The Shorncliffe nursing home has introduced a high-calcium diet as part of its efforts to reduce broken bones caused by falls.
"When people were falling, they were breaking bones like crazy," said nutritionist Alinda Buckler. "Now, when our people do fall, they're not breaking their hips like they were."
Buckler looked at many different possibilities for getting more calcium and vitamin D into the diets of the elderly residents. She devised a simple, yet effective method: fortifying whole milk with skim milk powder. Now other seniors' facilities in Vancouver Coastal Health Authority, including the Kiwanis Care Home in Gibsons, are using Buckley's formula in their own menus.
The fall-prevention program at Shorncliffe began two years ago. The staff kept careful records of incidents of residents falling and considered different ways to prevent falls and injuries. Many changes have resulted. High-risk people can wear padded hip protectors. Staff look for ways to avoid hazards like rugs and slippers that can trip people. Getting people to drink plenty of water is important, because dehydration makes them more likely to stumble. Many drugs can have similar effects, so Shorncliffe holds regular care conferences to reconsider whether medications are necessary.
"It was my job to look at how to get calcium into the diet," said Buckler, because when calcium is lacking, the body will take calcium from its own bones.
Buckler said many seniors don't eat enough dairy products or other high-calcium foods to get their recommended 1,200 milligrams of calcium daily. Their appetites often get smaller as they age, and they may have medical problems which make eating and digesting food more difficult.
"If you're not a milk drinker, there's no way you can get your calcium," she said. As a result, many institutions give residents calcium supplements: three big pills a day. But Buckler is a firm believer in the philosophy of "food first."
People don't absorb the calcium from supplements as well as from milk, she said. Since many seniors are already taking several medications, she hates to add yet more pills to their daily routine. And the supplements are expensive, an important consideration in a time of tight health budgets.
Buckler decided instead to add skim milk powder to regular milk to make a fortified milk high in calcium, vitamin D and protein. Residents get a half-cup serving of the fortified milk at breakfast, providing 316 mg of calcium. As well, every day the kitchen adds skim milk powder to fortify another dish on the menu, such as pudding, cream soup or mashed potatoes.
People who are lactose intolerant can't digest the milk powder well, so they need the calcium supplements. But for people who can digest milk, Buckler said, that is a better choice.
"Food works. Food is absorbed better," she said.
And according to dietary aide Rachel Johnson, who serves the fortified milk daily, people generally don't notice the supplementation.
"It tastes like milk," Johnson said.
Buckley's next big project, if the funding comes through, will be to study ways to increase the fibre in seniors' diets.
