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Nutrition is not a dirty word

by Isabel Fawcett

Just hearing the word nutrition spoken can be a turn-off to some people. Old habits die hard, especially to elders who have enjoyed the traditional days of home cooked meals sufficient to feed a small army. For some in my mother's generation, nutrition can be subjective. Memories of home food may undermine motivation more than elders care to admit.

Like many other words, the word nutrition means different things to different people. Cultural influences and age shape elders' notions of what comprises good nutrition. Some in my mother's generation do not consider food to be a real meal if there is no meat.

I grew up in a time where meal portions were not over-analyzed. Back then, it was considered a compliment to home cooks when everyone's dinner plates were full. Leaving any edible food on one's plate was not politically correct. Cooks like my mother always took mental note.

When Mom cooked for our family, she loved it when her brother and his family joined us. My uncle's appetite was hearty, and Mom's leftovers always became generous takeout gifts to our guests.

I was the finicky eater in my family. My uncle never failed to tell me, "You've gotta eat, Isabel. That's not good. You've gotta build up your strength." Now that I am a full-time caregiver to my octogenarian mother, at times when Mom picks at her food, I occasionally resort to my uncle's infamous line about the need to 'build up your strength.' There really is nothing else to say to an elder who is independent minded, as Mom and her contemporaries have every right to be.

If I were to speak to my mother about the benefits of nutrition, her eyes would glaze over in no time. Worse, she might laugh me out of caregiver police town. Then, what?

Registered Dietitian Consultation

Years ago, Mom had an appointment with a registered dietitian. When Mom shared her news about her upcoming appointment with the registered dietitian she was not thrilled. We both had visions of heavy duty medically imposed meal restrictions looming on the horizon of an otherwise happy family kitchen. I had never visited with a registered dietitian before. Neither had my mother. Still, the pre-visit angst was palpable.

Not only did I have preconceived notions about registered dietitians, I envisioned double-duty in the kitchen as Mom's then-part-time caregiving cheerleader.

In my youth, I equated the science of dietetics with boring, tasteless foods and a list of medical thou-shalt-nots carved in stone. I had a flashback to a therapeutic diet prescribed for one of my relatives. It was most unappetizing. No. Make that downright depressing.

Registered dietitians brought to mind institutional food from the 1960's and 1970's; the kind of meals hospitalized patients were forced to eat prior to being discharged from the hospital.

As Mom's caregiving transportation and chronic illness cheerleader, I decided to suffer through her appointment with the registered dietitian. The pleasure and surprise at Mom's visit with the dietitian was all mine. The registered dietitian was lively and funny. Most importantly, she started her discussion with the patient's existing meal habits and choices, not the other way around.

Mom left her appointment smiling, a few non-perishable food samples in hand, and believing that she could, and would, better balance her nutrition.

Nutrition and Diabetes Management

Mom did so well in balancing her meals and nutrition needs that her then-endocrinologist decided that he would discontinue her prescribed twice-daily insulin injections regimen. Great medical news. It is easier said than done for some diabetics to sustain progress and the self-discipline required to better manage their blood glucose levels using a meal exchange system.

Diabetic meal exchanges groups foods according to calories, carbohydrates and other nutrients. Diabetics who are savvy may exchange foods within a food grouping based on similar nutrient content, and, the manner in which such foods reportedly affect the diabetic's blood glucose.

Mom, then in her late 50s, studied and followed her meal exchanges long enough to be insulin injection free for almost a year. Mom and her then-doctor were saddened when she eventually had to resume a medical regimen of two insulin injections daily. But, the meal exchange system had done its job, for a time, in helping to better regulate Mom's blood sugars.

Healthy nutrition is a lifetime endeavor requiring unwavering commitment. Challenging though it may be, good nutrition need not be all-or-nothing proposition for elders and their caregivers.

A Different Approach to Nutrition

We caregivers commonly encourage each other to take our respective care circumstances one day at a time. That includes nutrition. The larger care picture may be entirely overwhelming to any reasonable individual.

A less stressful approach and practice of nutrition for elders and their caregivers may be allowing ourselves time to become better informed on the basics of good nutrition. Each day, each week, or, each month take a single positive step toward healthier and more balanced nutrition.

One step may become a lifetime habit if caregivers and elders don't try to accomplish too many nutrition best practices at once. Instead of turning our elders' lives upside down with a major nutrition overhaul and inevitably increasing caregiver stress, choose a baby step.

Every nutrition journey starts with a single step. Just don't forget the sustained commitment part. Commitment to good nutrition habits one day at a time may make all the difference in the world to caregivers and their elders.

Nutrition Resources for Caregivers and Elders

American Diabetes Association, Making Healthy Food Choices, http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices.html

American Diabetes Association, What Can I Eat, http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/

US Department of Agriculture,*Inside the Pyramid [MyPyramid]; 2005; Food Pyramid Interactive.

Tufts University, Modified MyPyramid For Older Adults, 2007.

*The USDA's published timetable to publication and release of the seventh edition of Dietary Guidelines for Americans is anticipated in Fall 2010.