For a variety of reasons seniors too often suffer from malnutrition – not all of them because of sickness. Just this week figures release suggested one in three elderly Australian receiving home care, are at risk of malnutrition.
The mind boggles about what the figures might say if all elderly were included.
I remember all too well my honest to goodness embarrassment when a doctor told our family that my elderly Mother was malnourished. Guilt! Yet, I had no idea. Underneath her many layers of clothing, most of it lose, my mum was not much more than 45 kilos. Wow. What a shock! My father too had trouble with food. And I have seen many, many patients with problems.
Here is a check list of things to consider, when food is not the pleasure it once was.
- Have a meal together – not Mum or Dad watching you have a coffee and a biscuit as you fly out the door. Sit down for a meal and watch what they eat. It may be that company increases the appetite.
- Are soft foods being eaten, but chewable foods left behind?
- Does your parent waive off the idea of a meal, preferring to have a drink, and promising to eat later?
- Are their clothes loose?
- Do their dentures click?
- What’s in the fridge? Much? Check the use by dates.
- Do they choke on their food? Or on their drink?
This is why these observations are important.
If you are waived off a meal, but encouraged to have a scotch instead, this may be a sign that alcohol, a known appetite suppressant is having a n effect on your parent. Try and change the schedule around a bit so food comes before drink.
If you hear their dentures click, there’s a good chance that chewing is not easy and that’s another reason to skip meals. Get your parent to the dentist or denture clinic. Of course gum disease and bad natural teeth are also a concern – when was the last trip to the dentist? Eating soft foods is also a tip off on that one.
No food in the fridge? Why not? Do your parents have enough money to buy food – don’t laugh, it is a real concern. Many of us do not know the financial situation of our parents – we just assume they’re okay. But prices of everything are rising, and bills need paying. Gently find out, without alarming anyone, if they are okay financially.
If they are struggling, try and find a solution.
If there is no financial assistance available, look at getting Meals on Wheels or a similar low cost service. If they protest, remind them that malnutrition leads to a whole bag of trouble including illness, and accidents (such as falling).
If none of these issues is obvious, consider this: have they changed medications lately? Some do have unpleasant side effects, which many elderly people just accept without even mentioning this to their chemist or GP. There may be an alternative medication.
If you notice, or hear them speak of, choking on their food then here is a further issue to investigate. Losing the ability to swallow confidently or consistently is called dysphagia (from the Latin meaning unable to eat). Nobody likes to choke – it is terrifying.
A simple solution is not to eat. It’s not a long-term solution though is it? Sometimes it is caused by an obstruction in the throat – but often it is more a mechanical malfunction.
A swallow is a hugely complex action, and it just takes one group of muscles to become slack, or the brain to become a little confused, and the event becomes frightful.
Combine this with the growing necessity to down a load of pills everyday, most of which get stuck or thrown up, and pretty soon you have a person who does not trust themselves to swallow. This can be investigated by a speech pathologist, who will have tricks up their sleeve for alleviating the severity of the condition.
(Do your parents know how good frozen meals are these days? Make sure they do! It’s a handy and easy way to knock up a quick meal.)
THINGS TO DO:
☐ Check finances – if fridge content is depleted
☐ Make a dentist of denture clinic appointment
☐ Encourage a new eat then drink routine
☐ Get a GP referral to a speech pathologist if choking is the issue.
If a person feels that a pill is ‘stuck’ half way down – try eating a small buttered piece of bread … to push the blighter out of the way. Failing that a warm drink slowly sipped may help.
AN OUNCE OF PREVENTION:
Try putting pills in teaspoons of yoghurt – it helps lubricate the mechanics. Hate yoghurt? Try jam – but not toooo sweet as that can cause the throat to spasm as well. When in doubt, go to the GP!
