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“Food nourishes the spirit as well as the body.” That might sound like something you’d hear from your favorite, and not quite diet-friendly, restaurant, but it’s actually part of a paired Practice Paper/Position Paper from the American Dietetic Association (Dorner et al 2010b). While the ADA is perhaps more commonly thought of as the agency who tells us things we don’t want to hear about our favorite foods, the newly-released companion papers emphasize the importance of providing older adults with food options that fit their desires, tastes, and rights.
The papers present this new emphasis on enjoyable foods in a culture change/person-centered care framework. (See our previous post on the topic.) The position paper states that “[c]are for individuals who reside in health care communities must meet two goals: maintain health and preserve quality of life,” and that while these two goals can conflict, food must also “enhance quality of life” (Dorner et al 2010a). Person-centered care, the paper argues, has reminded us that individual dignity, autonomy and choice should guide caregiving.
Such reminders, however, often sound like obvious platitudes without any clear means of implementation. Fortunately, the position paper also presents more specific arguments for tasty food. It reminds us that, due to changes in health and sensory ability, food can be less appetizing as we age. For individuals in care facility, the very desire to eat is often a victory. As most of us have experienced, diet foods restrict our range of food choices and our food pleasure. Citing a literature review on the high rate of malnutrition and undernutrition in older adults, the paper stresses weight maintenance as a pragmatic measure of adequate nutrition, and states that restrictive diets tend to lower food intake, while “more liberal diets are associated with increased food and beverage intake.”
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