Nutrition and the Older Adult

CONDITIONS AND INTERVENTIONSANGIE STIEGEMEYER, MA,RD,LD, BSN,RN

SOUTHEAST MISSOURI STATE UNIVERSITY

Nutrition and the Older Adult

Health-sense of well-being

Quality of Life-measure of life satisfaction

Medical Nutrition Therapy-treatment of nutritional aspects of disease

Topics Covered

Cardiovascular Disease (CVD)/Heart DiseaseStrokeHypertentionDiabetes/DMOsteoporosisConstipationOsteoarthritisAlzheimer’s DiseaseUnderweightElder AbuseEnd of Life Care

Nutrition for CVD

Decrease amount of fat

Reduce cholesterol intake

Increase fiber, F & VLimit Sodium

ExerciseMaintain Healthy

WeightReduce StressSmoking Cessation

Stroke

Reduced blood flow to brainEtiology

Blocked arteries Easily clotting blood cells

Effects Deprive brain of oxygen-nerve cells die

Differing levels of paralysis

Stroke

Risk Factors Hypertension, high chol., DM, smoking, family hx,

obesityS/S: FAST

F-Facial weakness A-Arm & Leg Problems S-Speech Problems T-Time to call 911

Nutrition Normalize blood pressure

Hypertension

Systolic 140mm Hg or higher AND/OR Diastolic 90 mm Hg or higher

Effects- excess tension on vessels & organs Wears them out before normal aging process Kidney damage

Risk Factors Excess alcohol intake, high sat. fat intake, overweight

& obesity, low calcium intake, smoking

Nutrition for Hypertension

DASH DietWeight managementModerate alcohol intakeLimit sodiumAdequate calcium, potassium, magnesium

DM

1/5 over 65Greater risk for CVDEffects

Amputations Macular degeneration Vision loss Neuropathies Increased platelet aggregation Increased infection Decreased healing

Nutrition for DM

Diagnosis and criteria for mgmt same as younger adult

If kidney disease, limit protein (0.8-1.0 g/kg)MVIAssess cognitive function and create

appropriate care planAsses Hemoglobin A1C

Below 7% is goal

1

135---------6%170---------7%205--------8%240--------9%275--------10%310--------11%345-------12%

OsteoporosisPorous bones80% womenBone density greatly declines after

menopauseEffects-falls & fractures

Wrist, spine, hips Kyphosis

OsteoporosisNutrition

Calcium Vitamin D Exercise Limit caffeine F & V Limit sodium Limit SSRIs

Chronic Constipation

2 or less BM Q WeekEtiology

Medications Diseases-Parkinson’s, cancer, DM,IBS

Risk Factors Dehydration Medications Mineral supplements

Chronic Constipation

Treatment Exercise Fluid Fiber

Foods psyllium

Avoid laxatives if possible Bowel Retraining

Osteoarthritis

Etiology-cartilage loss, hardening of soft tissue, inflammation, changes in synovial membrane

Pain in joints-most common in knees & hips

Osteoarthritis

Treatment Control pain Weight loss Antioxidants Flavanoids Vitamin D Chondrotin & Glucosamine-cartilage repair Fatty acids & Oils

Alzheimer's Disease

Dementia-memory impairmentPlaques & Tangles in brainEffects

Confusion anxiety agitation loss of oral muscular control impairment of hunger & thirst mechanisms chewing & swallowing difficulties

Alzheimer's Disease

Treatment Safety Maintain nutrient dense diet

Plenty of time Focus on eating Serve finger foods Encourage drinks

Nutrition forUnderweight & Unintentional Weight Loss

Adequate kcals1-1.5 g/kg protein1 mL/kcal fluidNutrient dense foodsAdded fatsAdded kcalsBoost, Ensure

Elder Abuse

Abuse, neglect, exploitation

1-800-392-0210 (For suspected elder mistreatment in the home and in long-term care facilities)

End of Life Care

Respect patient & family’s wishesCollaborate & Refer

Palliative care, HospiceCompassion & Empathy