N U T R I T I O N

What Elders Think about Food B Y P E G G Y K . Y E N

M any elders identify with a cultural or religious group that has distinct traditions, attitudes, and beliefs about food. (If the reader doubts that food

is an extremely important part of culture, he or she should try changing the stuffing or the dessert served to relatives for Thanksgiving dinner this November!)

The nutritional well-being of elderly residents of nurs- ing homes and other institutions depends on how well they accept the food served. Beans, a low-fat, inexpensive source of protein, fiber, and calcium, are a food nutri- tionists would love to see elders eat regularly. But to many older adult Americans, a plate of beans is "Depression food" or "poor people's food"- - i t just is not a culturally acceptable meal. Beans could be presented in a fun and favorable way to help them gain acceptance, perhaps as part of a Tex-Mex food festival or disguised in soups and stews.

Food for Celebration

Older adults use of food for celebrations reflects their overall culture, as well as their individual family varia- tion on the celebration. Sharing some of your own tradi- tions helps elders reveal the important parts of their own family traditions. Ask elders something like, "How does your family celebrate birthdays? My mother always made us a special meal and let us sit in the place of honor." Encouraging elders to share their traditions gives them a chance to reveal what is really important about them. Perhaps the specific food items are not that special. It m a y b e the permission to choose the menu and the atten- tion paid to the celebrant, something more easily accom- modated in a care setting than a menu change. Older adults can gain satisfaction just from talking with others about their food traditions. There may be no need to recreate the tradition.

PEGGY K. YEN, RD, MPH, is a nutrition consultant for Cardiovascular Disease and Nutrition Services, Local and Family Health Administration, Maryland Department of Health and Mental Hygiene, in Baltimore. GERt~TR NURS 1995;16:187-8. Copyright �9 1995 by Mosby-Year Book, Inc. 0197-4572/95/$3.00 + 0 34/1/65500

Treating Illness with Food

Nutritional supplements and certain foods, such as chicken soup, are often used by elders to treat or prevent illness. Feeding a cold with chicken soup may be benefi- cial, because steam helps clear nasal passages and the broth supplies fluid. But even when scientific evidence does not support their use, elderly people may believe strongly that supplements or certain foods are necessary. Advice f rom health professionals to "quit wasting money" on supplements may fall on deaf ears. Scientific evidence is not usually the basis for an older adult's belief that these substances will be helpful. Careful listening

The nutritional well-being of elderly

residents of nursing homes and

other institutions depends on how

well they accept the food served.

will help health professionals find the basis for the belief. Listen for statements that reveal what is important to the person. Does he value "natural" remedies? Or is he looking for a way to control the aging process? If it is the latter, there may be a substitute behavior that he will accept. If natural remedies are important to him, suggest that large doses of vitamins are not the way Mother Nature packages them, and that there may be a better way to ensure adequate nutri t ion--that is, with proper food.

Ethnic Influences

The food habits of various ethnic groups are well doc- umented in lists found in nutrition textbooks and other sources. 1 Lists tend to stereotype individuals and are best used as background information. For example, rice ap- pears on food habit lists as a staple food of China. But northern Chinese people eat many wheat products, such as dumplings, bread, and noodles, and may not miss rice at every meal. Do not assume that elders eat a certain way because they are from a particular ethnic group, or you

GERIATRIC NURSING Volume 16, Number 4 Yen 187

may find yourself catering to a preference for rice or some other food where none exists. This is one of the rea- sons for interviewing new patients about their eating habits when they are admitted to a nursing facility or meal program. Dietitians want to know whether the menu pattern of the facility can accommodate an elder's habits enough to ensure an adequate food intake. If older adults practice strict vegetarianism, for example, the meal cycle may be able to accommodate their habits on some days and not others. Special arrangements may be possible, if they are not required every day. A study that looked at the attitudes toward dieting and body size in white and African-American older women, showed distinct differ- ences in attitudes, another cultural influence on diet. Overweight black women over age 65 were much more likely than overweight white women the same age to be

satisfied with their weight and to think of themselves as attractive. Among women the same age who were not overweight, white women were much more likely to con- sider themselves overweight. These attitudes would cer- tainly be important to the effectiveness o f an obesity intervention program for both black and white older women. Nutrition and health attitudes may be assessed with questionnaires, and it is valuable to do so when be- havior change is the focus of nurses efforts. 2 �9

REFERENCES

1. American Dietetic Association and American Diabetes Association ( 1989-1992). Ethnic and regional food practice: a series. Chicago: American Dietetic Association,

2. Hollis JF, Carmody TP, Connor S J, Fey SG, Matarazzo JD. The nutrition attitude survey: associations with dietary habits, psychological and physical well-being, and coronary risk factors. Health Psychol 1986;5:359-74.

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188 Yen July/August 1995 GERIATRIC NURSING