LTC Resources - Nutrition


As older adults age, their nutritional requirements change.

Why is it important?

  • 34% of older Canadians are at nutritional risk, and women more so (1)
  • Older adults are at risk for under-nutrition due to dietary, economic, psychosocial, and physiological factors (2)

Common Causes

  • Increased sedentary lifestyle  and lowered metabolic rate (5)
  • Increased deficiency in key vitamins and minerals; a reduced sense of taste and smell; difficulty chewing or swallowing; a restricted diet for a health condition; eating alone; loss of appetite; and medications (5)
  • Chronic conditions or disability may affect ability to cook (2)
  • Poor oral hygiene (2)

Key Considerations

  • Advise to follow Canada’s Food Guide
  • Discuss any concerns with serving sizes, dietary restrictions, Nutrition Facts table
  • Assess for vitamin/mineral deficiencies with attention vitamin B6, B12, D, calcium and iron (3)
  • Screen for obesity: calculate Body Mass Index•
  • Develop a healthy eating plan- consider budget limitations, refer to a dietician, community programs for meal preparation (e.g. safe cooking practices) and meal planning

Consult the following for patient handout information:


1. Dieticians of Canada. (2013). Online nutrition screening tool helps older adults identify if they
    have risk factors leading to poor nutrition
. Retrieved March 12, 2014 

2. DiMaria-Ghalili, R. (2012). Nutrition in the Elderly, Nursing Standard of Practice Protocol: Nutrition in Aging.
    Retrieved March 12, 2014 from:

3. EatRight Ontario. (2014). Seniors Nutrition. Retrieved March 12, 2014 from:

4. Health Canada. (2007). Food and Nutrition: What is a Food Guide Serving? Retrieved March 12, 2014 from:

5. University of Rochester Medical Center. (2014).  Nutrition Needs in Older Adults.
    Retrieved March 12, 2014 from:


Dehydration occurs when an individual’s body loses more water than it takes in. The body will not have enough fluids to
carry out normal functions.

Why is it important?

  • Older adults are vulnerable to shifts in water balance- in both over hydration and dehydration
  • Dehydration can result in serious problems:
    • heat injury
    • cerebral edema
    • seizures
    • low blood volume shock
    • dizziness/fainting and risk of falls
    • kidney failure
    • constipation
    • coma
    • death (2) (3)

Common Causes

  • Age-related changes in body composition resulting in depletion of total body water (4)
  • Decreased renal function (4)
  • Thirst sense becomes less accurate (4)
  • Poor tolerance for hot weather (4)
  • Intense vomiting and diarrhea (3)
  • Vigorous exercise and not drinking enough water
  • Inadequate nutrition intake
  • Increased urination

Key Considerations

  • Risk factors: 85+, female, dementia,  multiple chronic diseases, medications, fever, dehydration history, use of diuretics (water pills) (4)
  • Parkinson’s disease or stroke may cause swallowing difficulties leading to decreased fluid consumption (1)
  • Signs of dehydration: little or no urination, sunken eyes, skin lacking elasticity and resilience when pinched, low blood pressure, a heart rate faster than normal, reduced blood flow to the extremities, dry mouth,  dizziness/sudden confusion, weakness (3) (1)
  • To confirm diagnosis, consider blood tests (electrolytes, kidney function) and urinalysis (3)
  • Treatment usually involves replacing lost fluids and electrolytes as oral rehydration
  • In life threatening emergency situations provide intravenous (3)
  • Identify medications that may be causing water loss (1)
  • Eat Right Ontario recommends: women 9 cups (250ml per cup) a day and men 12 cups (2)
  • Certain liquids, such as fruit juices, coffee, or carbonated drinks can make diarrhea worse (3)


  1. Alberta Caregiver College. (2014). Support for Caregivers of Older Adults: Hydration. Retrieved February 20, 2014 from:

  2. Dieticians of Canada. (2014). Facts on Fluids- How to Stay Hydrated. Retrieved February 19, 2014 from:

  3. MAYO CLINIC. (2014).  Diseases and Conditions: Dehydration. Retrieved February 19, 2014 from:

  4. Mentes, J. (2012).  Hydration Management. Nursing Standard of Practice Protocol: Managing Oral Hydration. Retrieved February 19, 2014 from: