Dignity, malnutrition and comfort in later life

Food and Nutrition in Later Life -The Vital Ingredients

One size does not fit all…..

4

11.5%

17.1%

24.4%

33.1% 33.1%

30.4%

26.6%

12.3%

20.9%

25.2%

30.2%31.4%

33.7%

28.4%

0%

5%

10%

15%

20%

25%

30%

35%

16-24 25-34 35-44 45-54 55-64 65-74 75+

Prev

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sity

Men Women

Adult obesity prevalence by ageHealth Survey for England 2010-2012

Patterns and trends in adult obesity

Adult (aged 16+) obesity: BMI ≥ 30kg/m2

Malnutrition

The Nutrition Screening Week surveys(BAPEN 2013) indicated that the proportionof underweight individuals (BMI < 20 kg/m2) admitted to hospital rises steeply above theage of 70 years..

Older people accounted for most of the malnutrition in hospital (62%)

In older years chronic disease and ill health can create dietary challenges

93% of malnutrition is in the community

Psychological and Social Well Being

Psychological well-beingHow happy or content we feel with life

Social well-being A sense of involvement with other people and with our communities

Diet quality can play a central role in maintaining cognition and well-being

Shatenstein et al, 2012 Experimental Gerontology. Haveman-Nies et al, SENECA study Age and Ageing 2003.HALCyon Programme

Specific nutrients affect ourwell being and function

Folate

Zinc

Vitamins B12

Omega 3 Fatty Acids

Selenium

(Abouh-Saleh and Cooper, 2006, Levitan et al, 2000, Nowak et al, 2005, Williams et al, 2005,Bodnar and Wisner, 2005, Bamber et al, 2007)

Vitamin B6

CHO

Energy

Preservation of cognitive abilities is central to the maintenance of independence and quality of life among older adults

Shatenstein et al, 2012 Experimental Gerontology

Kuh et al, HALCyon Programme Public Health 2012 HALCyon Programme

Crucial elements of ageing well

Feeling Useful Being socially engaged

Being productive

Towards the end of life

Conclusion - one size does not fit all

• Good nutrition can help to combat chronic disease, manage weight and function

• Under-nutrition predisposes to disease and adversely affects its outcome. This has important economic implications but can adversely affect mood, happiness, comfort.

• Older people and partner agencies with a remit for older people’s health should be provided with consistent and appropriate messages concerning nutrition in later life.

Do we listen to our clients?

• Do we know what is good for older people?• In chronic disease and life limiting conditions

we need to be aware that food can create considerable anxiety, misunderstandings, become a battle ground.

• Do we take into consideration all the challenges around food?

• Do we address beliefs and values?• Do we aim to improve QoL or nutritional status?

Malnutrition, dignity and later life.

•Do we really cater for the individual needs of our ageing population?

•If diet is a habit of a lifetime - are individuals able to enjoy what they have habitually eaten when in a care home, nursing home?

•Do individuals feel engaged in the preparation and choice of meals?

Creating the Right Environment