NUR 1172 | Module 04 Discussion - Dietary Concerns of Older Adults.docx | Rasmussen College

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Module 04 Discussion - Dietary Concerns of Older Adults Discuss dietary concerns and barriers for an older adult to maintain appropriate nutrition levels. Identify the types of concerns and barrier... s they may encounter. Include two client teaching and nursing interventions for prevention of nutritional deficits as well as the consequences of inadequate nutrition and hydration. Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials, be sure to provide proper attribution and/or citation. Please check the Course Calendar for specific due dates. Need Help? Click here for complete discussion forum instructions. • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Antony, That was a very thoughtful post. I must agree with you that a nurse should be aware that poor nutrition, especially in the elderly, can negatively affect the health of that population. In your post, you mentioned that “depression can cause obesity which can be likewise harmful to the geriatric population's health”; however, Berry and Marcus, (2000) noted that “depression is probably the most common cause of weight loss in the elderly”. During the literature review for your post, did you find any articles supporting the claim that depression can cause obesity in the elderly? Reference Berry, E. M., & Marcus, E. (2000). Disorders of Eating in the Elderly. Journal of Adult Development, 7(2), 87-99. (Post is Unread) Thread: Post: Romario Blissett Module 4 RE: Romario Blissett Module 4 Author: Marc Felix Posted Date: July 31, 2016 12:27 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Hello Romario, From reading your post, I was able to find some very useful information in term of concern about diet in the elderly, especially in the nursing home population. I was just curious about the statement you made in regards to "13 cups of water". You mentioned that "Any male above the age of 19 should drink 13 cups of water per day", is that from an evidence based researcher? What is the significant of it? Moreover, you mentioned that at the facility where you work, "all residents are given diuretics upon admission". Is that an admission criteria for you facility? Since everyone health condition is different, I am just curious on how the determination to give everyone diuretics upon admission. Since diuretics increase production of urine, and some causing loss of electrolytes in the urine (Harvey & Jordan, 2010), how do they help maintain satisfactory hydration level? Reference Harvey, S., & Jordan, S. (2010). Diuretic therapy: implications for nursing practice. Nursing Standard, 24(43), 40-49. (Post is Unread) Thread: Post: Dietary Concerns RE: Dietary Concerns Author: Markeeta Sheppard Posted Date: July 30, 2016 11:03 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 of the resident in my facility are a little reclusive so we try to encourage them as much a we can to get around and make some friends and socialize. that's a great way to help. Nutrition and healthy eating. (2015, August 05). Retrieved July 27, 2016, from http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy- eating/in-depth/calcium-supplements/art-20047097 (Post is Unread) Thread: Post: Dietary Concerns of Older Adults RE: Dietary Concerns of Older Adults Author: Hadassa Bardette Posted Date: July 30, 2016 9:57 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Nutritional issues like you mentioned above are what I combat every day at the facility I work at. We always encourage our residents to drink more of the water and juices we provide with each meal. for older adults like you mentioned they can also become deficient in vitamin and its harder to get them to eat foods that are enriched with these vitamin since some of them have their own particular liking and the problem with their diminishing appetite. unfortunately the only way to combat that is to provide vitamin supplement in pill form to these residents which I fill is the worst. Some of those pills are huge in size and awful in taste. I really enjoyed reading your post and just wanted to share my own experience. thank you for posting. Nutrition and healthy eating. (2015, August 05). Retrieved July 27, 2016, from http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy- eating/in-depth/calcium-supplements/art-20047097 (Post is Unread) Thread: Post: Dietary Concerns RE: Dietary Concerns • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 I understand you when you have mentioned the older patients with Alzheimer's can forget to eat their food on time. I think this problem can be easily solved by getting a caregiver with those kinds of the patients in order to remind them to eat at the time they should do it.To prevent a poor nutrition, a nurse can help them get a diet plan and also educate them on the food intake. The patients are able to stay or become healthy by having planning meals. (Post is Unread) Thread: Post: Module4 RE: Module4 Author: Michelle Lewis Posted Date: July 30, 2016 8:41 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 I too believe loneliness plays a huge role in appetite and nutritional value on an elderly's diet. Something we may not think about is are they are receiving enough vitamins with their daily meals. One way we can help be sure they receive all the vitamins they need on a daily basis is providing them a multi-vitamin they can take daily. Vitamins like C and D are vital to our lives as they help our immune system and help calcium in our bones. Nutrition and Aging. (2006, March). Retrieved July 26, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682454/ (Post is Unread) Thread: Post: concerns and barriers RE: concerns and barriers Author: Antony Stimphile Posted Date: July 30, 2016 8:16 PM Status: Published • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 encourage the patients to eat, it doesn't mean that they will eat the meals provided. Also depending on what kind of health condition and medication they're taking, it can affect their appetite. Another reason a patient can have a loss of appetite is from having depression. If a patient has been in a nursing home for quite some time or they were placed in there unexpectedly, it can lead to depression. (Post is Unread) Thread: Post: Module 4 RE: Module 4 Author: Merilyne Francois Posted Date: July 30, 2016 3:27 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 I agree with you about the many barrier that older adult have. While those barriers can cause them to suffer, some of them would feel that they are losing their independence if they ask for help. I know many older adult, that feel too proud, embarrassed or ashamed to let people know that they need help. Educate them and the family is a big step, to help them understand the importance of having adequate nutrient for the body. The family, caregiver should also let them be as independent as they can be while they are providing the necessary help need to maintain a perfect balance. Great post (Post is Unread) Thread: Post: dietary concerns of older adults RE: dietary concerns of older adults Author: Merilyne Francois Posted Date: July 30, 2016 3:20 PM Status: Published • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Edie Smith Posted Date: July 30, 2016 3:15 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Biological factors are indeed a concern, but there are other barriers that affect the older adults’ nutrition. Factors such as mobility and economics can significantly affect older adult’s nutrition. In my opinion, an older adult with impaired mobility will find it challenging to prepare more nutritious meals as standing for long periods can be difficult. I believe this immobility can affect their ability to shop for groceries for meal prep. Research shows that poverty affect people perception of food, in that some foods are perceived as a luxury, therefore the individual who has a certain financial constraint may choose not to buy certain foods. An elderly adult who’s only income is social security may not buy food which sometimes are fruits, vegetable, and quality protein which are necessary for the proper nourishment of the body (Arcury, Quandt, Bell, McDonald, & Vitolins, 1998). A nurse could intervene by seeking to get help from social services for this patient. Arcury, T. A., Quandt, S. A., Bell, R. A., McDonald, J., & Vitolins, M. Z. (1998). Barriers to nutritional well-being for rural elders: Community experts' perceptions. The Gerontologist, 38(4), 490-498. (Post is Unread) Thread: Post: concerns about nutrition in elders RE: concerns about nutrition in elders Author: Korinne Meikle Posted Date: July 30, 2016 3:11 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 married and had kids. My grandparents met during this catastrophic event and married. They moved to England where my father was born. My grandfather couldn't find work so they immigrated to Brazil and there my uncle was born. They were sponsored by a family in the United States and moved to upstate New York where they grew up. Few decades later my family made it down to Florida where I was born. My grandparents lived with us up until my parents were divorced. My grandparents never spoke much English, well no English really just the "yes" or "no" responses. I was never taught Polish which I never understood cause I feel like that could have made me identify more with my ethnicity and communicate better with them but I understood it. When I asked my dad about why I was never taught it he said that basically that everyone was just trying to conform to American culture, I don't know? They went to English classes at the local high school but didn't really catch on. My grandfather (sweet to me:)) was always so stern and stubborn. My dad took care of them when they moved to Florida. So my grandfather would tinker around and usually was at the flea market buying junk. He was a hoarder. Reflecting back on his life I would definitely put the causes of his hoarder due to what happened to them. I watched the isolation of being different take a toll on them. Social media was not created yet which I think would have helped them connect with family or others that survived. I didn't learn till about a few months ago how tough my family had it when they moved to America. I mean I always knew it was a struggle. We surprised my uncle for a birthday in Texas and started to reminiscing. Comical to my dad and uncle now; but thinking