Caring for Loved Ones at Home

An Illustrated, Easy-to-Follow Guide to Short or Long-term Care 4th Edition.

10. Good Nutrition

It makes sense that what goes into the body affects how well a body heals itself or comforts itself. Good eating habits and good nutrition can make a world of difference to how one feels and heals. The book, What to Eat When You Don't Feel Like Eating, is an excellent, short cookbook of healing recipes for all people, but especially those who are sick. You must also remember how important it is to keep drinking during the day so that you do not become dehydrated during an illness. Some things to keep in mind about healthier and more enjoyable eating:

We all have different nutritional needs, tastes and appetites. When anyone is ill, the needs may have to be adapted to what the person can tolerate or even enjoy. Some children may not be able to eat very much but might have something from their favourite fast food restaurant. It may not be perfect but it is a beginning.

Someone's appetite depends on their physical condition, level of exercise and other distractions. Someone with little to do but watch television may begin to eat larger amounts of unhealthy food that they normally would not eat. Provide delicious alternatives.

Medication, poor teeth, chronic fatigue and one's overall condition may affect the appetite and taste buds. Simple oral hygiene can improve one's joy of food. Encouraging regular brushing is still important when someone is ill or recovering from a condition.

A well-balanced diet includes food from different food groupsproteins from fish, poultry, meat, and eggs; milk and milk products; fruits and vegetables; and whole grain breads and cereals. From a good combination of these groups, one gets the nutrition, vitamins and minerals necessary for healthier living.

People need different amounts of food. They may need more from one food group depending on their condition. Some people need to eat healthier to regain strength. Athletes require more bulk from whole grain breads, pasta and cereals. People weakened from too little food over a long period of recovery need to eat higher calorie meals. During or after a prolonged illness or recovery, it is necessary to speak with a dietician or other knowledgeable person about what foods, and in what quantities, the person should eat. People should be able to eat what they enjoy as well as what is 'good for them.' A balanced diet allows for sweets, snacks and desserts in moderation. People may also enjoy something completely new since they will have no memory of this food affecting them badly like their more familiar foods.

Serving meals should, when possible, include foods that are not all the same colour (e.g., all yellow vegetables, white potatoes, applesauce and pale meat). Making the meal visually pleasing may encourage a healthier appetite. The dishes, food tray and napkins should be clean. The food tray should rest comfortably on the person's lap or on a small bed tray.

Some people prefer, or need, smaller meals offered more often than the standard three meals a day. For example, someone might benefit from smaller portions of food every 2-3 hours with snacks by the bedside during the night. It is better to offer less, than too much. Too large a portion can be overwhelming, and literally, nauseating.

Any little thing you can do to add to the joy of a meal is a gift. For example, bringing the morning paper with breakfast, having a flower on the tray with lunch or giving a puzzle for a child to play with after dinner.

Eating is often a social gathering. The person who is in bed may enjoy the company of others with them rather than eating alone. For example, for people who have difficulty eating enough calories each day, conversation, review of everyone's day and general social activity may encourage them to eat more than they had originally thought they could.

People often have very particular habits around their meals. These should be followed as much as possible. For example, assist someone who likes to 'dress for dinner' with grooming. If they enjoy some background music, try to make this available in their room.

Help people wash their hands before and after a meal. Wash your own hands as well before and after handling any food to help prevent the spread of germs. Be especially careful to cook meats and eggs thoroughly; wash raw vegetables and fruits; use hot water and soap to clean dishes, glasses, cooking utensils and your cutting board.

If the person can come to the dining table, encourage them to do so. If they need to stay in their room, you might set up a card table or other temporary table there. If the person needs to remain in bed, make sure their back is well supported with pillows while they are in the sitting position.

If the person needs help with cutting their meal and/or with feeding, remember they are not a baby and, therefore, should be helped in the most respectful and relaxed way possible. The person should continue to feel as a valued member of the family rather than a patient that needs help to eat. Follow the person's lead so you are helping them in ways that are supportive and comfortable.

When helping someone to eat, the food should be bite size. Spoons should only be two-thirds full. Older people's tongues are shaped differently and, therefore, should not be spoon fed in the same way as younger people. Put smaller amounts in the side of their mouth and ensure the person swallows twice before giving more food to avoid choking. Straws that bend near the top can be very helpful to minimize spills. The pace should be leisurely. Clear the tray away as soon as the meal is finished.

Sitting up as straight as possible at the table or in bed with the head leaning forward is very helpful in preventing choking. The airway is more relaxed and open in this position. If possible, have the person sit up for about 30 minutes after the meal to encourage good digestion and minimize food coming back up.

If the person is having trouble swallowing liquids or food, speak with a professional. They may recommend that you thicken liquids to trigger the "swallowing reflex" and to put food in a blender to make it easier to swallow. Ensure the person swallows twice to get any food that may be caught at the back of the palate or throat.

The room where the person is eating should be at a comfortable temperature.

The food and drink should be the right temperature for the person. Warn the person if any food or drink is very hot. Check to see if it is possible for the person to have their usual wine, coffee or other drinks with their meals.

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Copyright © 1996, 1999, 2002, 2006 Harry van Bommel

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