaggars RN,BSN

Often the importance of nutrition and hydration can be overlooked in western medicine, instead a medication is prescribed to treat the symptoms that can be controlled or lessened with proper nutrition. However, in recent years the thought has shifted and the importance of both nutrition and hydration have begun to receive the recognition that they deserve in the importance of health.

When speaking of nutrition in the geriatric population, there are a couple of considerations to keep in mind. First, older adults absorb fewer nutrients from the foods they eat. The ability to digest fats decreases with age, and older adults often require fewer calories to maintain body weight as the metabolism slows with aging. The average daily number of total calories for people over the age of seventy should be between 1200-1600; calorie needs decline by 75% for people over the age of seventy, yet protein needs remain constant or even increase.

Older adults have a higher risk of malnutrition than the rest of the population; although there can be many reasons as to why, a couple of the common warning signs of malnutrition include the following:
An illness that affects the type or amount of food eaten( Diabetic Diet, Low sodium, Fluid restriction etc.)
Eating less than 2 meals a day
Not eating a balanced diet; instead depending on convenience meals, fast food, and junk food
Drinking more than three alcoholic drinks per day
Tooth or mouth problems that make it hard to eat (Dentures, Tooth Loss, medications that cause dry mouth, post stroke, swallowing weakness or problems etc)
Eating alone most of the time
Inability to shop, cook, or feed oneself
Diagnosis of dementia

To help an older adult have better nutrition, try some of the following:
Try to incorporate whole grains, bright deeply colored vegetables and fruits, beans and nuts, lean meat, fish (weekly if possible) poultry and eggs
Purchase as many unprocessed foods as possible, Choose fresh fruits and vegetables when possible, and frozen over canned.
Plan meals for a one week period, and try to prepare meals that the client prefers; while following the care plan for any diet specific restrictions.
Try to incorporate higher fiber in the form of fruits and vegetables, most provide 2-8 grams of fiber per 1 cup serving. Fiber promotes good health and elimination.
Remember that monounsaturated and polyunsaturated fats are healthier fat choices, while saturated and trans fat should be decreased or avoided completely.

Hydration has its own concerns with the geriatric population, older adults often lose their sense of thirst and so do not drink enough water. Your client should have at least eight 8 oz glasses of water (unless the client has specific fluid restrictions). Some ways to incorporate more fluid if the client doesn't care for water can include:
Eating high water content fruits and vegetables, such as: citrus fruits, watermelon, cucumber, tomatoes etc.
Bone broths as long as the client isn't on a sodium restricted diet
Any food that becomes liquid at room temperature, such as jello and popsicles  
Remember that fluid intake will include all liquids entering the body, including iv fluids and tube feedings.

With hydration it is important to recognize the warning signs of dehydration which include the following:
The person complains of thirst
The mouth, tongue, lips and skin appear dry
The eyes may look sunken
Urinary output is decreased, may be dark in color
Vomiting and diarrhea
Fever and excessive perspiration

Keeping these points in mind you can help your client maintain the best nutrition and hydration possible, and have a positive impact on your client’s health.