about how far they have came is very motivational. They told stories how they never went to the doctor if they were sick they usually had some old polish remedy to do the did the trick. They would rely on community centers to help put food being put on the table. Very simple way of living. I can't even imagine what it would be like to be taken from your family and culture and to never be back again. My grandmother always looked so sad so distant. If I could go back I would have liked to have her tell me about her experiences. I would have liked to have known the nightmare she lived. I am just so lucky that my dad wanted to succeed in life and provided me with the tools that I needed to be successful in life. Because I know for him it was a totally different story. (Post is Unread) Thread: Post: Module 4 RE: Module 4 Author: Brittany Moore Posted Date: July 30, 2016 10:55 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Schlenker, E. D., & Gilbert, J. (2015). Williams' essentials of nutrition and diet therapy (11th ed.). St. Louis, MO: Elsevier Mosby. (Post is Unread) Thread: Post: Module 4 RE: Module 4 Author: Brittany Moore Posted Date: July 30, 2016 10:50 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Physiological changes may lead the elderly to eat more microwaveable meals. These are not something one should eat every day, especially if there is a risk for hypertension. I love that you mentioned they should consult a nurse or doctor before taking supplements. Often, people think more is better and may become toxic by going over the UL of nutrients. Certain medications or metabolic disorders, on top of normal aging, may affect how Schlenker, E. D., & Gilbert, J. (2015). Williams' essentials of nutrition and diet therapy (11th ed.). St. Louis, MO: Elsevier Mosby. • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Hello Alexandria, great job on your discussion post. I definitely agree with the statement you made that proper hydration and other nutritional needs based on age and chronic conditions are important in the adult population. One major mineral I personally think is important to the elderly population is Calcium. The reason I believe that Calcium is one of the priority minerals for the elderly is because it is able to strengthen the bones and increase rigidity upon absorption. But while some may consume Calcium that does not mean it will be absorbed. Absorption of Calcium also requires other steps such as Vitamin D. Vitamin D is necessary for the active transport of Calcium. The Vitamin D hormone called Calcitrol has the ability to control the synthesis of a calcium-binding protein that carries the mineral across the mucosal cell and then into the blood. References Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. [VitalSource Bookshelf Online]. Retrieved fromhttps://ambassadored.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Dietary Concerns RE: Dietary Concerns Author: Antony Stimphile Posted Date: July 29, 2016 1:34 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Attachment: Dietary concern reply.docx (16.74 KB) (Post is Unread) Thread: Post: Dietary Concern Older Adults Dietary Concern Older Adults Author: Antony Stimphile Posted Date: July 29, 2016 1:00 AM Status: Published • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Your post was informative and you discussed very good points. The nutritional intake needs of the older generation have a lot of differentiating factors like you mentioned. A fixed income has a huge impact on this particular group because many of them are retired and do not work. Unfortunately you are correct, about healthier options being more expensive and considered a "luxury". From a socioeconomic perspective, healthcare professionals try to educate on health promotion and disease prevention by following a healthy diet and exercise regimen. However, many of these nutritious foods we recommend are too expensive for our targeted populations. It is hard as a healthcare professional to realize it is not only the individual's fault for not being healthy. Many disparities exist and it is important as a future nurse to realize the limitations for the older generation and help them adapt to a healthier lifestyle (Schlenker & Gilbert, 2015). References Schlencker, E., D., & Gilbert, J. (2015). Williams’ Essentials of Nutrition and Diet Therapy. St. Louis, Missouri: Elsevier Mosby. (Post is Unread) Thread: Post: Module4 RE: Module4 Author: Monique Barte Posted Date: July 28, 2016 7:59 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Hi Victoria, I agree with your post. With aging, the energy needs of the body and physiologic functioning of the body slightly decrease. However, some vitamin and mineral requirements increase so it is imperative that older adults are meeting these requirements to allow normal functioning. Symptoms such as dysphagia also greatly affect the older generation. It may cause them to eat only specific foods which can also cause malnutrition. I liked how you mentioned social gatherings to help the older adult group eat properly. People in general always eat differently with others than by themselves. This can positively affect the older adult group because they are being watched while eating. Even if they are not hungry, social gatherings can make a person eat just because they see everyone else doing it (Schlenker & Gilbert, 2015). References Schlencker, E., D., & Gilbert, J. (2015). Williams’ Essentials of Nutrition and Diet Therapy. St. Louis, Missouri: Elsevier Mosby. (Post is Unread) Thread: Post: Dietary Concerns of Older Adults Dietary Concerns of Older Adults Author: Tabitha Wilkins Posted Date: July 27, 2016 9:23 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Many older adults experience a decrease in their thirst and appetite which can cause them to suffer from nutritional deficiencies. The USDA urges drinking more water to combat dehydration which can be a problem for older adults due to their decreased thirst. Common vitamin deficiencies for older adults are calcium, vitamin D, and vitamin B12. Foods rich in calcium include milk, cheese, yogurt, leafy greens, and calcium-fortified foods. Foods rich in vitamin D include fatty fish, cheese, egg yolks, and vitamin D- fortified foods. Meat, fish, dairy, and eggs are rich in vitamin B12. As nurses, we must educate our clients on their food choices and include nutritious food options in their diet. We must also make them aware that they are at a higher risk of dehydration and urge them to drink more fluids. Institute of Medicine (US) Food Forum. (n.d.). Retrieved July 27, 2016, from http://www.ncbi.nlm.nih.gov/books/NBK51837/ Nutrition and healthy eating. (2015, August 05). Retrieved July 27, 2016, from http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy- eating/in-depth/calcium-supplements/art-20047097 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Hi Samantha, I completely agree with your answers on nutrition deficiencies. Even though some older people may eat properly, their nutrient intake can significantly decrease if the rate of absorption is not the same as it used to be when they were younger, which is why their nutrient intake must dramatically increase in order to compensate for that. As far as ways to teach older clients about nutrition, I think that community classes would be a great help. Nurses can give some tips and pointers on how to maintain proper hydration and vitamin intake. (Post is Unread) Thread: Post: BBohon_Dietaryconcernsandbarriers_July262016 RE: BBohon_Dietaryconcernsandbarriers_July262016 Author: Diana Wootten Posted Date: July 27, 2016 7:54 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Hi Bobbie jo, I agree there are many factors that may contribute to malnutrition for older adults. When we age, people tend to lose their sense of taste, so we utilize salt more for flavor. As a nurse, we need to educate why the patient needs to limit the sodium intake, so they understand. Educating the older adult on proper nutrition will also help them stay healthy. If they have a restricted diet, they should have an understanding of what they can eat and what they should stay away from. Referance Schlenker, E., Roth, S., & Williams, S. (2007). Williams' Essentials of Nutrition & Diet Therapy. St. Louis, Mo.: Elsevier Mosby (Post is Unread) Thread: Post: Dietary Concerns RE: Dietary Concerns • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Megan, I enjoyed reading your post. You made some valid statements about how important it is for the elderly to maintain the necessary nutritional intake no matter how less active they become or how their energy level decreases. You also mentioned dehydration being a major factor for the elderly and their nutrition. The elderly can experience dehydration from inadequate fluid due to the medications they take, physiologic changes, effects of disease, and environmental circumstances (Schlenker & Gilbert, 2014, p.312). Schlenker, E. D., & Gilbert, J. (2014). Williams' Essentials of Nutrition and Diet Therapy (11th ed.). Saint Louis, MO: Mosby-Elsevier. (Post is Unread) Thread: Post: Personal Experience Personal Experience Author: Karla Stallings RASMUSSEN INSTRUCTOR MANAGER Posted Date: July 27, 2016 7:05 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Family members consist of varying age ranges. Has anyone had an experience where an elder family member faced barriers? If so, share your thoughts. How were the barriers managed? Karla (Post is Unread) Thread: Dietary Concerns in Older Adults Post: • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Brittany, I liked how you mentioned microwaved meals being a dietary concern. With that being said, an elderly person may have trouble cooking a well-balanced meal for one person if living alone. He or she may also be on a fixed income which results in an improper diet. This is because the nutrient dense foods such as proteins, fibers, and calcium are more expensive than the microwave meals (Schlenker & Gilbert, 2014). A nurse could offer his or her elderly patient some resources to obtain food if they are on a fixed income. Some resources a nurse could recommend to the client are food stamp programs, meals on wheels and the senior nutrition program. References: Schlenker, E. D., & Gilbert, J. (2014). Williams' Essentials of Nutrition and Diet Therapy (11th ed.). Saint Louis, MO: Mosby-Elsevier. (Post is Unread) Thread: Post: Dietary Concerns of Older Adults RE: Dietary Concerns of Older Adults Author: Kaley Kinsler