MCC CHRM 2350 - Nutrition and the Elderly

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Nutrition and the ElderlyNutrition and the ElderlyDefinition of TermsIQ Pre-TestSlide 5TopicsObjectivesSlide 8Slide 9Nutritional Care in GeriatricsCase StudySlide 12Slide 13Given the following, would you be concerned about Emily’s nutrition?Geriatric ProblemsSlide 16Sensory Changes with AgingSlide 18Psycho-Social Changes of AgingDepression ……………Slide 21Slide 22Slide 23Weight and MortalityWeightWeight LossSlide 27SarcopeniaSlide 29Slide 30Slide 31ProteinSlide 33Slide 34ProtienSlide 36Dehydration: CausesDehydration: SymptomsDehydration Practical ApplicationFluidsFluid:Nutrient ComparisonSlide 42Slide 43Swallowing Practical ApplicationSlide 45DementiaEating Behaviors: OverviewEating Behaviors: ExamplesPrinciples of ManagementEating Behaviors: Questions?Eating Behaviors: StrategiesSlide 52Pressure UlcersPressure Ulcers: NutritionSlide 55Slide 56Slide 57Slide 58Slide 59Slide 60Slide 61Nutrients of Concern in the ElderlyRememberCholesterol in the ElderlyMacular DegenerationMacular DegenerationSlide 67Vitamin A IntakeSlide 69Practice Problem“NEW” InformationSlide 73Appetite Stimulation: ResearchResearch ResultsResearch ConclusionsWhat’s “NEW” in the “Old”?“Vittles and the Vintage Old”: Colorectal Cancer“Vitamins and the Vintage Old”: Colorectal Cancer“Vittles, Vitamins & the Vintage Old”: Stroke & Transient Ischemic Attack“Vittles, Vitamins & the Vintage Old”: Depression“Vittles, Vitamins & the Vintage Old”: Bone DiseaseSlide 83Slide 84Slide 85Post - TestSlide 87Slide 88Slide 89Nutrition and theElderlySandra Stork MS, RD, LMNTNutrition and the Elderly•Why study nutrition and the elderly?Definition of Terms•OLD – usual categorization–Young Old – 65 – 74–Middle Old – 75 – 84–Old Old – 85 and olderIQ Pre-Test•IQ = Inquiry Quotient•Test your knowledge and stimulate your interest and inquiry.Topics•Changes of Aging Related to Nutrition•Geriatric Problems•What’s “new” in the “old”?Objectives After presentation, discussion, and completing practice problems, you will be able to:•Describe the “Guiding Principles” of Nutritional status and care in the elderly.•Identify nutrients pertinent to elderly. •Review the physiologic changes of aging which impact nutritional status and care.Objectives•Identify the association between selected Geriatric Problems and nutrition:–Sarcopenia -Weight Loss–Dehydration -Swallowing–Dementia -Pressure Ulcers–Constipation -Depression•Develop strategies for the treatment of these problems.•Reduced Nutrient Reserves•Reduced Response to StressNutritional Care in GeriatricsCase StudyCase Study•Emily Elder (85 y.o.) was walking with her neighbor Oliver Older (87 y.o.) to the Senior Center. On the way Emily slipped on ice and broke her hip. She was taken by ambulance to the hospital. You are the health care provider responsible for Emily’s care.What information is neededto evaluate Emily’s currentnutritional status and determinehow to provide for her nutrition?Given the following, would you be concerned about Emily’s nutrition? Height: 5’6” (167.6 cm) Weight: 110# (50 kg) Previous Wt 140# (63.6 kg) Body Mass Index 17.8 kg/m2Albumin 3.2 gm/dLRecent Poor Oral IntakeGeriatric Problems•What geriatric problems impact nutritional status?Sensory Changes with Aging•Decreased sense of smell due to decreased olfactory cells•Decreased number of taste buds–  Loss of sweet and salty– Less loss of bitter and sour•Decreased vision•Hearing lossPsycho-Social Changes of Aging • Economic–Less income; less money for food•Social – Lack of Socialization–Loss of mobility; can’t drive–Loss of friends and loved ones•Psychological–Loss self-worth; value–Depression; BIG problem (Bayer quote)Depression ……………The attitude that: “Of course he/she is depressed, I’d be depressed too if I were that old and had all those problems…..”puts elderly at risk of not receiving clinical attention for a very treatable disorder. Just because it is “understandable”, does not mean that depression is inconsequential or normal as people age. Barb Bayer, RN, MSN, CSDepression …………… is the most common psychiatric condition affecting the elderly, but it is often unrecognized and untreated. The myth that depression is just a natural part of aging is widespread in our youth-oriented society. It is also a belief held by many elderly themselves, their families, and unfortunately, many health care professionals.Geriatric Problems•Weight Loss•Sarcopenia•Dehydration•Swallowing•Dementia•Pressure Ulcers•Constipation•DepressionWeight and Mortality Potter, et al, 1988 Corrada, et al, 2006Weight•Primary Parameter•Standard Tables•TRENDSWeight LossPractical Considerations•5% in one month•7.5% in three months•10% in six monthsLong Term Care GuidelinesAmerican Healthcare AssociationWeight•Normal Trends in Aging–Peak Weight at 75 years old–General Trend of Weight Loss after 75•Abnormal (Unintentional) Weight Loss•Depression•Practical Application–Nutrient Dense Food–Foods from Food Guide PyramidSarcopenia•Definition: Loss of muscle mass in aging.•Results: Lower basal metabolic rate –Weakness -Decreased Functional Status–Reduced Activity Level–Decreased Bone Density•Practical Application–Progressive Resistance Exercises–Adequate ProteinProtein •Higher protein intake required to maintain nitrogen balance •Contributors:–Lower energy intake–Impaired insulin action–Decreased efficiency of protein utilizationJ.Nutr.Healthy Aging, 2006Protein •1.0-1.25 gm/kg/day •At least one high protein food at each of three meals•Physical activity to maintain muscle mass -Exercise against resistanceProtien •Add nonfat dried milk solids •Add cheese, peanut butter, eggs and nuts (if dentition permits)•Use commercial protein powders or supplements Practical SuggestionsGeriatric Problems•Weight Loss•Sarcopenia•Dehydration•Swallowing•Dementia•Pressure Ulcers•Constipation•DepressionDehydration: Causes•Decreased thirst sensation with aging•More dependent on others to obtain fluid•Decreased ability to concentrate urine•Increased incidence of incontinence with self-imposed fluid restriction•Increased use of medications contributing to dehydration•Increased losses: vomiting, diarrhea,


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MCC CHRM 2350 - Nutrition and the Elderly

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