Customized food in the nursing home – why individually tailored meals are important

This article is written from Swedish perspectives. Hopefully, it can inspire interested individuals from other countries.

Knowledge about tailored nutrition is necessary in elderly care. For the resident, it's about well-being and respect, but also an important risk-preventing feature in care. Tailored nutrition in elderly homes is about more than serving food. It's about meeting each resident's needs to promote well-being and health. By offering nutritious, consistency-adapted, and specially tailored meals, while creating a pleasant meal situation, the elderly home can improve the residents' quality of life and well-being.

Foto: Mostphotos

Diet that is adapted to everyone's needs


There are a multitude of conditions and situations where the diet may need to be adapted to the resident's needs with regards to choice of food or consistency. Culture, religion, medication, diseases, swallowing difficulties and allergies are examples of factors that influence food choices, even for those who are malnourished or at risk of malnutrition.

From a patient safety perspective, it is important to design the diet so that it contributes to symptom relief, increased well-being and recovery. A prerequisite for optimal individual adaptation is a person-centered approach. Malnutrition is a common contributing factor to premature death in the elderly.

The choice of food also shows to what extent the operation respects the individual's wishes and needs. For example, the operation may serve a boringly composed vegetarian dish to someone who does not eat pork. If the alternatives are not well thought out, they risk contributing to the resident becoming malnourished and the planning of meals becoming discriminatory against those who have special needs or wishes.

For the resident, it is important that the adapted diet is tasty, nutritious and prepared with care. If the food is delivered to the accommodation, it is important that the staff, and also the resident if they so wish, receive information about what the food contains. In the case of food allergies, it may also be important to keep different dishes separate so that no one accidentally ingests allergenic food.

Dishes can be labelled as gluten-free, lactose-free, milk-free, soy-free, nut-free or egg-free only if they meet the requirements of the food regulations.

Adapted diet in elderly care - creating meals that meet all needs


Serving an adapted diet in elderly care is crucial for the residents to feel good, have energy and get the right nutrition. With increasing age, dietary needs and eating ability can change, making it important that meals are both nutritious and individually adapted. Recognizing and meeting specific dietary needs for the elderly can contribute to a better quality of life and increased well-being.

Why is an adapted diet important in elderly care?


Diet and nutrition are central to health, but as you get older, the ability to absorb and utilize nutrients is affected. Chewing and swallowing difficulties, reduced appetite and sensitivity to certain foods are examples of factors that can affect what and how an older person can eat. Therefore, it is important that the diet in elderly care is adapted to ensure that each resident gets the nutrient intake needed to feel good.

Different types of adapted diet


Energy and nutrient dense diet  
Many elderly people have reduced energy needs, but the need for nutrients remains the same. For residents with little appetite, energy and nutrient-dense meals can make a big difference. By adding nutrients in the form of extra fat, protein and carbohydrates, the food can provide the energy needed without the portions becoming too large. For example, enriched soups, nutritional drinks and small snacks can help residents get enough nutrition.

Consistency adapted diet  
Difficulties chewing or swallowing, such as dysphagia, are common in the elderly and can make it difficult to eat regular food. Consistency adapted diet, such as finely divided or pureed food, is easier to eat and reduces the risk of choking. This diet allows residents to continue eating nutritious food without compromising safety.

Easy-to-chew diet  
For residents who have chewing difficulties but can handle slightly larger pieces, an easy-to-chew diet may be a good option. Easy-to-chew meals are prepared in a way that makes the food softer and easier to chew but still retains its consistency and taste.

Special diet for intolerances and allergies  
Many elderly people may need a special diet due to allergies or intolerances, for example to gluten or lactose. It is important that these needs are taken seriously and that the staff have knowledge of how to replace certain ingredients to create safe and tasty meals for all residents.

Diet for specific health conditions


Diet for diabetes  
Diabetes is common in the elderly, and for people with diabetes, it is important that the food is adapted to maintain stable blood sugar. This means that meals should contain slow carbohydrates and have an evenly distributed intake of nutrients throughout the day. Dietary advice and individual assessments are important to support diabetics in elderly care.

Diet to prevent malnutrition  
Malnutrition is a major problem among the elderly, and for residents who have difficulty getting enough food, extra care is required. Small and frequent meals with high nutritional content can be a solution. Food that both looks appealing and tastes good can also help to increase the appetite of the resident.

Salt-reduced diet  
Many elderly people suffer from high blood pressure or cardiovascular diseases and need a salt-reduced diet. The food is then prepared with less salt and flavored instead with herbs and other seasonings to be tasty and at the same time healthy for those who need less salt in their diet.

Creating a pleasant meal situation


In addition to adapting the food itself, the environment and setup around the meals are important to create comfort and make it easier for residents to eat. Here are some tips to promote a positive meal environment:
- Serve the food in an appealing way - Colorful and beautifully presented plates can make a big difference for the appetite.
- Create peace and quiet around the meal - A calm environment with muted sounds and without disturbing elements contributes to a nice meal.
- Provide support when needed - Some residents need help with eating, and the care staff can be close to assist without rushing.

Collaboration to meet dietary needs


In order to create a diet that truly meets the residents' needs, it is important to have close cooperation between kitchen staff, care staff, licensed healthcare professionals and dietitians. Regular conversations and follow-ups around the residents' health status and dietary preferences make it possible to adapt the meals so that they constantly maintain high quality and nutritional content.

Reflection questions - adapted diet:
Care staff:
- Do you get good information about what the food served contains?
- Do you have clear information about which residents need a special diet?

Manager, nurse, occupational therapist and physiotherapist:
- Do you have good conditions to offer the residents an adapted diet?
- Are there areas for improvement? Are those who have an adapted diet that is cooked and served with care?

Residents and relatives:
- Do all residents receive equally carefully prepared food on the unit?


Erland Olsson
Specialist nurse
Sofrosyne - Better care every day

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