Posted Date: July 27, 2016 12:40 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Markeeta, Nutrition requirements can sometimes be confusing and a lot to remember, so I like that you included that picture reference. It is an easy to read guide that is not overwhelming. Patients can stick this on their refrigerator to serve as a quick guide and reminder when they are in the kitchen and hungry. Perhaps the nurse can also identify individual needs specific to the patient and write those on there as well while educating the patient on the importance of consuming adequate amounts to maintain enough energy and nutrients for the body. (Post is Unread) Thread: Post: Dietary Concerns of Older Adults RE: Dietary Concerns of Older Adults Author: Samantha Berberette Posted Date: July 27, 2016 11:48 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Shelby, I like how you talked about Alzheimer’s disease being a reason to poor nutrition because they forget to eat. Parkinson’s disease is a neurological disorder that can make it difficult for a patient to eat because of the difficulty in feeding themselves and preparing meals (Schlenker & Gilbert, 2015). Other reasons why an older adult may not be consuming the proper nutrients is because of trouble with feeding themselves, preparing foods, and grocery shopping (Schlenker & Gilbert, 2015). I agree with nurses educating the patient about proper nutrient intake is important in trying to improve their nutritional status. Also, nurses can conduct nutrition screenings, such as the Mini Nutritional Assessment (MNA) because they show warning signs of malnourishment and can then make changes to their diet based on results (Schlenker & Gilbert, 2015). Also, nutrient supplements combined with food in older adults who are at a nutrient deficiency can replenish the body (Schlenker & Gilbert). References Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. [VitalSource Bookshelf Online]. Retrieved from https://ambassadored.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: week4 Post: week4 Author: Merilyne Francois Posted Date: July 26, 2016 10:59 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 A good diet can reduce many disease and help in their management. Our appetite and taste change as we age. I used to work at a nursing home facility and I could see how improper nutrition affected the life of the resident. Many of them became weak. they have involuntary weight loss, they became irritable, and they got sicker every day just because they body lacks of nutrient. According to Chandra (2002) malnutrition in older adult can be as high as 35%. Loss in muscle mass on people older than 65 can be considered normal, but also malnutrition can play a role in it. loss of teeth makes it harder for them to enjoy the food that they usually enjoyed. Swallowing problem, some of them cannot swallow and they have to be put on nectar consistencies fluid. That alone can decrease their appetite and because of less intake of nutrient. Older people needs to take a daily vitamin to compensate for many nutrients that they are losing. Vitamin D deficiency is common on the elderly patient. Without vitamin D the body cannot absorb calcium. Deficiency in calcium cause osteoporosis. People with dementia are at higher risk to suffer malnutrition. Some of them do not know when they are hungry or thirsty. Their caregiver has to force them to eat something. Depression can make people lost their appetite and be prone to suffer from malnutrition. Many people older than 65 living alone can suffer from depression. many elderlies are often misdiagnosing when they suffer from malnutrition. To maintain appropriate level of nutrition, healthcare worker should make sure that their illness is not a result of lack of nutrient. Getting a healthier version of the food they like without compromising too much the taste. Encourage eating and fluid as much as possible. Exercise, getting out in social event, enjoying a morning sunbath to get some vitamin D. getting daily intake of vitamins. Respect their culture. Good oral health and hygiene are important to maintain. One of the most important point is education. http://www.healthinaging.org/aging-and-health-a-to- z/topic:nutrition/info:unique-to-older-adults/ Chandra RK. Nutrition and the immune system from birth to old age. Eur J Clin Nutr. 2002;56(Suppl 3):S73–6. [PubMed] (Post is Unread) Thread: Post: concerns and barriers concerns and barriers Author: Hadassa Bardette Posted Date: July 26, 2016 10:20 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Nutrition is an important determinant of health in elderly patients. Eating difficulties can lead to serious consequences for older adults, including significant weight loss, malnutrition, aspiration pneumonia, dehydration, slow healing, and depression. Many elderly patients have an increased risk for malnutrition compared with other adult populations. Physical obstacles can take the form of difficulty in holding and using utensils or in conveying food from plate to mouth, decreased ability to chew and swallow, decreased appetite, and decreased awareness of hunger and thirst. this kind of barrier can come from diseases like arthritis and strokes. patient teachings for these kinds of barriers would include timely and routine meals that are low in distraction. offering patients lots to drink to combat dehydration and provide a positive social environmentto combat depression and isolation. reference http://www.healthinaging.org/aging-and-health-a-to- z/topic:nutrition/info:care-and-treatment/ (Post is Unread) Thread: Post: Dietary Concerns Dietary Concerns Author: Samantha Manzano Posted Date: July 26, 2016 10:19 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 As a person ages, he or she begin to go through physiologic changes that concern many organ systems and other bodily functions that slowly slow down. For example, the cardiovascular system begins to weaken as a person ages and can’t pump blood efficiently. With that said, oxygen and nutrients aren't delivered throughout the body as much as they should be (Schlenker & Gilbert, 2015). The renal system becomes less efficient. It could either not eliminate enough fluids causing a person to be over- hydrated or eliminate too much fluid causing a person to be dehydrated. Another major issue is muscle loss and bone mass decrease. As a nurse it is our role to make sure the client understands what role they need to play in promoting their health. We need to teach them (clients) to properly regulate the amount of fluids they intake that is appropriate for them. We can also teach them to try and intake the proper amount of nutrients that can help them. For example, when an elderly is having issues with not eliminating enough fluids, he or she could lower their sodium intake which can cause urinary retention. To aid in the avoidance of muscle loss we can inform a client to increase the amount vitamin B6. Vitamin B6 works as a coenzyme and helps preserve muscle mass (Schlenker & Gilbert, 2015). Reference Schlenker, E. & Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy (11th ed.). St. Louis, Missouri: Elesvier Inc. (Post is Unread) Thread: Post: nutrition in older population nutrition in older population Author: Alexandria Lewis Posted Date: July 26, 2016 10:07 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Proper hydration and other nutritional needs based on age and chronic conditions are important in the adult population. Not all patients know their nutritional requirements appropriate for their conditions resulting in poor outcomes in their health. As people age there are physiological changes that accompany a growing body. The overall function of the body begins to decline. This contributes to an increase in risk factors for chronic conditions. The nutritional need changes as people age. Some people may not know the nutritional needs that their body requires as they age. Factors that can contribute to limiting the patient from nutritional education can be socioeconomic such as poverty, access to transportation, access to healthcare and cognition. Also poverty can limit a person’s options to healthy foods. Not having access to appropriate healthcare to receive education for specific needs is also detrimental to the older population. Also another important factor to know for the population is if they are able to actually feed themselves. Public health nurses and other educators can reach these populations by understanding their target demographic and being able to have effective communication with them. Nurses can also administer the mini nutrition assessment to evaluate each person individually. Without proper education and appropriate nutrition the mortality risk increases. The older population is more at risk for complications of their chronic conditions without proper nutrition. (Post is Unread) Thread: Post: dietary concerns of older adults dietary concerns of older adults Author: Korinne Meikle Posted Date: July 26, 2016 9:45 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 The older adult population is at an all time high. It is extremely important to understand the nutritional aspects that their bodies require. We then, as nurses, need to accommodate each individual, because everyone has different cultures and educational backgrounds. As one ages their body becomes vulnerable to malnutrition and chronic diseases. The nutritional needs of the older adult population are influenced by the drastic changes in their body composition, the function of their organs, and weight loss. As one ages, simple daily activities become sometimes nearly impossible, such as, chewing or swallowing food. This can then make eating food not enjoyable and result in weight loss or anorexia. Rheumatoid arthritis is a common disorder that affects the joints in the hands and this can cause the person to be unable to prepare meals for them selves. Elderly people are often on multiple medications, which can often cause a lower food intake. Depression and lack of income can also play a rule in their nutrition. As a nurse, it is important to educate these people about the changes their bodies are going through and what they need to do to supplement their nutrition. For example, calcium deficiency is common in the elderly population. It is important to educate these people about taking adequate actions to keep their calcium intakes in a proper range. Starting at the age of 51, women should increase their intake to 1200mg. this is important to reduce bone loss and fractures. Some elderly do not get enough vitamin D which play hand in hand with calcium. As a nurse we can suggest and educate these people about fortified fluids such as soymilk or fortified yogurt, which will supply both vitamin D and calcium. We can also educate about the importance of fluids. Dehydration is a concern for healthy and ill elderly. Because of the changes in the hypothalamus, older people do not get as thirsty resulting in a lower intake of water and dehydration. Dehydration then causes lots of issues such as problems swallowing and confusion. Older adults are also at risk for overhyrdration because the excess water is not being excreted efficiently. As a nurse we can teach the signs of dehydration and show them how to monitor their fluids to prevent dehydration and overhydration. Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. 310-315 [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Dietary Concerns of Older Adults Dietary Concerns of Older Adults Author: Markeeta Sheppard Posted Date: July 26, 2016 9:22 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 As we get older we begin to need different nutrients because we are changing as we get older. Even though we are older we still need to exercise and maintain a healthy diet. Some dietary concerns and barriers that older people may experience are weight control, constipation, poor dental health, digestion problems, sense of taste and smell, poor appetite and mobility. It is important that we education our patients on the importance of having a maintaining good nutrients. We could provide that patients with a picture like the one below that shows how much from each food group that they should consume and how doing do will allow them to maintain their health. Another thing is exercise. Some older people don’t exercise because they can’t walk. But as nurses we can educate them on different types of exercises that they can do sitting or lying down. It is important that as nurses who are caring for these patients that we ensure that they are eating something. Sometime older people don’t eat because of the way they have to eat their food. I have seen older people not eat because their food has to be pureed. In cases like this we must encourage the patient to eat something even if it’s a cup of yogurt or some apple sauce. In cases like these you have to teach the patient how important it is for them to eat and sometimes just lending an ear will give them motivation to eat. (2014). Special nutrition concerns for seniors. Retrieved July 27, 2016, from http://www.upmc.com/patients- visitors/education/nutrition/pages/special-nutrition-concerns-for-seniors.aspx Beattie, L., & Nichols, N. (2007, May 29). Nutrition and the elderly. Retrieved July 27, 2016, from http://www.sparkpeople.com/resource/nutrition_articles.asp?id=869 (Post is Unread) Thread: Post: Dietary Concerns of Older Adults Dietary Concerns of Older Adults Author: Shelby Sexton Posted Date: • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 Depression is a good point made. Alot of older adults I feel see their life as unproductive and become depressed. This can make them not want to eat. Other reasons for malnutrition could be from loss of sense to smell and taste. It could also be from lack of accessability. If the elderly person is disabled or has a lack of motion, then this means that the person may not be able to go to the grocery store. There are organizations that may offer delivery of meals. (Post is Unread) Thread: Post: Romario Blissett Module 4 Romario Blissett Module 4 Author: Romario Blissett Posted Date: July 26, 2016 7:58 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Concern about the diet of the elderly is a growing topic. While working in a nursing home I have experienced a heavy focus on making sure all residents receive their three balanced meals per day. One dietary concern for older adults is maintaining sufficient Iron levels. Iron consumption typically comes from animal sources such as beef. If there is a significant malnutrition of Iron, it is possible to consume an adequate amount from Iron supplements. One significant contribution Iron has to the body is providing the core for heme in hemoglobin which carries oxygen to the tissues and returns carbon dioxide to the lungs for excretion (Schlenker & Gilbert, 2015). Some older adults have a decreasing sense of thirst which may require special attention. Any male above the age of 19 should drink 13 cups of water per day and if an individual has low water intake their energy intake decreases as well. At times an older adult’s lack of thirst may stem from taking multiple medications because aging changes may impact the thirst center in the hypothalamus. One substantial threat to maintaining satisfactory hydration levels is the use of diuretics. With the admission to the nursing home I am currently employed all residents are given diuretics upon admission. While many older people may be passionate about their bowel movement they may sometimes request the application of diuretics to their medication regime and overlook the importance of the intake of additional fluids. (Schlenker & Gilbert, 2015). Client teaching is composed of educating the client of the specific topic. Educating the client about the risks of malnutrition such as being more susceptible to physical illnesses than those who are well nourished. Another opportunity to inform a client for the prevention of nutritional deficits comes in Calcium. “Many persons cannot or will not consume enough calcium-rich foods to reach their requirement and depend on supplements.” (Schlenker & Gilbert, 2015, p.143) Because calcium gives strength and rigidity to the skeleton it is not only important to the elderly population because of the risks of falls, but all ages. References: Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. [VitalSource Bookshelf Online]. Retrieved fromhttps://ambassadored.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: concerns about nutrition in elders concerns about nutrition in elders Author: Emily Sallah Posted Date: July 26, 2016 7:50 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 It is hard keeping the older population in good nutrition standard because as we get older one of the first things to go is our sense of thirst and hunger. Being older it is viable that we keep hydrated and feeding our bodies the nutrition that they need so that the older population can fight away infections, diseases, breaks amongst otherthings. A lot of times when elder patients are placed in retirement homes they receive prepared meals • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 The nutrition levels in older adults tends to be a bit difficult to maintain due to a few dietary concerns and barriers. Many of them suffer consequences from improper intake, like dehydration and nutritional deficits. Hydration is very important in older adults, because dehydration can cause a decrease in alertness and cognitive function (Schlenker, 2015). Nutritional deficits can cause major problems like osteoporosis if not enough calcium and iron (especially in women) is taken. There are a couple of factors that can affect proper nutrition intake. The main one that comes to mind is income. For the most part, many older adults do not work and end up living off of some sort of fixed income. Many older adults may not be able to buy fresh fruits and vegetables, so they tend to resort to buying canned food items that have been heavily processed, which can increase the chance of hypertension or diabetes. What can also affect nutritional levels is the rate of nutrient absorption. For instance, loss of gastric acid can affect the absorption of essential vitamins like B12 and it reduces the absorption of thiamin, folate, calcium, and iron (Schlenker, 2015). What nurses can do to educate older patients on maintain proper nutritions is have community support groups to teach them how to increase nutrient intake with the foods that they eat. Nurses can also create health care plans that are more focused on the patient's nutritional needs so that nutrient intake can be better monitored. Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. 310-315 [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Dietary Concerns Dietary Concerns Author: Michelle Lewis Posted Date: July 26, 2016 7:32 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 As we age, our nutrition levels seem to decrease leaving the elderly with more health issues due to poor nutrients. One concern we need to be aware of is getting the right amount of vitamins out of our daily eating. As we age our appetites decrease, and we may only eat once or twice a day while not eating the healthiest foods to provide effective amounts of certain vitamins such as vitamin C or vitamin D. Both these vitamins are important to our health by helping our immune systems and our bonestrength. One way we can help ensure that they receive the proper amount of these vitamins is to put them on a supplement to help maintain proper levels of vitamins. Another concern we need to be aware of is making sure they are drinking adequate amounts of fluids. As we age, we tend not to feel thirsty, and this can lead to dehydration very easy especially if taking a diuretic. One way we can help keep hydrated is by refilling waters often and telling them how much they are drinking. We could also have them drink water in between TV shows, for example, every time a new show comes on to take a drink. Reference: Nutrition and Aging. (2006, March). Retrieved July 26, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682454/ (Post is Unread) Thread: Post: Module 4 Module 4 Author: Monique Barte Posted Date: July 26, 2016 7:28 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Factors that can affect the older adults nutrition intake include living on a fixed income, education level, physical disability, and physiologic changes. Older adults living on a fixed income tend to buy foods with a high shelf life; • 1 • 2 • 3 • 4 • 5 to taste those. This creates an imbalance in nutrients due to not eating the foods they need. Planning meals as you said is a very effective way to have the elderly eat. I believe that it will also help those with alzheimer's or other memory deficiencys stay in a routine and help them throughout their days as well as get all of the proper nutrients they need. (Post is Unread) Thread: Post: Nutrition and Older Adults Nutrition and Older Adults Author: Edie Smith Posted Date: