A therapeutic diet is intended to treat a disease or help manage a medical condition. Examples of diets often ordered for residents in long-term care facilities include: diabetic, renal, low sodium and low fat/low cholesterol diets. These therapeutic diets are not always warranted in the elderly population, however, where poor nutrition or malnutrition may be a concern.

The elderly and residents in long term care facilities often have altered or diminished meal intake which may be related to illness, medications, change in cognition, depression, decreased taste or available food choices. Therapeutic diets can be quite restrictive, and may result in a residents’ favorite foods not being offered which could result in decreased meal intake and possibly unplanned weight loss.

The focus for the elderly and long term care residents is on quality of life, quality of care and residents’ rights. The Academy of Nutrition and Dietetics recommends individualizing and liberalizing diets for residents in long-term care facilities to maximize meal intake for those at nutritional risk. Therefore, a diagnosis of diabetes, hypertension, hyperlipidemia, etc., does not automatically mean a resident should be placed on a therapeutic diet. If a resident is eating poorly, dietary restrictions are not logical because the resident is probably eating very little sugar, sodium or fat if their appetite is decreased at meals. In many cases, non-restrictive diets help improve meal intakes by allowing greater food choices.   Issues like diabetes and high blood pressure are usually managed by medication instead of dietary changes in the chronically ill and frail elderly.

Education is an important factor regarding non-restrictive diets, as families and residents alike may have questions regarding diagnosis and foods being served. The dietitian and dietary manager alike are available to educate and assist residents with food choices. The key to success is making sure the resident consumes an adequate amount at each meal. If easing up on diet restrictions helps to increase caloric intake, this may most beneficial for the resident.