In long term care, we are often working with elderly residents who unfortunately feel like eating is a chore. It is quite common for an elderly person to have a decreased or poor appetite as they age. But nursing homes must be creative in offering foods to their residents who have diminished food intake. Some elderly residents will shy away from too much food at a meal because the amount of food can be overwhelming. They may complain that the “extra” uneaten food is being wasted. Residents needing to improve their food intake may need to be served fortified foods (addition of protein, fat, and/or carbohydrates to foods) or “nutrient-dense foods”. These nutrient dense foods are foods that are typically already being offered but with a few items added to raise their nutritional content.

Supplements are often used to boost the calories and protein for a resident and can be very effective in stabilizing weight status. But utilizing “food first” is a smart alternative to supplements. Smart in that it is more cost effective to fortify the food rather than purchase an oral supplement in most cases. But first you must find out what the resident’s favorite foods are and try to incorporate nutritional density to these foods. Remember resident food preferences should always be considered when planning their menu to improve food intake. If you order an item such as Super Cereal and the resident only likes cold cereal, you have not enhanced their intake. Also, find out which meal is the best meal for the resident. Breakfast tends to be the best meal for many residents and nutrient dense foods may be a hit at this time. But other residents may not eat well until lunch and dinner and appropriate food items can be added at those meals.

Here are some ideas and tips to help get our residents to eat:

  • Offering smaller, more frequent meals
    • Between meal snacks or nourishments; i.e. at 10:00 a.m., 2:00 p.m. and/or h.s.
    • Increasing portion sizes of favorite foods
    • Ice Cream added to every evening meal
    • Substitute 8 oz. whole milk at meals instead of 2% milk
    • Calorie dense foods (i.e. cheese, gravy, honey, ice cream, jam, jelly, pudding, peanut butter, sour cream, cheese sauce, etc.) added to menu

Foods may also be fortified such as:

  • Super Topping for cereal (a combination of whole milk, brown sugar and margarine)
  • 6 oz. Super Cereal at Breakfast in place of the regular cereal
  • Super Mashed Potatoes (made with half and half with margarine)
  • Super Pudding (pudding powder mixed with half and half)
  • Extra margarine for bread, toast, crackers, vegetables, potatoes, rice, etc.
  • Half-and-half or cream for hot chocolate, milk shakes, cereal, cream soups, etc.

Always be careful with any diet, consistency or thickened liquid restrictions or allergies when offering these nutrient dense foods. Monitor the resident’s acceptance and tolerance of these foods. The resident may become fatigued with the same food product at each meal (i.e. mashed potatoes at every lunch) so it is important to adjust and change when preferences change. There is no benefit in offering nutrient dense foods if the resident does not eat them. The resident’s nutritional well-being is of upmost importance and providing them with foods that give them extra calories and protein without increasing the volume of food provided can be a huge benefit for their overall health.