By Leni Wood, Head of Nutrition and Wellness at Nellsar Care Homes
The escalating diabetes crisis in the United Kingdom
The UK is currently facing an escalating diabetes crisis, with an all-time high of more than five million individuals grappling with the condition, as per the latest statistics released by Diabetes UK. Equally disconcerting is the revelation that an additional 850,000 individuals remain undiagnosed, painting a stark picture of the pressing need for comprehensive diabetes care that addresses the diverse challenges faced by these individuals.
The distinct impact of diabetes on older adults
An essential component of managing diabetes is encouraging a nourishing and balanced diet. The British Dietetics Association advocates steering clear of processed foods and refined sugars while prioritising hydration and embracing a whole-food diet rich in protein, healthy fats, complex carbohydrates, and an abundance of vegetables.
However, adhering to the general dietary guidelines for diabetes is not a one-size-fits-all solution, especially for older adults. Many seniors grappling with diabetes may find themselves underweight, on the precipice of undernutrition, rendering the uniform reduction of calories, fats, salt, and sugar inappropriate for their unique circumstances.
The vital role of nutritional expertise
Several factors conspire to impact the appetite of older individuals, including the side effects of medications, oral health complications, dehydration, social isolation, and various illnesses. To ensure that older individuals with diabetes receive optimal support, it is essential they undergo a thorough nutritional assessment led by a registered dietitian.
In care homes, such as the 13 within Nellsar Care Homes, onsite nutritionists emerge as an essential tool in supporting residents contending with diabetes. These professionals collaborate closely with care home kitchens to craft meticulously personalised menu plans, offer culinary recommendations, and deliver educational sessions to both the dedicated staff and the residents. The guiding principle here is the promotion of a “food-first” approach, fine-tuned to individual preferences — ensuring that residents have ready access to delectable and nutritionally enriching meal choices, irrespective of their diabetes status.
Further efforts are undertaken to elevate the dining experience for residents living with diabetes. Simple yet impactful strategies, such as mentoring nutrition and catering teams to prominently feature balanced and healthy options on menus and tea trolleys, are effective. In a conscious move towards fostering inclusivity, at Nellsar, we choose to refer to these options as “healthy choices” rather than limiting them as “diabetic options.”
Another crucial aspect to consider is residents’ food preferences and their previous approaches to self-managing diabetes in their own homes. While some individuals may have adhered to diabetes-specific diets, it is of paramount importance to acknowledge that sugar-free alternatives do not universally cater to everyone’s taste buds or dietary requirements. For those dependent on insulin, meticulous blood sugar level management is achievable, yet the task assumes added complexity for individuals living with conditions such as dementia, who often have a penchant for sweeter foods.
The significance of moderation
In the context of diabetes management within care settings, moderation emerges as the guiding principle. Striking a delicate balance is imperative, with an emphasis on avoiding overly sweet treats while simultaneously recognising the increased availability of reduced-sugar and reduced-carb alternatives.
Managing diabetes within care homes is undeniably intricate, requiring a customised and all-encompassing approach. Diabetes care ought not to be restricted to the mere control of the condition, rather, it should look beyond these boundaries and focus on the quality of life for those living with the condition — redefining every meal as a potential source of nourishment and delight. The prevailing thought is to abandon the notion that “sugar is off-limits” for individuals living with diabetes, urging us instead to adopt a person-centred approach that acknowledges the profound impact of dietary choices on overall wellbeing.
As the prevalence of diabetes in the UK surges, particularly among older adults, it becomes evident that a tailored approach to diabetes care is the need of the hour. Such an approach should prioritise personalised nutrition plans, respect for individual culinary inclinations, and an inclusive outlook from care teams. Once this is achieved, we, as care professionals, can unlock the potential for improved quality of life and greater nourishment — two key pillars that characterise great care.
Leni Wood is Head of Nutrition and Wellness at Nellsar, a family-run group of 13 care homes throughout Kent, Surrey, and Essex. Built on strong foundations, Nellsar has worked hard to build the trusted reputation of its homes and prides itself on being approachable, accountable, and empathic in its relationships with the families it supports.
