"My elderly mother isn't eating and she
has lost a lot of weight. Should I give
her a nutrition supplement drink to replace the meals she should be
eating?"
Under-nutrition
due to lack of eating is a common problem among elderly people. It is also
dangerous. Under-nutrition and extreme thinness can lead to higher mortality
rates, according to a study published in the American Journal of Clinical
Nutrition. It is a problem that can't be ignored.
Geriatricians
(specialists in treating the elderly) take weight loss among the elderly very
seriously and caregivers should, too. However, some caregivers feel that
feeding their parent a nutrition supplement drink, such as Boost, in lieu of
meals ensures the elderly loved one is getting the nutrition they need. This
isn't the case, according to Dr. Amy Ehrlich, Associate Professor of Clinical
Medicine and Interim Division Head of Montefiore Medical Center's Geriatrics Division.
"Just
giving them a can of Ensure for dinner isn't enough," she says. "It
is always better to try to use regular food to maintain a person's
weight." If a caregiver wants to use nutrition drinks, they should be used
between meals, as a snack or supplement to add calories to the senior's diet –
not as a meal replacement.
Work with a doctor to determine elder's
nutrition needs
Weight
loss is a marker of frailty. However, it is not a normal part of aging. Dr.
Ehrlich stresses that it is critical to find out what is causing the senior's
loss of interest in food. A doctor should conduct a detailed medical evaluation
to determine the cause of loss in appetite and weight loss. "There are a
variety of treatable conditions that could be the culprit: ulcers, thyroid
disease, dementia, depression, even ill-fitting dentures. All are treatable, so
rather than immediately turning to a supplement, work with your doctor to
address the cause of the problem," Dr Ehrlich says.
If a
caregiver does decide a nutrition drink is right for their elderly loved one, a
doctor should still be consulted to determine the type of supplement to use.
For example, diabetics must choose a low-sugar product.
Frail elderly have different nutrition
requirements
There
is a misperception that frail elderly people should adhere to the same low-fat,
low-calorie diet that is recommended for the general population. However, Dr.
Ehrlich says that for frail elderly who have substantial weight loss, the
opposite is true. "I'll see a 94-year-old person who is losing weight and
he is restricting everything, eating a low-calorie, low-fat diet. It would be
better to eat a bowl of ice cream, for the caloric intake!"
Elders
who have experienced weight loss should eat what they like. And don't be afraid
to incorporate eggs, cheese, peanut butter…even ice cream into the diet.
There
is no need for low-fat milk or cheese.
Elders
often can't (or don't want to) eat three large meals a day. Rather, encourage
them to have smaller, more frequent meals, including snacks, even before bed.
Nutrition drinks and supplements can interact
with medications
Supplements,
including nutrition drinks, can cause dangerous drug interactions in the same
way prescription medications do.
If an
elder is taking prescription and over-the-counter drugs and supplements, the
drugs may conflict and, basically, go to war against each other, while also
damaging otherwise functioning body organs and systems. Check with your doctor
to avoid interactions. "I encourage my patients to bring in all their
medications, supplements and vitamins, so I can check for possible
interactions. I call it the 'brown bag visit," Dr. Ehrlich says. As an
example, vitamin supplements may negatively interact with blood thinners like
Coumadin.
The
bottom line is that nutrition drinks are not a magic fix for lack of eating or
under-nutrition. These products are not bad when used as a dietary aid and
supplement to regular meals. However, they should not be used as a meal
replacement for elders – especially those who are frail or thin.
(Source: Agingcare.com
- Dr. Amy Ehrlich MD is Geriatrics Fellowship Program Director for Montefiore
Medical Center's Geriatrics Division in New York and an Associate Professor of
Clinical Medicine. She is board certified in Geriatric Medicine and Internal
Medicine.)
(POSTED 16
FEBRUARY 2014)