My older parents often feel unwell. What can we do each day?

If your older parents seem to feel unwell often, the first thing to look at is what they eat each day: are they eating enough, and do meat, fish, eggs, beans and milk still appear at most meals? Then check four everyday things: enough to drink, moving every day, regular sleep times, and a doctor or pharmacist who knows every medicine they take. If they stay tired for several weeks, or if you are worried that they are getting unwell more often than before, take them to a doctor to look into the cause.

What everyday changes should I look out for in older parents?

Many changes with age happen slowly, so the people who live with them may not notice. When you visit or eat together, look at these points.

They eat less and feel full sooner

The US National Institute on Aging (NIA) says changes in the body with age can make some people feel full sooner than when they were younger, and that lack of appetite can also be a side effect of a medicine. A parent who used to finish a plate of rice and two dishes may now leave half of it.

Food tastes different

The NIA explains that growing older, dental problems and medicine side effects can change the senses of taste and smell, and that both matter for a healthy appetite. Smoking and alcohol can also affect taste. If your parents say food "has no taste", or keep adding fish sauce, this may be why.

Chewing gets harder

The NIA notes that people with tooth problems or dentures that do not fit often avoid meat, fruit and vegetables, and may miss out on important nutrients. Watch whether your parents push aside pieces of meat or leave fruit with a firm texture.

They eat alone

If your parents live alone, or one of them is often out, meals can become rice with one dish, or whatever is easiest, again and again. The NIA suggests eating with friends or at a community centre, so that people also have company while they eat.

My parents get ill easily. What should they have every day?

The answer to "what should they have?" starts with checking the food they already eat every day. Check that each day still has rice or other starch, vegetables, fruit, meat, fish, eggs or beans, and milk, in amounts your parents can actually finish.

Use the food groups as a checklist

The UK NHS guide to eating a balanced diet includes eating at least 5 portions of a variety of fruit and vegetables every day, basing meals on higher-fibre starchy foods such as rice, having some dairy or dairy alternatives (such as soya drinks), eating some beans, pulses, fish, eggs, meat and other protein, and choosing a variety of foods from the 5 main food groups. Compare these with the Thai food your parents eat.

When you compare these food groups with what your parents eat now, the gaps usually become clear quickly, such as a day with no fruit or a day where the only protein is a few pieces of meat on rice.

How can I help when my parents eat less than before?

You do not need to change everything at once. Small adjustments to taste, texture and company can make meals easier to finish.

Make food more appealing

The NIA suggests these ideas:

• Season food well, but with herbs, spices, lemon or lime juice or vinegar rather than extra salt.
• Vary the shape, colour and texture of foods, and try a vegetable, fruit or seafood they have not had for a while.
• Cook or steam vegetables for a shorter time, so they keep more flavour and some crunch.
• Being more active may make people hungrier.

Make food easier to chew

Choose softer ways to cook meat and fish, such as minced pork in soup, steamed fish or steamed egg, and cut fruit into small pieces. The NIA advises seeing a dentist if chewing is hard, and having the fit of dentures checked.

Eat together

The NIA suggests sharing cooking, eating with friends, or having meals at a community or religious centre. If you live apart, a regular weekly meal together, or a video call at mealtimes, lets you see how much they eat.

How much should older parents drink?

The NHS says most people should drink enough during the day so that their pee is a clear pale yellow colour, and that the UK government recommends 6 to 8 cups or glasses of fluid a day.

Thailand is hot for most of the year, so keep a glass or bottle of water where your parents sit, and offer a drink with every meal and snack. Choose plain water or unsweetened drinks most of the time.

How can I help my parents move more and sleep well?

Moving every day and keeping regular sleep times are part of everyday care, not only for younger people.

Move every day

The NHS advises adults aged 65 and over to:

• be physically active every day, even if it is just light activity
• do activities that improve strength, balance and flexibility on at least 2 days a week
• do at least 150 minutes of moderate-intensity activity a week, or 75 minutes of vigorous activity
• reduce time spent sitting or lying down, and break up long periods of not moving

Walking to the market together, watering plants, tai chi in the park in the morning and standing up during TV adverts all count. The NIA notes that moderate exercise may improve appetite, energy and outlook. The NHS advises speaking to a doctor first if someone has not exercised for some time or has health concerns.

For older parents' heart and blood vessels, see How can we care for older parents' heart and blood vessels?

Keep regular sleep times

The NIA suggests going to bed and getting up at the same time every day, keeping caffeine from tea, coffee and soft drinks to earlier in the day, and avoiding long naps of over 30 minutes late in the day.

If your parents wake up several times a night, see Older parents waking up at night: how can family help?

Keep in touch with people

The NIA also notes that boredom after retirement can leave people tired, and suggests taking part in activities they enjoy, such as volunteering or meeting friends and family. A temple activity, a community group or regular time with grandchildren can give the day a shape.

What should I check about my parents' regular medicines?

Older adults often take several medicines, and the NIA warns that taking medicines the wrong way or mixing certain drugs and supplements can be dangerous.

• Make one list. Write down every medicine your parents take, including medicines from other doctors, medicines bought without a prescription, vitamins, supplements and herbal remedies, even ones they use only now and then. The NIA advises telling the doctor about all of them.
• Ask before adding anything new. The NIA advises talking with a health care provider before starting any new medicine or supplement.
• Ask whether they still need everything. At each visit, the NIA suggests asking whether all the medicines are still needed.
• Use one pharmacy. Filling prescriptions at the same pharmacy keeps the records in one place.

The NIA also notes that some medicines change how food tastes, dry the mouth or reduce appetite, and that some foods can change how medicines work. If your parents eat less after starting a new medicine, tell their doctor or pharmacist.

When should I take my parents to see a doctor?

Talk to a doctor if:

• they have been tired or low on energy for several weeks with no relief (the NIA advises calling a health care provider)
• food seems to get stuck or is hard to swallow
• they are clearly eating less, or lose interest in food (the NIA notes this can also be a side effect of a medicine)
• they seem to get unwell more often than before and you are worried, so that a doctor can look into the cause
• feeling down lasts a few weeks or months
• chewing is hard, in which case see a dentist as well

The NIA says the doctor will usually ask about sleep, daily activities, appetite and exercise, so the notes you make about meals, drinks and sleep are useful to bring. Tell the doctor about any regular medicines, and do not stop or change them without advice.