Eating Problems in the Elderly

Eating Problems in the Elderly
Possible Causes	Nursing Interventions
GI Disturbances ■ Difficulty swallowing ■ Constipation ■ Nausea and vomiting ■ Gastric reflux (GERD)	Observe Pt for signs of swallowing difficulty (coughing while eating, holding food in the mouth, frequent attempts to clear throat); suggest consult with speech therapy for evaluation. Monitor bowel patterns; determine if Pt has trouble passing stool; assess for impaction. Investigate cause of nausea and vomiting and assess for signs and symptoms of GERD. Document and report assessments, interventions, and outcomes.
Oral Problems ■ Missing or poorly fitting dentures ■ Missing teeth, dental cavities, gum disease ■ Dry mouth	Inspect dentures for proper fit, use dental adhesive, suggest dental consult if necessary. Provide mouth care before and after meals as needed. Offer fluids frequently while eating, to provide sufficient moisture to foods. Document and report assessments, interventions, and outcomes.
Functional Deficits ■ Weakness; inability to feed self; tremors ■ Difficulty sitting upright, confined to bed ■ Poor vision, less discriminating taste buds, and other sensory deficits	Suggest consult with occupational therapist for assistive devices. If Pt needs to be fed, offer small spoonfuls slowly and allow ample time for chewing and swallowing. Ensure Pt is in upright, comfortable position for eating. Use all assistive devices including glasses, hearing aids, and special, handled utensils. Document and report assessments, interventions, and outcomes.
Neurologic Issues ■ Depression ■ Anxiety ■ Pain ■ Dementia	Work with health-care team to help manage pain, anxiety, and/or depression effectively. Provide consistent staff members to feed Pt; have family member present at mealtimes, if possible. Document and report assessments, interventions, and outcomes.
Medication Side Effects ■ Anorexia (e.g., psychotropic drugs and digoxin) ■ Nausea, vomiting, taste changes (e.g., chemotherapy) ■ Constipation (e.g., opioid analgesics) ■ Drowsiness (e.g., sleeping meds, antianxiety agents)	Evaluate medications for possible source of eating difficulties. Work with health-care team to change or discontinue drugs, if possible. Treat side effects if medications cannot be changed (stool softeners, antiemetics, etc.). Evaluate effects of interventions. Document and report assessments, interventions, and outcomes.