July 26, 2016 5:26 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Proper nutrition is very important to good health. One factor that is a causes for dietary concern in the older adults is; biological changes in the digestive system that are age related. One such change is a reduction of gastric acid secretion, which makes the gut more susceptible to small bowel bacterial overgrowth. According to Ahmed and Haboubi (2010) in a study entitled Assessment and management of nutrition in older people and its importance to health, “ bacteria growth has been linked to reduced intake of macronutrients and reduced body weight.” Research shows that the elderly adults experience a decline in appetite as they age which affect their food consumption. Another barrier to nutrition is a decrease in the sense of taste and smell. Taste and smell make a meal more enjoyable. Hence, the deterioration of these senses can affect the older adult ability to enjoy a meal and could reduce the desire for food. Ahmed and Haboubi (2010) state that “the decline in the sense of smell decreases food intake in older people and can influence the type of food eaten.” The author further states older patients with a reduced sense of taste tend to have a less varied diet and consequently develop micronutrient deficiencies. There is also the concern of older adults not drinking enough water. Research shows that age-related renal impairment has reduced the responsiveness of antidiuretic hormone, resulting in impaired thirst drive in the older adults making it difficult to replenish fluid intake orally as their desires to drink fluids is impair (Wells and Dunbrell, 2006). Two ways the nurse can intervene is to offer fluids regularly and remind them to drink. The nurse can also offer nutritious/healthy snacks in between meal time as this will provide some percentage of the needed nutrition intake that is affected due to loss or reduced appetite. Ahmed, T., & Haboubi, N. (2010). Assessment and management of nutrition in older people and its importance to health. Clinical Interventions in Aging, 5, 207–216. Wells, J. L., & Dumbrell, A. C. (2006). Nutrition and Aging: Assessment and Treatment of Compromised Nutritional Status in Frail Elderly Patients. Clinical Interventions in Aging, 1(1), 67–79. (Post is Unread) Thread: Post: BBohon_Dietaryconcernsandbarriers_July262016 BBohon_Dietaryconcernsandbarriers_July262016 Author: Bobbie Jo Bohon Posted Date: July 26, 2016 3:02 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 As we age the body tends to have a harder time keeping up and maintaining certain nutrients. There are other factors that may contribute to malnutrition for older adults. Some of these barriers would be bad dental hygiene, digestion, and sense of taste and smell. The elderly find it harder to care for there teeth. Most may have dentures and find certain foods hard to chew. If these people have problems when they eat then theywon't eat. We may teach them to chop up their food into smaller peices, or try supplements to ensure they are getting the proper nutrients. As for digestion, the body has a harder time doing so as you age. Less saliva and stomach acid is produced so less nutrients is absorbed. Having the patient eat smaller more frequent meals is a helpful way to aid to digestion in the elderly. Having them chew their food more thoroughly is important also. When the body ages we loose our sense of taste and smell due to taste bud deterioration. Those with this problem may eat very sweet or salty foods to try and make up for it. This creates a imbalance of nutrition. To help stop this we may make the patient's plate more appealing. A variety of colors, herbs, and spices can help the patient and appeal to what is left of their senses. http://www.upmc.com/patients-visitors/education/nutrition/Pages/special- nutrition-concerns-for-seniors.aspx • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 to combat this loss in bone density, older adults must supplement their diets with higher amounts of calcium and vitamin D (United States Department of Agriculture, 2016). There are some barriers that older adults may encounter when attempting to maintain the proper nutrient balances and they include: disabilities that limit movement or driving, inability to afford healthy foods, and lack of education. Often, older adults may be unable to go to the grocery store to buy their groceries because they are confined to a wheelchair or use a walker to get around, these limited movements can also inhibit the individual’s ability to cook a healthy meal for themselves. This barrier can be overcome by asking a family member, caregiver, or even a neighbor to go grocery shopping for them and help prepare future meals by food prepping at the beginning of the week. There are also many programs that offer and deliver nutritious meals to the elderly. These meal programs are also offered to low income individual’s. Often, older adults are living off of their savings account and social security income, sometimes these financial means are fixed and considered to be low income. This makes it difficult to purchase healthy foods which are often more expensive than unhealthy food. This can be overcome by utilizing the programs that provide meals for these low income individuals and sometimes it is necessary to apply for assistance from the government in order to purchase food. Even if money is not an issue, people still may not purchase healthy foods because they are not educated on the potential nutrient and health benefits that these foods or the potential dangers of consuming too much unhealthy food. This is where it is vital for nurses and other healthcare providers to educate the older adults and the public on how to determine what an adequate amount of each nutrient would benefit their health. This is especially true with hydration; it is imperative that all older individuals stay hydrated in order to maintain optimal cognitive and body processes such as nutrient absorption and food digestion (National Institute on Aging, 2016) References National Institute on Aging. (2016). Drinking Enough Fluids | Go4Life. Retrieved from https://go4life.nia.nih.gov/tip-sheets/drinking-enough- fluids United States Department of Agriculture. (2016). National Agricultural Library. Retrieved from fnic.nal.usda.gov/lifecycle-nutrition/older-individuals World Health Organization (WHO). (2016). WHO | Nutrition for older persons. Retrieved from http://www.who.int/nutrition/topics/ageing/en/index1.html (Post is Unread) Thread: Post: Module4 RE: Module4 Author: Monica Castro Posted Date: July 25, 2016 8:09 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 My husband’s grandmother lost her spouse of 60+ years not too long ago and she has struggled significantly since. One of the things that has been affected by her emotional state is her nutrition. She is diabetic and has a strict eating schedule in order to keep her blood glucose levels steady. After her loss, she was very depressed and did not want to eat. She would only say that she was not hungry and would get sick if she forced food down her throat. About three months into this new routine, she suffered a fall and broke her hip. It turns out that she got light headed when she got up from her chair and lost consciousness. When she hit the ground she fractured her hip which she had to have surgery to repair it and is still going through rehabilitation to get better. The fainting spell was caused by her malnutrition and diabetes. This woman is very religious and was devoted to the local church in her hometown. All her friends were from this church and all her activities were centered around this church. After her husband died, she visited the church less and less until she stopped going all together. She entered a state of depression which affected her social life. Today, her family and group of medical professionals are helping her get back to her normal life little by little. Baby steps are important because we do not want to overwhelm her even more. But as you mentioned, social interactions and proper nutrition after the loss of a loved one change dramatically and it is important to restore the person back to health as soon as possible. Reference: Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition: Chapter 13. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Dietary Concerns for Older Adults RE: Dietary Concerns for Older Adults Author: Monica Castro Posted Date: July 25, 2016 7:52 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Ashley great post. I specifically liked the key points you made about family members and nursing aids helping the elderly with their daily tasks. As younger adults we tend to forget and take for granted all the simple daily activities we are able to carry out on our own that older adults need constant help with. I could not imagine going to the grocery store and not being able to reach an item that I need. I usually even climb the shelves if I have to. But for an elderly person that is not able to walk or reach for things, grocery shopping is not only physically impossible but also humiliating. Which could contribute to them skipping out on the trips and not buying the foods they need. We have established how important nutrition is because of all the deterioration of different organs and systems. Older adults lack enzymes and other secretions as well as proper absorption and digestion which means they need to make up for all those lost nutrients by eating healthier foods, but if they have no way of obtaining these foods then their overall health pays the price. The entire situation is just heartbreaking. I cannot tell you how many elderly patients we have coming into my job to get dental treatment that are unaccompanied. It baffles me. They have such a hard time filing out the paperwork because their hands shake too much or they can’t remember all the medications they take. Many of them even skip out on surgery because in order to be sedated they need someone to drive them and that will be responsible for them, and they do not have anyone that they can count on. We forget that at one point our parents took care of us and did everything for us and they deserve the same attention and care. Reference: Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition: Chapter 13. