A Guide To Understanding Nutrition For Bedridden Seniors

By: Scott Grant, ATP, CRTS®

Fact-checked by: Kathryn Bubeck, Registered Dietician

Finding the right sources of nutrients is a key aspect of caring for a bedridden senior. You need to find food that they enjoy, that they are physically able to eat, and that contains the right balance of nutrients for their diet plan.

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Proper nutrition for seniors is incredibly important because it can have a direct impact on their health and mortality. Seniors with poor nutrition intake often have a weaker immune system and are more vulnerable to certain illnesses and infections. This effect is multiplied in seniors who are bedbound due to illness or diminished overall health.

The body behaves differently when a person spends the majority of their time in a bed. Because of this, it is important to keep their unique nutritional requirements in mind.

How Does Nutrition Differ For Bedridden Seniors?

The first major difference to consider is the senior’s caloric requirements. A person’s caloric requirements are normally determined by their basal metabolic rate (BMR) and their activity level. BMR is calculated according to weight, age, height, and sex. Thus, everyone’s caloric requirements are unique to their own body and their level of physical activity.

However, there are still some generally accepted guidelines that we can use for comparison. For example, the National Institute of Aging (NIA) recommends a calorie intake of 1,600 for women and 2,200 for men who are above 50 and not physically active. If they live an active lifestyle, then those requirements increase to 2,000 for women and 2,400 for men.

Even though these calculations are for seniors who are not physically active they still assume a certain minimum level of activity. They take into consideration energy that you burn simply walking around and performing normal daily tasks. That means they are not as effective for bedridden seniors who will burn even fewer calories during the day.

Feeding a standard diet for seniors to someone bedridden could lead to weight gain. Gaining a few pounds may not be dangerous in and of itself, but obesity in seniors is a growing problem that could lead to serious health consequences. It’s estimated that more than one-third of all adults over the age of 60 are in the weight range of obesity.

To determine the caloric requirements for someone who is bedridden you need to determine their resting energy expenditure (REE). The REE for men is their weight multiplied by 11. For women, the REE is their weight multiplied by 10. You then multiply the REE by 1.3 to determine a baseline caloric requirement.

In most cases, this is going to result in a daily caloric requirement that is lower than the average recommendation listed above.

bedridden senior woman being visited by her granddaughter
Proper nutrition may not heal a bedbound senior but it can prevent further degradation in some cases.

How Do The Nutritional Requirements Of Bedridden Seniors Differ?

Unfortunately, some other factors complicate these values. One of the most important factors to consider is whether the senior is suffering from any medical conditions that increase caloric requirements.

Bed Sores and Pressure Ulcers

For example, many people who are bedridden suffer from bedsores. When confined to bed, there is little opportunity for proper pressure relief. That’s why bedsores are clinically referred to as decubitus or pressure ulcers.

The body requires more calories than normal when it is working to heal itself. Dealing with bedsores can increase a senior’s caloric requirements by several hundred calories each day depending on their weight and the severity of the condition. It is also suggested to increase protein and/or supplements that contain glutamine and arginine which is standard wound care protocol for bed sores at most hospitals. 

Increased Number of Medications

When creating a meal plan for a bedridden senior you need to consider all of their conditions and the medications that they take. Certain medications can lead to weight gain in a normal scenario. That risk of weight gain can increase significantly in bedridden patients.

Dysphagia & Swallowing Disorders

Certain conditions can also impact a senior’s ability to consume or absorb specific nutrients. Dysphagia is a common medical problem that makes it difficult for bedridden seniors to swallow. It can make it very difficult to provide a senior with a well-balanced meal plan for prolonged periods.

The food needs to be prepared in a way that doesn’t pose any risk for the senior who cannot sit upright because they are at a higher risk of choking. Seniors who suffer from dysphagia can benefit from nutritional drinks that fill the gaps between what they need and what they are getting. Often, they are placed on a chopped or pureed food diet.

Digestive Disorders

You also need to consider the long-term effects of specific foods on bedridden seniors physically. There are some health conditions that they may not have at the moment, but that can develop after remaining in bed for long periods of time.

Chronic constipation is one problem that can develop over time. The opposite is also true and many people have problems with diarrhea as well. Both of these can be managed or prevented with the right diet plan.

Foods that are high in fiber like beans and vegetables are excellent sources of nutrition that can reduce the risk of constipation. It’s also important to ensure that they are drinking enough water on a daily basis.

Anemia

Seniors who are malnourished are more likely to suffer from anemia. Anemia reduces the oxygenation of tissues and slows down the healing process significantly. A properly balanced diet with sufficient nutrient levels can help prevent anemia as well as other conditions that are caused by undernourishment.

How Can You Improve The Nutrition Received By Bedridden Seniors?

A well-balanced diet for a bedridden senior should include calories from high-quality sources as well as sufficient levels of vitamins and other macronutrients.

Ideally, you want to provide nutrient-dense foods. To determine this, compare the number of vitamins, minerals, and antioxidants to the total number of calories the food has. This is particularly important for seniors who have a hard time eating or swallowing. The more nutrients and vitamins you can include in the meal the better because they are probably going to consume less food overall.

However, this doesn’t mean that meals should be larger than average. Many experts now recommend consuming several smaller meals throughout the day rather than three large meals.

woman caring for her bedridden husband at home
It’s not just important for seniors in bed to eat frequently but they must eat high quality, nutrient dense foods.

What Are Some High-Quality Nutrition Sources For Bedridden Adults?

To keep a bedridden senior nourished you need to find a source of nutrients in foods that they enjoy, that they are physically able to eat, and that contains the right balance of nutrients for their diet plan. This can be tricky at first but tends to get easier as you spend more time with them and monitor their condition.

Protein is one of the most important nutrients available to bedridden seniors. Consuming several grams of protein each day can help the body repair damaged tissue and build muscle mass. The gradual loss of muscle mass is a serious problem for bedridden seniors. The benefit of extra protein can help offset some of these losses. Lean meats and fish are an excellent source of healthy protein. (See the best protein drinks for seniors and the elderly here.)

Other high-quality sources of nutrients include fruits, whole grains, beans, and vegetables. These foods tend to contain healthy amounts of fiber in addition to other useful vitamins and nutrients like minerals and antioxidants.

Pre-made nutrition drinks are an excellent tool to have when caring for a bedridden senior. Companies like Kate Farms produce plant-based nutrient drinks for children, adults, and seniors. They are made without gluten, soy, dairy, or artificial sweeteners. They have several different formulas available. You may even be able to purchase the drinks from Kate Farms through your health insurance provider.

Wrapping Up

Managing the nutritional needs of a bedridden senior is an ongoing journey that can change at any time. You need to be constantly aware of their eating habits and any ongoing medical conditions.

Take time to find high-quality nutrition sources and manage their caloric intake properly. And don’t be afraid to rely on supplemental products like nutrition drinks to fill the gaps.

About the Expert

Because I strive to provide you with accurate information, I had this article fact-checked by Kathryn Bubeck, RD, LDN a registered dietician in North Carolina. She has dual bachelor degrees in Nutrition and Health Behavior Management and is currently pursuing a medical degree with a focus on oncology.
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