Food Allergies in Older Adults: Symptoms and Care Planning

By Silver Sitters

Food reactions require the right diagnosis. For an older adult in Broward County, a written allergy plan can help family members and caregivers understand which foods to avoid and how to respond to symptoms.

Recognize a serious allergic reaction

Call 911 for signs of anaphylaxis, such as trouble breathing, throat or tongue swelling, fainting or collapse after a suspected allergen exposure. Give the person’s prescribed emergency epinephrine promptly as directed. Do not wait to see whether symptoms become worse. Emergency assessment is still needed after epinephrine. Follow the dispatcher’s instructions.

Know the major food allergens

The nine major allergens recognized for U.S. food labeling are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans and sesame. Other foods can also trigger reactions. A mild past reaction does not guarantee that a future one will be mild.

Symptoms can include hives, itching, swelling, vomiting, wheezing or dizziness. Stop eating a suspected food and seek medical advice; urgent or severe symptoms require emergency help. A clinician or allergist should assess the cause rather than relying on a general list.

Allergy is different from intolerance and celiac disease

• Milk allergy involves the immune system. Lactose intolerance is difficulty digesting milk sugar and can cause gas, bloating or diarrhea. These are different conditions with different management.
• Celiac disease is an immune disorder in which gluten damages the small intestine. Gluten occurs in wheat, barley and rye. Celiac disease is not the same as wheat allergy or non-celiac gluten sensitivity.

Make the care plan usable at home

Read ingredient labels each time and ask about ingredients when eating away from home. Follow the person’s specific avoidance and emergency plan; do not assume that every older adult needs the same restrictions. Ask the care team about cross-contact, suitable food substitutions and how to use prescribed emergency medicine.

Keep the written plan accessible to anyone helping with shopping or meals. Confirm who can assist in an emergency and where the prescribed medicine is kept. An allergist and registered dietitian can help balance allergy management with adequate nutrition.