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Module4 RE: Module4 Author: Carlos Moreno-Espino Posted Date: July 25, 2016 7:12 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Very commonly the elderly gets lonely like you said and nutrition goes out the window. They lose the desire to eat, and hydrate, then they become malnourished and eventually get sick. Social interactions, are very effective in promoting good nutrition and health for the elderly. Also many health services provide nutritional guidance for them, which can tremendously impact their eating habits and avoid any further complications in the future. Good post!!! (Post is Unread) Thread: Post: loss of appetite RE: loss of appetite Author: Carlos Moreno-Espino Posted Date: July 25, 2016 7:05 PM • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 part of the stomach or small intestine have been removed, long-term medication with antacids or other heartburn medicines, and long-term alcoholism; can potentially lead to chronic health problems later on in life. Other factors and barriers that can affect the elderly population are poverty and economic uncertainty which could affect food choice and dietary diversity. Foods that are integral to a healthy diet (fruit, vegetables, and fish) may be perceived as a luxury. Healthier alternatives to everyday foods can carry a price premium (whole meal bread, spreads low in saturates). Food preparation facilities and skills may be limited in poorer households. Mental health and well-being it’s a major barrier that can affect older adults. Depression can lead to loss of interest in food, and dementia can impact on appetite and food intake. Foods high in fiber and complex carbohydrates such as whole grains, vegetables, and fruits are preferred. Fat intake should be less than 30% of total caloric intake, and nutritionally compromised patients should be encouraged to consume nutrient-dense foods. For malnourished elderly patients, counseling is effective in improving dietary habits. Referral to a clinical dietitian or nurse educator is recommended following general dietary advice from a physician. Dietary Reference Intakes (DRI) guidelines have been revised recently and adjusted for the needs of older adults aged 51–70 years and those over 70. There are increased allowances for the elderly for calcium, magnesium, vitamin D, fluoride, niacin, folate, vitamin B12, and vitamin E, with clinical studies of which have suggested improved outcomes in nutritional status in the elderly. Following careful nutritional assessment/guidelines have been developed to improve and maintain nutritional status in community-dwelling and hospitalized elderly patients. Older people are vulnerable to dehydration due to physiological changes in the ageing process, but this can be complicated by many disease states, mental and physical frailty that can further increase risk of dehydration. Age-related changes include a reduced sensation of thirst, and this may be more pronounced in those with Alzheimer’s disease or in those that have suffered a stroke. This indicates that thirst in older people may not be relied on as an indicator of dehydration. Reduced renal function is also a risk factor. The kidneys play a vital role in fluid regulation but their function deteriorates with age, and the hormonal response to dehydration (which is key to fluid balance) may be impaired. Reference National Institute on Aging (March 26, 2015). Smart food choices for healthy aging. Retrieved from: https://www.nia.nih.gov/health/publication/whats-your-plate/ (Post is Unread) Thread: • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 As we grow old, our bodies grow old with us. Every system in our bodies have an expiration date and changes within us are unavoidable. The older adults have problems with mastication, digestion, absorption, joint health, etc. Something as simple as chewing our food becomes difficult because we start to lose teeth. It is important for our elderly population to be educated on things like proper nutrition and health maintenance in order to insure a better quality of life. There are many things that have contributed to the longer life expectancies of adults these days, such as: antibiotics, better sanitation, better prevention and treatment for the most common causes of death in older adults, and higher standards of living. The body composition of an older adult is completely different from younger adults. They lose muscle and bone mass and gain more fat. This fat tends to settle more in the abdomen section and less in the extremities. Such composition raises the risk for cardiovascular diseases and diabetes. Abdominal fat releases more fatty acids which in return raise the blood lipid and insulin levels. Some older adults do experience the complete opposite reaction and tend to lose weight. Both of these things can cause loss of functional capacity, loss of independence, higher risk of fractures, frailty, disability, and diminishes quality of life. Other systems are affected with aging. Kidneys are less efficient which means fluid balance is poorly regulated and intake must be increased in order to excrete the appropriate amount of waste. The gastrointestinal system influences many important functions. Loss of enzymes and other secretions affect the absorption of important vitamins and minerals, changes in nerve and muscle functions causes constipation, and nutrient stores undergo rapid loss and are difficult to replace. All these changes affect the nutritional needs of the aging adult. Energy intake declines, women 70 and older consume 1525 kcal and men 70 and older consume 1900 kcal. Fiber intake needs to be increased in order to help with the gastrointestinal changes and avoid taking things like laxatives. Individuals over 70 should slightly increase protein intake in order to support nutritional well-being and prevent age-related muscle loss. Those that are chronically ill, underweight, recovering from surgery, or strength training are required to increase their protein intake even more. Minerals and electrolytes intake also increases with the exception of iron and sodium. Dehydration is a huge concern for older adults. Things like medications, physiological changes, and environmental circumstances contribute to inadequate fluid intake and ultimately lead to dehydration. My grandmother is diabetic and shows many of these characteristics. She has extra fat around her abdomen and her fluid intake is more than usual. She tells me that she constantly feels thirsty. This is most likely due to her disease and age as well. She also has problems when it comes to nutrition because she tends to crave all the things she is not supposed to eat, like carbs and sugar. It is a constant battle to keep her on track and away from foods that are harmful to her. But when it comes to older adults, it is all about education and attention. She needs to be constantly reminded of how important proper nutrition and fluid intake is for her health, whether from her doctors or family members. She also has issues with her blood pressure. She has had two strokes and needs medication every day. We always try to encourage light walking or exercise and cook her foods low in sodium. Her doctor is constantly on her about smoking and how dangerous it is for someone in her state of health. She has changed her smoking habits significantly but is still working on it. Elderly patients are stubborn and set on their ways. It is difficult sometimes to get their cooperation, but it is our responsibility as nurses to educate them and help them make the best decisions for their health. References: Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. [VitalSource Bookshelf Online]. Retrieved fromhttps://bookshelf.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Module 4 Discussion Module 4 Discussion Author: Samantha Berberette Posted Date: July 25, 2016 5:25 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Unfortunately, older adults who are frail and chronically ill are at a higher risk of nutritional status declining and disability increasing (Schlenker & Gilbert, 2015). If someone has a musculoskeletal disease (affects joints in hands, arms, and feet), it can prevent them from being able to prepare meals, go grocery shopping, and if severe enough prevent them from feeding themselves (Schlenker & Gilbert, 2015). Also, those with progressive neurological disorders (i.e. Parkinson’s disease) have trouble feeding themselves and preparing meals. Chronic conditions, such as the two previously stated usually require a food-related alteration (Schlenker & Gilbert, 2015). Having difficulty with self-feeding can affect the amount of food consumed (Schlenker & Gilbert, 2015). It is normal for older adults to reduce their food intake because of illness or limitation of food available for them (Schlenker & Gilbert, 2015). One way nurses can prevent nutritional deficits in older adults is by conducting nutrition screenings (Schlenker & Gilbert, 2015). There is a Mini Nutritional Assessment (MNA) for adults who are over the age of 65 (Schlenker & Gilbert, 2015). Nutritional screenings show warning signs of malnutrition that can lead to losing independence and disability in their future (Schlenker & Gilbert, 2015). If a nutrition screening shows warning signs of malnutrition, a nurse can then take the appropriate actions to make sure that the patient’s health does not go into a downward spiral (Schlenker & Gilbert, 2015). Another way to prevent nutritional deficits is by putting older adults that have low energy intakes and chronic health problems on nutrient supplements (Schlenker & Gilbert, 2015). Nutritional supplements can be used to replenish the body in patients who just has a serious illness (Schlenker & Gilbert, 2015). Nutritional supplement should never replace food; they are there to aid in nourishment to the body (Schlenker & Gilbert, 2015). Anyone on a nutritional supplement should be supervised by a health care professional (Schlenker & Gilbert, 2015). Consequences of inadequate nutrition include muscle weakness, frailty, and increases mortality risk (Schlenker & Gilbert, 2015). Muscle and bone mass loss are going to occur with age, but making sure your body has enough protein, calcium, and vitamin D are ways to slow it down (Schlenker & Gilbert, 2015). Dehydration is a concern for older adults because medications, diseases, and physiologic changes increase the likelihood of insufficient amounts of fluids to be consumed (Schlenker & Gilbert, 2015). Dehydration can affect cognitive function, awareness, and influence the watering down of medications (Schlenker & Gilbert, 2015). Overhydration can occur as well, which is why it is important to monitor fluid intake (Schlenker & Gilbert, 2015). References Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. [VitalSource Bookshelf Online]. Retrieved from https://ambassadored.