I began to become interested in senior nutrition in a very direct way, at an extremely specific time. My mother has celiac disease. She avoids all products containing wheat or gluten. In her late eighties, my mother lives alone. She gets around only with difficulty, sees and hears poorly, but still lives (and cooks) independently.
I live across the continent from my mother, but my three sisters live in the same city. When my mother took a fall and spent a week in the hospital, I was concerned, of course, but helpless at the same time. My sisters buzzed around my mother, keeping in touch with me through dozens of e-mails and telephone calls. They advised me not to break into my life and fly in, especially as I had already planned a trip for the next month. My mother would survive, and stay in her home, but now with live-in home care on a full-time basis.
“These people are real pros,” one sister told me, relieved finally to have another pair of hands involved in my mother’s care. “They’ll wash her when she needs it, make sure she takes her medication at the right times, take her to doctor appointments, and they even cook. They know what they’re doing.”
Once on the scene, I talked to several of the caregivers. We had a long and detailed discussion about medication, which in my mother’s case is complex, involving painkillers, which need to be carefully monitored. We also discussed my mother’s celiac disease. By all indications, the caregivers understood the ins and outs of the gluten-free lifestyle. I was shocked, then, when one caregiver nearly served a plate of spaghetti to my mother. Groggy from her medication, my mother might have eaten it. Standard spaghetti is filled with gluten.
The caregiver told me she thought it was enough that she avoided coating the pan-fried chicken she made for my mother with flour, and she knew my mother could not eat conventional bread. She did not give the spaghetti a thought, and did not read the ingredients. We had a thorough discussion of gluten-free eating. This set my mind at rest about my mother and her diet, but it got me thinking about the food-related challenges facing the growing numbers of people in home care.
A Idea Is Born
A few days after the spaghetti incident I was flying back home, and travel gets me to thinking. Home caregivers watch medication with great care. They know what to do in an emergency. They keep careful records of their clients’ activities and routines. Beyond these basics, do they really understand the gluten-free lifestyle, the dairy-free diet, the needs of diabetics? Do they know to read ingredient labeling? What about sodium restricted diets? Do they think taking away the saltshaker is all they need to do? Are they aware that most hidden sodium comes in the form of processed foods?
Do they…? ElderEats is about the dozens of feeding “do they’s” that came to my brain in the coming weeks. Every time I came to the question about how to keep people who cannot feed themselves nourished, the questions became more numerous, the issues more complicated. I did research, and uncovered more than a dozen food restrictions that can arise in a home care setting. As a trained food professional, I realized that basic nutritional concepts also come into play. I then grasped the obvious when I added my third parameter: can the caregiver actually cook, in a culinary sense? Giving the matter more thought, I added sanitation and food storage to the list. Finally, I worked out the need to discuss how the caregiver can help with the physical process of food handling and consumption, from cutting the food to keeping a plate warm for slow eaters. Each of these five areas is challenging.
Eating is not the only facet of home care, but it is an important one. Meals function as vital high points in the day for the person in home care. The person should look forward to well-planned, well-prepared, safe, nutritionally appropriate meals. There is no leaving this critical area to chance. We need a systematized approach that covers every base. That’s ElderEats.