The other day, I visited my mom, who has some memory issues. I went to the fridge and found some really old, expired meat. It freaked me out. I never thought of this as a worry.
Signed, Funky fridge fear.
I have seen many interesting furry and colourful items in the fridges of many seniors. The question is whether this is indicative of issues caring for oneself and the answer is usually — yes. Sometimes it is the first clue in an individual’s changing physical or cognitive abilities.
Older people change in their use of the kitchen, cooking habits and their shopping routines. This can occur for a variety of reasons. Changes in mobility, access to supermarkets and more time spent eating alone are just a few examples.
Seniors with weakened immune systems are at the greatest risk for food-borne illness. These high-risk populations are less able to fight off disease and are therefore more susceptible to illness. Making safe food choices is a key strategy at any age; but as people get older, there may be reasons why this becomes more problematic.
Many chronic illnesses — like infections and diabetes as well as kidney disease — can make it more difficult to fight off infections. The body is not as able to mount the same response to bacteria like E. coli and salmonella. The stomach acid produced by the body is reduced as we age, and some medications can further reduce the production of gastric acid, which kill harmful bacteria.
Some seniors cannot manage to keep track of food, as they can become confused about day and date and may not be able to comprehend expiry or “best before” dates. They may also not recall when they purchased their food, forgetting which days of the week food items were bought. This is a cognitive issue that is related to other functional concerns.
In the past, mom may have had a routine to check her fridge for spoilage, but now may not remember when or how to do this. Family can gently remind the person to do a cleanup, but it is usually necessary to take a more proactive approach and ensure that old food is tossed away when you are present.
This can become a delicate issue, as many seniors do not like the idea of throwing out food and tight budgets may exacerbate the negative response. Taking the person shopping may help and offers a chance to exchange and/or organize food products.
“Family should also watch out for symptoms of food-borne illness such as stomach cramps, fever, headache, nausea, vomiting or diarrhea,” statesKhashayar Amirhosseini, manager of food and nutrition services at Baycrest.
Vomiting and diarrhea are the most common symptoms. Their onset usually occurs between one hour and five days after eating contaminatedfood. Check with a doctor if you see repeated issues with this. Bacteria increase if food is not cooked or stored properly. Additionally, many pathogens are passed between people through improper hand washing when handling food. Hand washing is the best way to prevent the spread of disease.
Issues can emerge in meal preparation when someone is less cognitively intact. These individuals don’t cook as often, so they may undercook chicken, raw eggs and other products. Infectious disease worsens the cognition of a vulnerable individual, so it is critical to be protective. Some individuals with cognitive issues hoard food and this puts them at higher risk of contracting food-borne illnesses.
Have a routine whereby one day a week is designated as “cleanup day.” A cleaning lady, caregiver or a family member can ensure that this is done as part of the kitchen routine. Ensure that utensils, countertops, sinks and other food contactsurfaces are cleaned and sanitized after each use. You may have no choice but to step in more if you see evidence of repeated problems.
Family members can also take food items home for their own use if these products are “almost -expired.” This action is often pleasing to some older adults who see that their food is not being tossed out under their watch and going to those they love.
This is another tough and awkward caregiver management issue, but one that needs attention; otherwise, it can truly lead to serious problems.
Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. She is co-author of Dementia A Caregiver’s Guide available at www.baycrest.org/dacg Email questions to email@example.com