Aged care facilities should aim to offer flexible dining options and special days, such as barbecues, themed or cultural meals and birthday gatherings, as much as possible, says dietitian and author Ngaire Hobbins.
Ms Hobbins answers Australian Ageing Agenda’s questions on eating for a healthy brain for aged care residents.
AAA: What food is best to ensure a healthy brain and what food should be avoided?
NH: The evidence suggests that chronic inflammation is one possible contributor to brain changes leading to cognitive decline and dementia. Some foods are thought to contribute to chronic inflammation.
Those food items tend to be the ones that have undergone the most changes from their original form before being eaten – the things we all know are not the best for us, such as fast food, take-away, commercial cakes, pastries, snack bars and confectionery.
Each one probably does little or no damage, but eat them often or at most meals and that could well be a problem.
In contrast, some food is thought to help reduce chronic inflammation. Those include nuts and seeds and the oils made from them, oily fish and generally foods that are close to their original form such as vegetables, fruits, wholegrains, dairy foods and ideally only moderate amounts of locally sourced meats.
What are your top tips on nutrition for maintaining good cognitive health and reducing the risk of dementia?
First and foremost, staying physically and mentally active is paramount, as is maintaining social connections and learning new things. But beyond that, in middle age do all you can to build muscle strength and lose excess weight
In later age, weight loss is no longer ideal. Instead focus on keeping up physical activity to maintain muscle and weight. Choose good quality protein foods such as fish as often as you can and surround that with as many different colours as you can from vegetables, fruits, nuts, seeds, grains, herbs and spices.
What other dietary and nutrition advice do you have for people with dementia?
Weight loss is common and damaging in dementia. Nearly 50 per cent of people, when diagnosed, have lost weight in the year prior. If weight loss is allowed to continue without attempts to slow it down or stop it, people decline physically as well as cognitively more quickly. They can end up in care because of physical incapacity, not because reduced cognitive capacity requires it.
How can aged care facilities help residents eat food that is better for their brain?
Ensuring weight loss is avoided and residents have access to food they enjoy are important to body and soul. Offering flexible dining options as much as possible is ideal as are special days, such as barbecues, themed or cultural meals and birthday gatherings.
For those with dementia, I always advise that even if a resident is not eating food in front of them, we must assume that they could be hungry. The task is to find creative ways to help the resident continue to enjoy meals and snacks.
Using a ‘family’ style dining environment that is not cluttered or full of distractions like medication trolleys can help provide memorable cues to eating as well as opportunities for mimicry of use of cutlery. Finger food can help for those who wander so they can pick up snacks on the go. Reminders and prompts can work well for some residents.
Getting the best history possible is also important. Knowing the food enjoyed in childhood and in earlier life can give invaluable clues for preferences.
And last, but certainly not least, remember that dementia is a life-limiting illness as is frailty in very advanced age. In these cases, there is no need to restrict any foods considered to be unhealthy if they are enjoyed. Think deep fried, salty fish and chips, cream on desserts, ice cream, cakes, chocolate or whatever will provide joy and a calories. The exception is if there are swallowing issues and in that case, investigate appealing texture modification options.
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