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Spotting Eating Disorders in Elderly Patients

Spotting Eating Disorders in Elderly Patients

October 5, 2021
October 5, 2021

Why do eating disorders occur in the elderly?

For older adults, especially those in residential care environments like long-term care or nursing homes, nutrition is very important. Issues with food intake and meal preparation are even common reasons that someone can end up in a congregate living facility. According to Today’s Geriatric Medicine, eating disorders can be the result of stressors like “widowhood, retirement, chronic illness/disability, death of an adult child, and growing old/facing mortality.” The same article identifies additional triggers like “lack of enthusiasm for life; attempts to get attention from family members; protest against living conditions, such as in a nursing home; economic hardship; and medical problems.” In addition to occurring as a result of medical circumstances, eating disorders also can “occur comorbidly with depression or other types of anxiety disorders, so these can also serve as clues to possible problems.”

Signs of elderly eating disorders

Older adult patients should be monitored regularly for any sign of an eating disorder. A home health care nurse or aide or residential care assistant may be the first person to recognize problems with elder nutrition. Today’s Geriatric Medicine also offers the following potential signs of an eating disorder in the elderly:

  • “significant change in weight (up or down) over a relatively short period of time
  • changes in behavior such as disappearing after a meal or using the restroom after eating something
  • boxes of laxatives, diet pills, or diuretics
  • desire to eat in the bedroom alone rather than eating with family or spouse
  • missing food
  • sensitivity to cold
  • excessive hair loss, dental damage, or heart or gastrointestinal problems.”

Anorexia of aging

Problems with nutrition are another issue characteristic of the growing patient acuity in residential care. The journal Nutrients describes how “Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings.” Some of the reasons for this problem are tied to medical conditions, medication that causes a loss of appetite, social isolation, and depression.

Treatments for eating disorders in the elderly

Nutrients also shares that “Presently, no specific therapeutic agents have shown to be clearly effective in treating anorexia of aging.” Some of the suggested treatments in this article include nutritional supplementations that address consequences more than causes, such as energy or protein supplements. Medications can also help, but their long-term use is discouraged. For example, corticosteroids, growth hormone, anabolic steroids, and other appetite stimulants. Side effects of these medications are a significant drawback. Ultimately, Nutrients advises “Specific individualized care plans should consequently be implemented to guarantee the provision of adequate amounts of food and limit weight loss. Finally, multi-stimulus interventions and specific strategies, including food texture adjustments, flavor enhancements and feeding assistance, may be effective in the management of anorexia in frail and institutionalized older people.”

Developing the senior care workforce

Assisted living, senior care, and long-term care facilities often face staffing challenges, such as retention, engagement, and knowledge gaps. The combination of high turnover and low employee engagement can inevitably lead to reduced quality of care. By partnering with HealthStream, organizations can be confident in staff development while addressing the rise in increased patient complexity.