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NUTRITIONAL CONSIDERATIONS IN

THE CARE OF THE ELDERLY

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.

ABCS
Aim

OF

NUTRITION

of Fitness Build a Healthy Body Choose Sensibly

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 either water-soluble (e.g. such as the B complex vitamins and vitamin C) and generally not stored by the body for future needs, or fatsoluble(e.g., vitamins A and D), which can be stored by the body.

MACRO NUTRIENTS
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.

AGING CHANGES THAT 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

RISK FACTORS FOR 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

Female

Male

Vegetables and Fruit

Grain Products Milk and Alternatives

6 3

7 3

Meat and Alternatives

ASSESSMENT

Anthropometric Measurements

Height and Weight

N BMI = Over 65 24-29

Skinfold thickness and Circumference

TIPS FOR 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.

IMPROVING FOOD INTAKE


Preventing poor nutrition is much easier than treating 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

GO TO EMERGENCY IF:
sudden high temperature/signs of confusion people who don't eat well are more prone to infections 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% or more in 6 months dehydration loose bowel movements coughing while eating or swallowing dental or mouth problems

NUTRITIONAL DISORDERS
Dehydration Normal Need:

30 ml/kg Body weight = 6-8glasses/day= 1.5 L urine Impaired cognitive functioning Poor oral intake Enteral Tube feedings Undiagnosed DM Diuretics Abuse of Laxatives

Etiology

Dysphagia

Impaired Swallowing

Oropharyngeal Dysphagia /Transfer dysphagia Trouble initiating or swallow or difficulty with voluntary transfer of 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

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

Eyes - The eyelids can be swollen or inflamed. The cornea of the eye can become soft. The bluish tinge of the white of the eyes can disappear. In an advanced stage, the inner surface of the eye might seem dull, lusterless and rough. Face -When the mouth of the patient is held half open, angular wrinkles emerging out the mouth can be seen. They can become scars in advanced stages. A mucous lining can develop inside the mouth, which might protrude out and appear to be a part of lips. Deep cracks 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 of malnutrition. The salivary glands of people with malnutrition swell like mumps. Mouth - Taste buds can completely disappear in case of malnutrition. Patients suffer with sores 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 of energy body starts utilizing the muscles, saving the fat for emergency. Muscles start appearing like jelly and lose their toning. Skin - The skin complexion becomes dull and yellow. Xerosis, meaning dry and crinkled skin is the term used to describe the condition of the skin. The color under the nails also fades away. It is known as Follicular Hyperkeratosis, which appears like goose bumps but don'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 can swell, with puss emerging from the bone below the gum line. The bone and teeth become easily 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

TREATMENT
Home delivered meals Nuritional Supplements Promote Self Feeding Enteral Nutrition TPN