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Dietary Concerns for older adults Dietary Concerns for older adults Author: Megan Williams Posted Date: July 25, 2016 5:24 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 As we age, we become less active, the metabolism slows down, and energy level decreases. Because of Many elderly lose the sensation of thirst. This is due to a dysfunction with a negative feedback loop in the brain that regulates the urge to drink fluids. This is one of the many barriers for the elderly and their nutrition. Dehydration can have detrimental effects on the body, including death. So the need for the elderly to drink proper amounts of fluids is important. Another barrier or concern is the loss of calcium and vitamin D loss which leads to weak bones. This is due to an overall decrease in nutrition, decrease in exposure to the sun, and a decrease in the ability for the absorption of calcium especially if vitamin D is already low. The lack of vitamin D and calcium can lead to easily broken bones due to the lack of strength. In these two cases, the nurse can take measures to try and eliminate the problem or decreasing it. The nurse can always make sure that there is water by the patient’s bed side along with educating and encouraging the client to drink some whenever they look that way or to encourage them to finish a glass of water in a certain amount of time, etc. The nurse can also encourage the consumption of foods with calcium and vitamin d and explain the importance of it. International Osteoporosis Foundation (2014) “Why Seniors are more Vulnerable to Calcium and Vitamin D Deficiency” Retrieved from: https://www.iofbonehealth.org/news/why-seniors-are-more-vulnerable- calcium-and-vitamin-d-deficiency Perry, Susan. (201) “The Neural Regulation of Thirst” Retrieved from: http://www.brainfacts.org/brain- basics/neural-network-function/articles/2008/the-neural-regulation-of-thirst/ WHO (2016) “Nutrition for Older Persons” Retrieved from: http://www.who.int/nutrition/topics/ageing/en/index1.html (Post is Unread) Thread: Post: Dietary Concerns for Older Adults Dietary Concerns for Older Adults Author: Brittany Moore Posted Date: July 25, 2016 5:17 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 The main dietary concern for an older adult is ensuring they are getting the proper nutrition while consuming the limited calories they need. This can be a delicate balancing act because if they do not eat nutrient dense food, they may be eating more calories than they need. It can be further complicated by eating microwave meals and indulging with dessert too often (Schlenker & Gilbert, 2015). One intervention is checking off the number of cups of water the person has had. I have found this particularly useful if there are caregivers with the older adult. Documentation ensures everyone is aware of how much more they need to drink, especially if there are caregiver changes. Teaching the client and their family about their protein needs would be a great intervention as well (Schlenker & Gilbert, 2015). References Schlenker, E. D., & Gilbert, J. (2015). Williams' essentials of nutrition and diet therapy (11th ed.). St. Louis, MO: Elsevier Mosby. (Post is Unread) Thread: Post: Dietary Concerns for Older Adults RE: Dietary Concerns for Older Adults Author: Kristin Shriver Posted Date: July 25, 2016 3:47 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Hi Ashley, I enjoyed reading your post. It was interesting how you discuss the psychosocial issues that can be barriers to older adults when trying to maintain their adequate nutrient needs. When a person is older and disabled, it can make it even more difficult to be able to meet nutrient goals, especially since nutrition needs increase as one ages. There are many programs that bring healthy meals to the elderly and the disabled (United States Department of Agriculture, 2016). Nurses should be aware of these programs and educate older adults and their caregivers about their specific nutrient needs and what programs are available in their area. References United States Department of Agriculture. (2016). National Agricultural Library. Retrieved from fnic.nal.usda.gov/lifecycle-nutrition/older-individuals (Post is Unread) Thread: Post: Module 4 RE: Module 4 Author: Kristin Shriver Posted Date: July 25, 2016 3:22 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Hi Krizza, I enjoyed reading your post. It think it is very important for people to remember that as one ages, the various body systems are not operating at optimal levels and require more nutrients in order to function properly. You made a very interesting point regarding older adults and the increased use of laxatives. This is due to dehydration and an increased need for fiber to be added into the diet. It can imagine that older adults may have a hard time in being able to determine how many fluids they need to consume on a daily basis in order to provide their body with an adequate amount of nutrients. This is where nurses and other health care providers needs to provide older adults (and/or their caregivers) with education on their changing nutrient demands. (Post is Unread) Thread: Post: Dietary Concerns for Older Adults Dietary Concerns for Older Adults Author: Ashley Wercinski Posted Date: July 25, 2016 12:54 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Older adults living with a disability who use a cane or walker, have vision loss, or no longer drive will have a difficult time when they have to go grocery shopping for healthy foods (Schlenker & Gilbert, 2014, p.314). They might not be able to get to where they want to go, or reach the items they want. A way to overcome this obstacle could be if a family member goes grocery shopping with them, or the older person can make a list of everything they need and have their caretaker go for them. A nurse could also go over what foods are best for their diet and help create a list. Psychosocial distress due to a loss of a spouse or separation from family could lead to disinterest in food (Schlenker & Gilbert, 2014, p.314). A way to overcome this would be to make sure the individual has a strong support group. A nurse should communicate with the individual’s family or close friends to let them know the situation. If this person doesn’t have family members close by, then a nurse should be there for support and listen to what they have to say showing compassion. The elderly can experience dehydration from inadequate fluid due to the medications they take, physiologic changes, effects of disease, and environmental circumstances (Schlenker & Gilbert, 2014, p.312). Dehydration affects alertness and cognitive function (Schlenker & Gilbert, 2014, p.312). If an elderly person isn’t alert, they can fall and break a bone or get hurt. Undernutrition in the aging adult lowers immune function, slows production of red blood cells, and accelerates muscle loss. Nurses should be there for health promotion to teach the elderly about proper nutrition and maintaining a healthy diet (Schlenker & Gilbert, 2014, p.312). Schlenker, E. D., & Gilbert, J. (2014). Williams' Essentials of Nutrition and Diet Therapy (11th ed.). Saint Louis, MO: Mosby-Elsevier. (Post is Unread) Thread: Post: Module 04 Nutrition in Elders Module 04 Nutrition in Elders Author: Miriah Grace Posted Date: July 25, 2016 11:27 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Chronological age and physiological age are the two contributing factors to aging. Chronological age is the amount of time you have been alive in the world, while physiological age is the age your body acts and feels (Schlenker & Gilbert, 2014, p. 310). There are a few nutrients of concern in the elderly. Energy needs usually decline with age because exercise is usually reduced with age as well as metabolic rates declining (Schlenker & Gilbert, 2014, p.311). Lower fiber intake is common among elderly people because whole grains and fresh produce are consumed less frequently due to the extra time it takes to prepare the food and additional cost. In order for one to treat the low consumption of fiber, fiber supplements are recommended to prevent constipation and promote digestive health. Protein intake decreases due to a palate change therefore making some meats a less likely food choice. Protein is also expensive and if an elderly person is on a fixed income it can become a barrier. It is also a challenge for elderly people who live alone to make a single meal rich in protein. The intake of iron is a mineral that is decreased because of the fixed income issue and not getting meats, fish, poultry, and dairy which can result in iron deficiency anemia. Calcium is another nutrient of concern for the elderly. This is because low intake of dairy products due to limited income or increasing lactose intolerance can contribute to increasing incidence of osteoporosis. Due to a changing metabolism in older age one’s ability to metabolize vitamin B12 is decreased resulting in B12 malabsorption. An elderly person can find B12 in other sources such as fortified cereal and vitamin B12 supplements (Schlenker & Gilbert, 2014, p.312). Dehydration is common with the elderly because the sense of thirst is often depressed with the aging process. Kidneys that are older are unable to save water like the used to when for lower intake (Schlenker & Gilbert, 2014, p. 312). It is important to remind elderly people to drink often in order to avoid the complications that can accompany dehydration. The risk factors of dehydration in older adults consist of problems with mobility, medications such ad laxatives or diuretics that promote fluid loss, confusion, and problems swallowing (Schlenker & Gilbert, 2014, p. 312). A nurse could provide the elderly with some diet tips that would teach them about the importance of adequate nutrition. A nurse could inform a client about adequate nutrient intake by focusing on nutrient density for energy, lower sugar and fat intake, and maintaining adequate vitamins and minerals in the diet. A nurse could also inform the client about consuming adequate protein sources and plenty of fiber from, whole grain vegetables and fruits. In order to prevent dehydration and prevent constipation one should monitor fluids at home or under the nurse’s care (Schlenker & Gilbert, 