The future of nutrition for the elderly
Life expectancy in Germany is rising and society is becoming increasingly older. In 2015, 4.7 million people were over the age of 80 in Germany and in 2050, this figure is expected to reach around 9.9 million. At the same time, the Federal Care Improvement Act (‘Pflegestärkungsgesetz’) is supporting the many elderly people who want to live in their own homes for as long as possible and to choose what and when they eat. Up to now, there was no data available on what the elderly expect from nutrition and nutritional care and how state and private providers can rise to the challenge.
A study carried out to investigate these areas by the Institute for Biomedicine of Ageing at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and funded by the Karl Düsterberg Foundation has now been published.
Society is becoming increasingly diverse which is also partly due to immigration. An increase in heterogeneity and individualisation is likely among 75 to 85 year olds, reflecting these changes in society. Consequently, a variety of options will be required that address various factors such as taste, health, financial resources, living conditions and social integration. ‘Nutrition for the elderly often requires some adjustments and additional support, which means services must match the needs of elderly consumers as closely as possible,’ explains Prof. Dr. Dorothee Volkert from the Institute for Biomedicine of Ageing at FAU. ‘The elderly also have their own ideas about individual nutritional care. Factors such as locally-grown food, traditional and seasonal dishes will continue to be an important consideration in the future.’
All participants in the study expressed their desire to feed themselves according to their own requirements in terms of values, taste and quality, for as long as possible. Nutrition for the elderly in future should ideally counteract the loss of autonomy the elderly suffer as a result of ageing and illness. In addition, the menu should cater for the individual’s level of independence and take personal requests and taste preferences into consideration at all times.
The elderly showed a great deal of interest in receiving information about nutrition – preferably researched and provided by family members. In future, we can expect media awareness among the elderly and the desire for detailed information about nutrition to increase. However, there is a tendency for older people to give little consideration to their own situation in terms of their potential need for help in the future.
The elderly want social contact, be it while shopping, while ordering and having groceries delivered, while preparing lunch, for example, or while eating. Social contact not only changes when people get older, it also becomes less frequent. Today, only 28 percent of those aged 84 and above regularly eat with either friends or family. Cooking together, assisted trips to the shops or social meeting places that offer meals and other services could further increase the integration of nutritional care for the elderly in society.
The care model of the future will create individual options for nutrition that meet the expectations and requirements of the elderly in all physical conditions and states of health. It is also important for the elderly to be able to make decisions for themselves. What’s needed is a care model that facilitates a smooth transition from one option to the next, without any losses in quality or variety. This presents a challenge for both service providers and society in general that can only be overcome with the participation of all involved – not least the state and local authorities.
In 2016 and 2017, interviews were conducted by the Institute for Biomedicine of Ageing in Nuremberg and the Geriatric Day Clinic at the Barmherzige Brüder Hospital in Regensburg with seniors who live independently. To participate, the respondents had to live independently in their own home, be between 75 and 85 years of age, not require any care and not have any significant cognitive limitations. In 2017, the second step involved discussing the results of the individual interviews in two focus groups with experts in nutrition science, research and medicine, gerontology and psychology as well as with nutritional care providers. The aim of this discussion was to identify resources and opportunities in nutritional care today and to generate ideas for nutritional care suitable for the changing individual needs of elderly consumers in future.
The Institute for Biomedicine of Ageing (IBA) at Friedrich-Alexander-Universität Erlangen-Nürnberg was opened in February 1980 and was the first institute for gerontology in Germany specialising in medicine and experimental gerontology. It was the end of a long process, as experimental gerontology was still uncharted territory in Germany in the 1960s and 70s. The breakthrough came in 1973 when FAU set up a Chair of Internal Medicine for Geriatrics. The establishment of an endowed professorship for clinical nutrition in advanced age in 2008 by the Theo and Friedl Schöller Foundation in Nuremberg was a milestone for the institute. In April 2009, Prof. Dr. Dorothee Volkert took up office as the only professor specialising in nutrition for the elderly in Germany at that time.
The Karl Düsterberg Foundation was founded in 1988 by Karl Düsterberg, founder of the company apetito. His daughter, Beate Düsterberg-Eissing, has been chairperson of the foundation since 2014. The Karl Düsterberg Foundation has been supporting science, research, and education in relation to food, food technology, nutrition and nutritional physiology as well as vocational training in the food industry since it was set up. It finances and supports initiatives such as the study conducted by the Institute for Biomedicine of Ageing (IBA) at FAU through donations, including donations by apetito AG.
Prof. Dr. Dorothee Volkert