kitchen and a dietitian and can accommodate these needs as directed by each person’s health care provider. Smaller centers and group homes may need more assistance in meeting these needs. The most commonly prescribed modifications include lowering sodium, dietary fat, and total calories. For most of the chronic conditions that may result in a need for day care, these modifications are consistent with the Dietary Guidelines and can be accommodated with a general menu, thereby limiting the need for highly specialized individual meals. It should be noted that the American Dietetic Association has long recommended liberalized diets for older adults (ADA, 2005). Consideration of unique special dietary needs is beyond the scope of the committee’s charge. Therefore, the committee focused on the majority of older adults and adults with disabilities who may or may not have common chronic conditions, all of whom are likely to benefit from a diet that follows the Dietary Guidelines.

Adults of any age who have functional limitations often need assistance with eating and drinking. Measures described below may be necessary to ensure that adequate food and fluid can be consumed regardless of whether the person can eat independently or is fed by a care provider, relative, or friend.

Meeting fluid requirements may be challenging for the functionally disabled and for older adults. Regardless of age, some disabled adults are unable to drink fluids without assistance, and some may want to restrict fluid intake to reduce the need to urinate. As individuals age, thirst sensitivity decreases; many older adults do not have the trigger initiated by a normal thirst mechanism to consume fluids. The frequent offering of small amounts of beverages helps such individuals meet their need for fluids.

Textures may be modified to accommodate oral health problems, including but not limited to loose teeth, oral lesions, and gum and periodontal disease. Modifications in texture also may be necessary to accommodate swallowing difficulties that occur because of chronic disease (e.g., Parkinson’s disease) or catastrophic illness (e.g., stroke, cancer). Examples of texture modifications include the dicing, mincing, pureeing, and liquefying of foods and the thickening of liquids.