The RenalTracker Team
October 19, 2020
Senior woman eating alone

Are you caring for an elderly family member who’s diagnosed with chronic kidney disease (CKD)? Do you struggle during meal times because they refuse to eat due to a loss of appetite?

Poor appetite is a common problem in older adults. It’s also one of the symptoms of declining kidney function. It’s an urgent issue to address, as seniors need to eat well to get adequate nutrients for optimal health.

Continual loss of the desire to eat can lead to weight loss, nutritional deficiencies, and worse, earlier death. Find out the causes of reduced appetite along with effective strategies to improve it and increase food intake in elderly individuals with CKD.

Why Are Older People Prone to Loss of Appetite?

Several elderly individuals lose the desire to eat as they get older. In 1988, researcher John Morley described this trend as the ‘anorexia of ageing.’ Around 15 to 30 percent of older adults are estimated to experience this ‘anorexia of ageing’ and it’s most common among: 

  • Women
  • Residents of nursing homes
  • Hospitalized patients
  • Older people with acute illnesses

Factors that Could Cause a Decrease in Appetite in Seniors

Senior man eating alone

As we age, there are a number of factors that take place in our body which could affect our desire to eat. These include:

1. Bodily changes that come with ageing

  • Sensitivity to smells - Some people develop sensitivity to specific foods, causing them to feel nauseated when exposed to them.
  • Impaired taste, smell, and vision - Senses of sight, taste, and smell are all important in the enjoyment of food, and the decline of these senses during ageing can reduce appetite.
  • Slowdown in digestion - The digestive system moves food through the body by a series of muscle contractions. This process can slow down with ageing, causing food to stay longer in the stomach. 
    A slowed digestion can make seniors feel full for longer periods and reduce their appetite.
  • Difficulty chewing, swallowing, or eating independently - The discomfort caused by wearing dentures as well as chewing difficulties are also associated with decreased appetite. 

2. Psychological and social factors

  • Diet restrictions - Some older adults might not want to eat at all when they have diet restrictions due to their health condition.
  • Unpleasant mealtimes - If mealtimes have turned into moments of arguments about their eating habits, seniors could dread mealtimes and avoid it.
  • Medications - Some drugs can leave a metallic aftertaste or a dry mouth, while others can alter a patient’s sense of taste or smell (e.g. antibiotics, mood stabilizers, anti-inflammatories, and diuretics). These can affect their appetite.
  • Loneliness or depression - According to various scientific studies, many elderly  experience feelings of loneliness and/or depression and this often results in a loss of appetite.
    Seniors who live alone may also find meal times less pleasurable because they have no one to eat with. This can intensify their loneliness.
  • Dementia - A person with dementia may have difficulty eating due to a loss of appetite and memory loss. Dementia can make them forget how to chew and swallow, or get them easily distracted by their environment.

CKD and Appetite Loss

Chronic diseases like CKD can also impair appetite, especially in people with stage 4 to 5 kidney disease. Studies show that the dietary intake of people with advanced stage CKD declines as they approach end-stage renal disease (ESRD).

Experts say this decline may be caused by an increase in uremic symptoms as a result of severe kidney damage. These symptoms include nausea and a loss of appetite. 

The signs of kidney damage-induced appetite loss are:

  • A strong food dislike
  • Gastric problems
  • Dental problems
  • Decreased sense of smell
  • Weight or muscle loss

Although persistent lack of appetite in older people with CKD can lead to adverse health effects, patients and their families should remember that a diminished appetite is a natural effect of CKD progression and/or ageing. 

Renal dietitians and other experts of the healthcare team are instrumental in improving the appetite and increasing the food intake of kidney disease patients. 

Fortunately, there are also simple steps that caregivers can implement at home to help achieve these goals. Read on for some practical tips. 

8 Tips to get Older CKD Patients with no Appetite to Eat

Seniors eating with family

1. Know the the root cause of appetite loss

If your older relative suddenly loses their appetite, talk with their doctor. They might need a check-up so their doctor can assess and identify the exact cause of their appetite loss. 

Depression and dementia must be identified and managed with the help of a professional.

2. Keep them hydrated, but limit fluids during meals

Dehydration is a contributing factor to a lack of appetite, so remember to keep your elderly adult hydrated. Instead of drinking too much over a short period of time, have them sip fluids to prevent filling them too much.

3. Address dryness and metallic aftertaste in the mouth

Chewing a sugarless gum, brushing the teeth, or swishing an alcohol-free mouth rinse can help stimulate saliva flow in seniors who have a dry mouth. This also improves their taste which may boost their willingness to eat. 

Other ways to prevent mouth dryness are reducing the intake of coffee, alcoholic beverages, and sugary drinks.

Below are some tips to get rid of metallic aftertaste in the mouth:

  • Use plastic utensils and dining wares if metal silverware worsens the metallic taste.
  • Infuse water with mint, lemon, cucumber, or fruit slices if the water tastes strange to the patient.
  • Have them brush their teeth after meals.

4. Flavor up dishes to make them more appetizing

Since older people’s taste buds have become less sensitive, foods lacking in flavor won’t help stimulate their appetite. 

The use of natural herbs and spices helps perk up dishes without increasing a food’s sodium and potassium content. Feel free to experiment on flavors to achieve the taste they like.

5. Boost the visual appeal of their food

Elderly individuals with severely impaired vision cannot clearly see the food being served to them. This can cause them to lose interest in eating their meals. 

Besides ensuring their food tastes great, enhancing the presentation of their food to make it look attractive could encourage them to take a bite. 

Here are quick tips to make dishes more inviting:

  • Place colorful vegetables like broccoli, carrots, or green peas on their plate.
  • Add some garnishes that complement their food, like chopped basil and minced chives.
  • Serve foods in colorful plates and bowls. The colors green, orange, and yellow are believed to stimulate hunger and appetite.

6. Offer them choice and control

Being diagnosed with chronic kidney disease, having limited food choices, and having to control their portions can make people with kidney disease feel like they’ve lost their independence. 

Offer them a variety of choices, or let them decide what they want to eat during meal planning. Just make sure the options still fall within their dietitian’s advice.

7. Hype up the mood

Your ward may get in the mood to eat in a nice setting and good company. Enliven dinner by setting the table, lighting up candles, and playing soft music in the background. 

Eat and chat with them. Talk about topics that interest them. Make mealtimes as simple, calm, and relaxed as possible.

8. Create a routine and stick to it

A consistent routine that gets them to eat their meals at the same time each day can prime your patient’s body to be ready to eat during the set times. Serving them their favorite foods on a similar schedule can also stimulate their appetite.

Bottomline

Encouraging a loved one with CKD to eat when their appetite dictates otherwise can be a challenge, but don’t get discouraged. Keep trying and extend your understanding. Always consider their needs as you explore more ways to get them to eat more and well. As always, work with your patient’s renal dietitian to ensure they get proper nourishment daily.