In a discussion with Delphine Dupré-Lévêque, let's delve into this often-overlooked health problem.
Taste, smell, touch, and, less commonly recognized, the vestibular sense can also be affected.
Loss of taste (ageusia) and smell (anosmia) are often considered secondary and inconsequential impairments compared to hearing or vision loss. Nevertheless, we rely on all these senses for our physical and mental well-being. Researchers note that it's not always easy to determine if a decrease in taste is due to a taste disorder or an issue with smell. However, the loss of taste has significant repercussions that are now being better understood. It's likely that awareness of this impairment will grow, especially in light of the COVID-19 pandemic. Approximately 20% of individuals infected with the virus experience a loss of taste and/or smell, making it a relatively common COVID symptom, unlike most other viral infections.
While researchers have been able to observe the proportion of people affected by a loss of taste and/or smell due to COVID-19, it's unclear how many people outside of this virus suffer from these issues. What is known is that a loss of taste and/or smell directly impacts nutrition. This is one of the reasons why approximately two million people in England suffer from malnutrition (including 670,000 elderly individuals at home or in nursing homes). Sensory impairments related to touch and the vestibular system are less common but also have significant consequences.
Gustatory and olfactory impairments are often considered secondary, inconsequential, and receive little attention from healthcare professionals or caregivers. Nevertheless, these impairments are crucial to consider as they affect our appetite.
When a person loses their appetite and weight, doctors tend to prescribe various tests to understand the issue, rarely mentioning the loss of taste (ageusia) or smell (anosmia). Several factors can cause a loss of taste, including tobacco and alcohol consumption, diabetes, cancer, neurodegenerative diseases, and certain medications that can alter taste perception or cause dry mouth. Additionally, an often-overlooked cause is poor dental hygiene, dental issues, or inadequate denture care. In the latter case, with regular oral hygiene, taste can often be restored.
The consequences are more significant than one might imagine. A loss of taste leads to a loss of appetite, weight loss, an increased risk of falls, hospitalizations, and an acceleration of loss of independence, which can result in premature death. It is estimated that 40% of elderly individuals are hospitalized due to malnutrition.
Smelling delicious food stimulates appetite and awakens the taste buds. When a person can no longer smell or taste, this becomes much more challenging. However, there are ways to address these issues.
Firstly, it's essential to check if the loss of taste is related to oral hygiene problems or a fungal infection. In these cases, the loss of taste is often temporary. You can consult a doctor to determine if it's caused by a specific medication, and if so, explore alternative treatment options.
In other situations, creativity is required to rekindle the desire to eat. The goal is to make eating enjoyable again. Here are some steps:
Engage in a conversation with the person affected, whether you're a family caregiver or a professional caregiver. Discuss their fondest meal memories, dishes they loved, meals prepared by their mother or aunt, dishes they enjoyed making themselves, or their specialties. Challenge yourself to recreate these dishes, ask them to share recipes, secrets, or special ingredients, and involve them as much as possible in the preparation process.
Full involvement in meal preparation includes recalling memories, listing all necessary ingredients and utensils, creating a shopping list, and encouraging the person to accompany you for groceries. This step is essential as it keeps the person active and physically engaged, as grocery shopping often involves walking. The market or supermarket offers a sensory experience with colors and smells, and interaction with others can stimulate appetite.
Invite the person to participate in the recipe preparation to the best of their abilities, whether it's peeling, stirring, or other tasks.
Plan menus together in advance, allowing the person to choose according to their desires and the season.
Ensure that each dish is adapted to any potential chewing difficulties.
Make mealtime enjoyable and, if possible, convivial:
Add a touch of "magic" to each dish, ensuring an attractive presentation from appetizers to desserts.
Set a beautiful table, removing any reminders of medications or other health concerns. Include a flower in a vase, use a tablecloth, and provide a napkin.
Consider dining outdoors. If the person eats alone, make arrangements for regular companionship during meals. Sharing a meal in a social setting can stimulate appetite and well-being.
Invite neighbors over for tea or a snack regularly, encouraging exchanges and social interactions. Depending on arrangements and possibilities, visit your neighbor's home as well.
Addressing sensory impairments, including gustatory and olfactory challenges, requires a multifaceted approach, understanding, and creative solutions to help individuals enjoy the pleasures of food and maintain their nutritional well-being.
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