The Trip is a piece of television brilliance from handsome yet still funny comics (rarely do the two go together) Steve Coogan and Rob Brydon. It’s the story of two mates on a journey – the context of many a great yarn, in any event these guys travel about Britain having lunches for which one of them is paid as a restaurant reviewer. So you end up joining these guys for lunch every episode, as they chatter, banter and annoy each other as only true and long time friends can when retribution or revenge for words uttered over a fine foie gras seem just silly.
It gave me something to aim for in my doteage … a series of long lunches (like we used to have before the world became so jaw tensingly dull and too busy to waste time with fun) with friends and foes, loved ones and lost ones.
If it could be anything like the easy relationship portrayed in this fine series, well, it might just be worth living a little longer.
IMMEDIATELY go to this clip – it’ll be worth trip!
The PC report on Aged Care assures an anxious public that very soon there’ll be no one left to do the caring.
Seriously? This is what they commission came up with? It has left me nodding my head in disbelief that so much effort and passion was put to the commission in the shape of submissions, and the result is this: more rules, less care, no hope.
Who gives a rosy rat’s backside whether or not you are paying 24% of this, or 15% of that for accommodation in a less defined facility (playing with words again….) if no one is there. You may as well stay at home and rot, at least it’ll be familiar chaos.
The report gives less than little attention to the fact staff don’t want to work in the industry, and that is what will bring it to it’s knees..
Perhaps it would have behooved them to spend time thinking about that, rather than suggesting that in-room hoists will make one iota of difference to a disenfranchised, generally female, generally part time workforce who cared enough to give it a go, but left after just 6 months. It’s NOT just the back breaking work.
I think a great quote in the report is from a submission from Amaroo Care, in respect of the laughable wages:
While aged care workers may have a passion for their work in making a difference for the elderly they care for or support, it remains a sad indictment upon our social values when an entry level zoo keeper attracts a base rate of $19.50 per hour for tending to animals while an entry level personal carer or support worker only attracts $15.90 per hour for providing care to our elderly in accordance with a new Australian industry award that came into effect during July 2010. (sub. 98, p. 14)
What did the report say? In essence it said the Commission couldn’t make any difference at all to wages and flick-passed the issue to another government body (the Australian Aged Care Commission). Of course they’re rushing around trying to sort that one out right now. Yeah, right.
It did however recognize that wages were low, disproportionate, and inadequate, forced upon a labor force that had a ‘poor bargaining’ position. But just to re-iterate, they can’t do anything about that.
What would have really irked those who work so hard in this area is the frankly outrageous notion that all the industry had to do to attract staff is sell the ‘positive aspects’ of a career in aged care. And what are they you may well ask? Well, one was the positive benefit of getting the chance to become familiar with the aged care resident.
To which I say, if I wanted to make friends I’d go to Zumba classes.
Making friends in aged care is actually not a positive. How could it possibly be, when one day you know you will be zipping those same people you have cared for into a crisp white death shroud, ready for the funeral home. Carers grieve, they do, it’s just that no one dares recognize the personal cost of doing the job. It’s not cool to cry.
These are the working conditions that nobody wants to talk about.
Difficult working conditions for an office worker means they have to contend with the air-conditioning that is set too low, or the canteen running out of soy milk, or having to walk all the way across the office to recycle their paper. Difficult working conditions in aged care means being punched in the stomach by a dementia patient, having to wipe peoples’ bottoms while they swear at you for taking too long, or stroking some poor lonely soul’s forehead while he dies in front of your eyes.
What are they doing about that?
The report suggests importing immigrants to do the work. Sure, it might mean they are under qualified, have little linguistic ability and frighten the bejesus out of the aged residents…but they won’t kick up a stink about poor wages, shortened shifts or patient ratios.
The last and most brilliant piece of logic to emerge was that it would be better for everyone if people didn’t actually go into aged care. That would solve the all the issues. Just stay home, it’s so simple.
The ideal Australian Aged Care model: stay home, we’ll send someone over – as soon as they get off the plane.