Senior Care: Gluten-Free Living for Our Elders

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If you are caregiving for an elder in your life who has been diagnosed with celiac disease or gluten sensitivity, extra attention is needed to ensure gluten is avoided, particularly if they are no longer living independently. 

The symptoms of untreated celiac disease in older adults can look different than what children or young adults experience. While an older adult might experience GI issues, they may also exhibit low bone density (osteopenia or osteoporosis) and could develop certain cancers if their celiac disease is left untreated.  

Changing one’s eating habits later in life can prove challenging. Transitioning to shared living spaces, such as assisted living facilities, can present new barriers for seniors who need to eat gluten-free. While it can be easier for your loved one to look out for gluten when living independently, if they are not in charge of their own meals, additional safeguards are needed. 

When it comes to assisted living facilities, some have been validated through the Gluten Intolerance Group’s Gluten-Free Food Service (GFFS) Validation Program as a Gluten-Free Safe Spot. For facilities that have not been validated, there are things you can do to help determine if it is a suitable place for your loved one. There are also ways you can communicate with any facility staff about the importance of avoiding gluten and how to do it effectively. 


Gluten-Free Tips for Assisted Living Facilities 

All staff members at the assisted living facility where your loved one resides, or that you are considering, must be made aware of the importance of maintaining a safely gluten-free environment. Some of the first things to review and discuss include: 

  1. How educated staff are about gluten-free food preparation, serving, and eating. 

  2. How kitchen surfaces, appliances, and utensils are cleaned to prevent cross contact. Read: 7 Tips for Avoiding Gluten Cross-Contact at Home (The principles can apply to facility kitchens, too.) 

  3. What best practices are being followed for food preparation, such as using separate sets of cookware and utensils like cutting boards, nonstick pans, food storage containers, muffin tins, and pastry brushes. 

  4. How well-versed staff are at reading packaged food labels to watch out for gluten. Educate them about the importance of third-party certified gluten-free foods and recommend they look for the GFCO certification mark for added assurance that the food complies with strict gluten-free standards. 

  5. Whether or not gluten-containing foods are stored separately from gluten-free foods in refrigerators, freezers, and cupboards. 

  6. How clearly gluten-free foods are labeled and if they are safely stored in sealable boxes, bins, containers, or bags to avoid confusion. 

  7. Whether or not there are separate condiment bottles and jars (for mustard, mayonnaise, etc.), or better yet, squeezable dispensers that don’t require using a spoon or knife to access. 

  8. How carefully gluten-containing foods are kept separate from gluten-free foods in serving and eating areas. 


Not all facilities have the budget or space to separate food containing gluten from gluten-free offerings. Check if you can provide special utensils, and even cookware, that staff can use when preparing food for your loved one. If so, make sure to label those items appropriately to avoid unintentional mix-ups. 

The risk of cross-contact is higher when using shared cooking surfaces that cannot be easily cleaned, such as a grill or a serving set up where serving utensils could be mistakenly used for both gluten-containing and gluten-free foods. Buffets and salad bars are both higher risk for cross-contact. In self-serve situations, request individual gluten-free plates be prepared for your loved one. This can either be done prior to anyone else serving themselves or a separate plate can be made up exclusively for them in the kitchen. 

According to Lindsey Yeakle, GFFS Program Manager, facility staff could assist residents with celiac disease or gluten sensitivity management by color-coding gluten-free menu items or printing a dedicated gluten-free menu. Staff could also keep a photograph of each resident in the kitchen, along with a list of dietary restrictions, to help comply with individual dietary needs. 

Dietary Choices and Nutritional Needs 

Often, seniors begin to eat smaller amounts as they age. Eating less can make it more challenging to meet nutrient needs. While a gluten-free diet does not have to be limiting, if an assisted living facility does not provide – or accommodate – gluten-free meals and snacks, this could create additional challenges to eating a balanced diet.  

To add to those challenges, a gluten-free diet may lack important nutrients. Make sure that facility staff are knowledgeable about including the right foods to offset vitamins and minerals that may be missing when gluten-containing grains are avoided.  

Some nutrients that could be lacking in a gluten-free diet are calcium, vitamin D, vitamin B12, and fiber. These nutrients are also common deficiencies in older adults, not just people with celiac disease. Iron, potassium, zinc, and magnesium may also be lacking in an older adult’s gluten-free diet.  

Read: Nutrients You’re Missing When Gluten-Free. 


Compliance with a Gluten-Free Diet 

Look for a facility with a varied and rotating menu. A static set of mealtime offerings could further limit choice and interest in eating. A facility that serves fresh foods and meals made on the premises versus prepared foods purchased elsewhere may be better for elders avoiding gluten. It is important to know a facility’s policy regarding gluten-free residents’ requests for gluten-free menu items and how they monitor food brought into the facility by guests.  

Senior living facilities, including assisted living facilities, are not required to follow or enforce a doctor’s diet prescription. The level of monitoring will vary by facility. Residents can typically choose what they will eat and choose if they follow a gluten-free diet. Some gluten-free seniors may be reluctant to comply when given the ability to choose other menu items. 

Gluten in Medications and Supplements 

If the facility uses dietary supplements to help residents meet nutritional needs, verify that the supplements are gluten-free. While gluten is not a common ingredient in medications, it can be found in supplements. When considering a supplement, look for products that are certified or labeled gluten-free or read ingredients carefully. While items labeled gluten-free should be safe to consume, we can only vouch for the gluten-free status of GFCO-certified supplements. If medication or supplements are served with food, ensure that staff provide gluten-free options. Read: Are Your Medications and Supplements Gluten-Free? 


Keeping our elders safe, particularly when in the care of others, requires education, communication, and vigilance. Check out these references for more information: 

Avoiding Cross-Contact (n.d.) 

Celiac Disease | Nutrition Guide for Clinicians (2018, January 31) 

Gluten-Free Seniors – What Are We Going To Do? (2018, June 21)  

Wolfram, MS, RDN, LDN, T. (2018, May 23). Special Nutrient Needs of Older Adults 

Yeakle, L. (2019, January 2). Offering gluten-free options can be a differentiator for senior living communities – Guest Column 


Contributions from GIG by Sheila A. Berry, Bastyr University Dietetic Intern, 2019-2020. This article has been assessed and approved by a Registered Dietitian Nutritionist. 


The information on this website is for educational purposes only. Consult your healthcare team when considering this information.  

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