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7/29/2019 Nutritional Considerations in the Care of the Elderly
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NUTRITIONAL CONSIDERATIONSIN
THECAREOFTHEELDERLY
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NUTRITION
The process of nourishing or being nourished,
especially the process by which a living organism
assimilates food and uses it for growth and for
replacement of tissues.
The science or study that deals with food and
nourishment, especially in humans.
A source of nourishment; food.
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ABCS OF NUTRITION
Aim of Fitness
Build a Healthy Body
Choose Sensibly
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MICRONUTRIENTS
are nutrients required by humans and other living
things throughout life in small quantities to
orchestrate a whole range of physiological
functions, but which the organism itself cannot
produce
include all vitamins and minerals.
Vitamins are eitherwater-soluble (e.g. such as the
B complex vitamins and vitamin C) and generally
not stored by the body for future needs, orfat-soluble(e.g., vitamins A and D), which can be
stored by the body.
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MACRONUTRIENTS
Nutrients are substances needed for
growth, metabolism, and for other body functions.
provide calories or energy.
are required in large amounts. proteins, carbohydrates, and fats.
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AGING CHANGESTHAT AFFECT NUTRITION
Some loss of taste and smell making food taste
bland
Loss of awareness of thirst
Dry mouth Problems with teeth and gums and loss of muscle
mass in jaws and throat cause difficulties with
chewing and swallowing
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RISK FACTORSFOR POOR NUTRITION
alcohol or substance abuse
memory problems
little exercise
depression
functional limitations
low income
limited education
limited mobility, transportation
medical problems, chronic diseases medications
restriction diets, poor eating habits
social isolation
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Female Male
Vegetables and Fruit 7 7
Grain Products 6 7
Milk and Alternatives 3 3
Meat and Alternatives 2 3
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ASSESSMENT
Anthropometric Measurements
Height and Weight
N BMI = Over 65 24-29
Skinfold thickness and Circumference
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TIPSFOR IMPROVING NUTRITION
Drinking plenty of water or other fluids will prevent
constipation and dehydration. Enough fiber in the diet
may help prevent constipation as well.
Darker-coloured vegetables and fruits have higher levels
of vitamins. Older adults may not absorb enough of the vitamins that
they need for healthy aging because of changes in their
metabolism. Other older adults may have limited food
choices because of medical conditions.
Vitamin supplements such as calcium, vitamin D,
vitamin B12 and folic acid can be helpful but always
check with your health care provider about taking
vitamin supplements.
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IMPROVING FOOD INTAKE
Preventing poor nutrition is much easier thantreating it. Some ways to improve food intake are:if
possible, avoid restricted diets
cater to food preferences
eat meals with a friend
prepare foods of proper consistency, temperature
and presentation
improve taste of food with herbs and spices
avoid hard-to-open packaging
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GOTOEMERGENCYIF:
sudden high temperature/signs of confusionpeople who don't eat well are more prone toinfections
dizziness, falling, passing out this could be a
result of weight loss Call a doctor during office hours with any of the
following symptoms:
weight loss of 5% or more in one month or 10% ormore in 6 months
dehydration
loose bowel movements
coughing while eating or swallowing
dental or mouth problems
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NUTRITIONALDISORDERS
Dehydration
Normal Need:
30 ml/kg Body weight = 6-8glasses/day= 1.5 L urine
Etiology Impaired cognitive functioning
Poor oral intake
Enteral Tube feedings
Undiagnosed DM
Diuretics
Abuse of Laxatives
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Dysphagia Impaired Swallowing
Oropharyngeal Dysphagia /Transfer dysphagia
Trouble initiating or swallow or difficulty with voluntary transferof food or fluid from the mouth into the esophagus
Esophageal Dysphagia
Difficulty with food transport after swallowing
Obesity Excess body fat
BMI above 30
Risk Factors Inactivity
Reduced metabolism
Lifelong patterns
Limited social contact
Poor dentition
Reduced mobility
Endocrine disorders
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Malnutrition
is the condition that results from taking an unbalanced
diet in which certain nutrients are lacking, in excess (too
high an intake) ,or in the wrong proportions
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Eyes - The eyelids can be swollen or inflamed. The cornea of the eye can become soft. Thebluish tinge of the white of the eyes can disappear. In an advanced stage, the inner surfaceof the eye might seem dull, lusterless and rough.
Face -When the mouth of the patient is held half open, angular wrinkles emerging out themouth can be seen. They can become scars in advanced stages. A mucous lining candevelop inside the mouth, which might protrude out and appear to be a part of lips. Deepcracks and reddening is also visible on the lips and corners of the mouth.
Glands - A swollen Thyroid gland just below the Adams apple is the clear indication ofmalnutrition. The salivary glands of people with malnutrition swell like mumps.
Mouth - Taste buds can completely disappear in case of malnutrition. Patients suffer withsores and reddening inside the mouth, with white patches of fungus on the tongue.
Muscles - The muscles start wearing away slowly. This is because, for the generation ofenergy body starts utilizing the muscles, saving the fat for emergency. Muscles startappearing like jelly and lose their toning.
Skin - The skin complexion becomes dull and yellow. Xerosis, meaning dry and crinkledskin is the term used to describe the condition of the skin. The color under the nails alsofades away. It is known as Follicular Hyperkeratosis, which appears like goose bumps butdon't go away even if the patient is warm.
Teeth - Tooth decay is also a symptom of malnutrition. The enamel of the teeth can be dotted
with white patches. Teeth can also don brown stains accompanied by pitting. Gums canswell, with puss emerging from the bone below the gum line. The bone and teeth becomeeasily breakable.
Psychological - The patient becomes unresponsive and disinterested in the surroundings.Listlessness, weariness and apathy are some of the common symptoms. In addition,dullness, irritability and poor memory are also notice
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TREATMENT
Home delivered meals
Nuritional Supplements
Promote Self Feeding
Enteral Nutrition TPN