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Senior Dietary Restrictions: Resource Guide

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“I’m so hungry,” Larry, age 72, said to his home care assistant as he sipped on chicken broth. “I would kill for a steak right about now.” The pair chuckled for a moment because they knew Larry’s temporary clear liquid diet would be finished tomorrow, after his colonoscopy.

Althea wasn’t as lucky. At age 66, she had a stroke that left her with dysphagia—difficulty swallowing. After she was hospitalized for aspiration pneumonia caused by inhaling small bits of food and beverages, Althea had to go on a pureed and thickened liquids diet.

“I’ve been blending my foods for months now,” she sighed. “They taste all right, but sometimes I sure miss getting my teeth into a nice, fluffy southern biscuit.”

Many medical conditions, tests and treatments can require an older adult to go on a restricted diet. Sometimes the restriction involves nutrient control, such as a low-sodium diet, while other times the consistency of foods must be altered, as with thickened liquids.

No matter why an older adult may have to go on a restricted diet, senior care professionals can play a key role in helping older adults learn how to prepare and manage their new dietary reality by using and sharing these resources.

Low-Sodium Diet

Millions of seniors with hypertension or heart failure must restrict their sodium intake. Fortunately, giving up the salt shaker doesn’t have to mean bland, unappealing food choices.

To help senior clients lower their sodium intake without compromising nutrition or food appeal, try:

  • DASH Diet: “Dietary Approaches to Stop Hypertension”—aka “DASH”—is a program developed by the U.S. National Institutes of Health in the early 1990s to study the effect of dietary intake on blood pressure. Since then, the diet’s effectiveness has been validated many times over. You can access the DASH eating plan , recipes and more for free at the NIH website.
  • Cut Out the Salt: Easy tips for reducing sodium consumption from EatRight Ontario.
  • Low Sodium Foods Shopping List: Easy-to-follow guide from Healthfinder.gov.

Low-Carb or Diabetic Diet

Older adults with diabetes or prediabetes may be advised to follow a special diet to better control their blood sugar levels. However, it’s not as simple as cutting refined sugar out of the diet. For guidance on putting together a healthy eating plan for a senior with blood sugar concerns, try:

  • American Diabetes Association Recipes for Healthy Living: The ADA offers a wealth of free recipes, in groupings that include vegetarian, budget-friendly and quick options, among others.
  • Basic Meal Planning: Diabetes Canada delivers a concise guide to healthy eating for diabetes management and prevention, along with recipes and other resources.
  • Sugar-Free Recipes: Many online recipe repositories offer sugar-free alternatives for appetizers, main dishes and desserts. This list from AllRecipes can get you started.

Clear Liquid Diet

Seniors facing certain tests or procedures may have to go on a clear liquid diet for some period of time in advance of the appointment. Alternatively, recovering from bowel surgery or another condition may warrant consuming only clear liquids for a while, too. “Clear liquid” means just that: a person must only drink thin, watery beverages they can see through.

This type of restriction is usually short-term because of the challenge in delivering adequate nutrients through thin liquids. Generally speaking, you can help a senior follow the doctor’s instructions and reference these guidelines for additional information on clear liquid diets:

  • Clear Liquid Diet Overview: This brief guide from Mayo Clinic covers the reasons why a person may need to follow a liquid diet, and what types of foods are generally allowed.
  • Adding Some Fun to the Clear, Liquid Diet: The organization Stop Colon Cancer Now offers this guide to exactly what types of things a person can eat on a liquid diet before a colonoscopy.

Pureed or Mechanical Soft Diet

Older adults who have trouble swallowing or chewing due to a stroke, cancer treatment, poor dentition or another condition may need to go on a pureed or mechanical soft diet for days or even years. A pureed diet consists of foods that do not require chewing because they have been

mashed or pulverized in a blender. Mashed potatoes are one example of an item on a pureed diet.

The term “mechanical soft” refers to the mechanical act of chewing. A mechanical soft diet consists of foods that require very little mastication, such as ultra-tender meats or vegetables that can easily be broken up into small pieces without using a knife.

Because pureed diets can be made at home using a food processor or blender, you can help seniors maintain adequate nutrition by suggesting types of food to blend together, such as appropriate ratios of fats, carbohydrates and protein.

For more resources about how to create appealing pureed and mechanical soft diets, refer to:

Thickened Liquids

Sometimes a person can swallow whole pieces of food but has difficulty drinking thin liquids like water. This type of dysphagia can affect seniors with dry mouth issues or other medical conditions. To avoid aspiration, these seniors may be prescribed a thickened liquids diet. Some guidelines:

  • Thickened Liquids – Nectar-Thick: This guide to thickened liquids by UPMC covers all the basics, plus nutrition concerns like how to address lactose intolerance and diabetes when creating thickened beverages.
  • Pureed Thickened Fluids Diet: Hamilton Health Sciences in Ontario provides this list of places to buy commercial thickening agents in Canada.
  • Tips for Choosing and Using Food and Beverage Thickeners: This article from AgingCare.com addresses important social concerns associated with a thickened liquid diet, such as how caregivers can help an older adult maintain dignity and independence in their mealtime routine when thickeners are involved.

It can be a challenge for some seniors to prepare a meal plan, shop and cook even when they don’t have a medical condition or procedure that requires them to follow a restricted diet. By understanding the common reasons why an older adult might have to follow a special diet, you can help them prepare nutritious meals that meet their doctor’s guidance for nutrition or food consistency.

Last revised: March 6, 2018

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