Case Study 7: Case Study-Assessment of the Nutritional Status of the Elderly

John, 78 years old, is a sometimes homeless veteran. He is missing many teeth from years of
no dental care. John receives a monthly retirement check but he has great difficulty meeting
his monthly bills, let along buying enough food, and this has caused many evictions. When he
can afford them, John has his prescriptions filled for a diuretic (for high blood pressure) and a
statin (for high cholesterol). John isn’t sure what his current weight is, but he has had to
tighten his belt to the last notch over the past eight months. He has no family with whom he is
still in contact, and he eats all of his meals alone. At a neighbor’s insistence, John is visiting
the local senior center to each lunch for the first time. The day he visits, each person is having
a free nutrition screen completed by a program staff member.

Questions:
1. Using the “Determine Your Nutritional Health” checklist given in your lecture, assess
John’s nutritional status. What is his score (1 pt)?

2. Review the “DETERMINE: Warning signs of poor nutritional health” checklist

shown in the Table (1 pt). Prioritize John’s nutrition problems based on this screening
tool (0.5 pt)
3. What should the local senior center registered dietitian do for John to help address the
Nutrition problems you identified in question number 2? (1 pt)
4. Using the lecture, determine the estimated calories requirements for John, a 78-year-
old male, who weighs 146# (66.2 Kg), is 5’11’’(1.8 m), and is considered fairly
active. (1 pts)
5. Calculate his BMI (0.5 pts). Does John need to gain or lose weight?(0.5 pts)
If John is losing muscle mass, what would you advise him? (1 pt – 0.5 pts for each
correct answer)
6. Based on the lecture, determine John’s estimated protein requirements (1 pt)
7. Also, John has difficulty chewing due to missing many teeth, so he avoids eating
many types of meats. What suggestions do you have to help him consume an adequate
amount of protein – they should name at least 3 (1 pt)
8. Determine John’s estimated fluid requirements.(0.5 pts)
9. John’s usual food intake is as follows: coffee, pastry, tuna salad on white bread, cola,
potato chips, canned beans, hot dogs, coffee, and pie.

What suggestions do you have to help him reduce his risk for chronic disease using
dietary modifications? (1.5 pts: they should list at least 3 ideas)