2014, p. 312). A nurse could also provide resources to obtain food for his or her patient on a fixed income or with limiting funds. Some resources a nurse could suggest are the food stamp program, meals on wheels and the senior nutrition program. References: Schlenker, E. D., & Gilbert, J. (2014). Williams' Essentials of Nutrition and Diet Therapy (11th ed.). Saint Louis, MO: Mosby-Elsevier. (Post is Unread) Thread: Post: loss of appetite loss of appetite Author: Lauren Ebert Posted Date: July 25, 2016 10:31 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 As people age it is not uncommon for them to have a loss of appetite and thirst, this can and often does lead to severe cases of malnutrition and dehydration. When an individual loses their loss of thirst it is important that we remind them how crucial staying hydrated is. Some people will stop eating due to lack of energy to make their food, in this case the nurse should suggest they be moved somewhere, where they will have their meals made for them like and assisted living facility. As nurse it is important to recognize these symptoms at the early onset. Some interventions a nurse might do it to take a deeper look in to the medications a patient is on. If a patient is on several medications that are known appetite suppressants this is something that they might need to bring up to the doctor. Sometimes it can be as simple as making eating a fun and social gathering. (Loss 2016) Loss of Appetite in the Elderly. (2016). Retrieved July 25, 2016, from http://www.aplaceformom.com/blog/01-23-2013-loss-of-appetite-in- elderly/ (Post is Unread) Thread: Post: Dietary Concern Older Adults Dietary Concern Older Adults Author: Antony Stimphile Posted Date: July 25, 2016 1:08 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Attachment: Astimphile_older aldults_072516.docx (34.519 KB) (Post is Unread) Thread: Post: Module 4 Dietary Concerns of Older Adults RE: Module 4 Dietary Concerns of Older Adults Author: Rachel Coghlan Posted Date: July 24, 2016 5:04 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 helpful (Health in Aging, 2012). I also found in my research that dementia patients do not like to ask for help with eating, so this cup would allow them to have control over when they drink, and keep them on track with getting enough water (Health in Aging, 2012). Health in Aging. (2012, March). Unique to Older Adults. Retrieved July 24, 2016, from http://www.healthinaging.org/aging-and-health-a-to- z/topic:nutrition/info:unique-to-older-adults/ (Post is Unread) Thread: Post: Dietary Concerns of Older Adults Dietary Concerns of Older Adults Author: Rachel Coghlan Posted Date: July 24, 2016 4:51 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 When it comes to nutrition, aging presents with its own special dietary concerns and barriers. A few of the things that can affect nutrition in older individuals are socio-economic factors, losing teeth, and dementia (Health in Aging, 2012). Socio-economic factors play a role in most people’s nutrition, but for older people financial limits can make it difficult to afford healthier foods like fresh fruits and vegetables (Health in Aging, 2012). Another socio-economic factor that influences the elderly’s nutrition is mobility. If a person cannot make regular trips to the grocery store, they will buy foods that will last a long time (Health in Aging, 2012). Often these foods are the unhealthier options. Losing teeth also affects an elderly person’s nutrition. When a person does not have many teeth left or has loose, sensitive teeth they may stick to softer items like pudding, bread, and potatoes (Health in Aging, 2012). These items do not contain all of the nutrients the body requires, and therefore a person does not get what they need to be healthy. Dementia can also affect a person’s nutrition. Many times people with dementia do not get enough to eat or drink (Health in Aging, 2012). People with dementia usually cannot shop or cook for themselves, and it is common for the medications they are on to suppress hunger (Health in Aging, 2012). When it comes to elderly people, I would suggest having a friend, family member, or neighbor plan regular shopping trips. Having a shopping buddy would ensure that the elderly person has regular access to the grocery store so they can buy healthier foods. If a person has dementia, I would suggest a family member meal prepping for that person so they have nutritious and complete meals. Next I would try to stress the importance of balancing an elderly person’s diet. I would try to help them come up with ideas for meals that would work in their life while still giving proper nutrition. When it comes to not having teeth, eating can be difficult, but I would try to stress the importance of fitting in fruits, vegetables, and protein. Smoothies and steamed vegetables are just two quick ideas for eating healthier. There are many consequences to not eating well enough. Poor nutrition in the elderly can be the beginning of many problems. When a person does not drink enough water or get enough nutrients they are not giving their body what it needs to survive. For instance, many older people do not get enough vitamin D (Health in Aging, 2012). Vitamin D is important because it helps our body absorbs calcium, which makes our bones strong. Not getting enough Vitamin D can result in osteoporosis (Health in Aging, 2012). If an elderly person’s bones get weak then there is a greater chance they will break something when they fall. In short, making sure an elderly person maintains appropriate nutrition levels is important because deficiencies can lead to many more problems. It is important that an elderly person has a support system to make sure they are getting what they need to survive. Health in Aging. (2012, March). Unique to Older Adults. Retrieved July 24, 2016, from http://www.healthinaging.org/aging-and-health-a-to- z/topic:nutrition/info:unique-to- older-adults/ (Post is Unread) Thread: Post: Nutrition in an Aging Population RE: Nutrition in an Aging Population Author: Krizza Guevara Posted Date: July 24, 2016 3:46 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Kaley, Your overview of the older adult population is eye opening. Although as a society, we are aware of the challenges older adults face, most of us never know the details. For instance, all of us require hydration, but older adults are at a greater risk of dehydration. Dehydration for older adults not only leads to thirst, but it affects other physical and cognitive functions as well. It is important for nurses to help older adults even with the simplest of tasks like placing a mark of how much water they should consume daily. Older adults face challenges we younger adults cannot understand yet, but through education of these issues, we are more aware of what lies ahead. (Post is Unread) Thread: Post: Nutrition in an Aging Population Nutrition in an Aging Population Author: Kaley Kinsler Posted Date: July 24, 2016 11:15 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 Aging adults require adequate nutrition to support mature body tissue, requiring perhaps more than an average healthy adult. Aging adults’ energy intake tends to decline as they get older. More protein is required in the diet to prevent age related muscle loss, but kidney function and urea excretion must be kept in mind for patients with kidney conditions. They require more calcium to prevent bone degeneration. Loss of gastric acid contributes to poor vitamin B12 absorbtion. Changes in nerve and muscle function as well as some medications contribute to constipation, thus there is a greater need for complex carbohydratess and fiber to assist with bowel elimination (Schlenker & Gilbert, 2015). One major concern is adequate hydration. Older adults are at risk for dehydration because they lose their thirst sensation, have issues with mobility, experience confusion, have problems swallowing, take medications that result in fluid loss, and can be incontinent which results in self imposed fluid restriction (Schlenker &Gilbert, 2015). Inadequate intake could have effects on the circulatory system and heart, bowel movements, and kidney function (Schlenker & Gilbert, 2015). The nurse can help by first identifying the recommended daily intake of fluid specific to the patient. The nurse can provide the patient with a container that can be refilled daily and place a mark of where to fill water that needs to be consumed each day. This gives the patient a visual representation and a daily reminder of what to drink each day. Adequate energy intake is also another main concern related to a number of factors, including physical, social, and environmental influences. Inadequate intake could result in muscle loss and fatigue, as well as insufficient energy to combat illness (Schlenker & Gilbert, 2015). The nurse can assist the patient by first identifying why the patient is not eating enough, and assist the patient in forming anutitional plan to ensure all requirements are met. For example, if it is an appetite issue, the nurse can help by identifying the patients main favorite foods and making suggestions of what to include and exclude based on individual nutritional requirements. Fats are the most energy dense nutrient and the diet can include a little more of this (20% to 35% of all calories consumed), especially when fats are obtained from healthy sources and contain essential fatty acids. It must be kept in mind that even though fats are easily digested, digestion may be slowed and it would be most beneficial to divide intake among different meals of the day (Schlenker & Gilbert, 2015). Schlenker, E., Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy (11th ed.). Retrieved from https://bookshelf.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Module 4 Dietary Concerns of Older Adults RE: Module 4 Dietary Concerns of Older Adults Author: Krizza Guevara Posted Date: July 24, 2016 1:35 AM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 • 1 • 2 • 3 • 4 • 5 these nutrients provide the most energy. The severity of dehydration affects cognitive function. The older adult should consume enough fluids, but not too much, to restore the balance. References Schlenker, Eleanor, Gilbert, J. (2015). Williams' Essentials of Nutrition and Diet Therapy, 11th Edition. [VitalSource Bookshelf Online]. Retrieved from https://ambassadored.vitalsource.com/#/books/9780323185806/ (Post is Unread) Thread: Post: Module 4 Dietary Concerns of Older Adults Module 4 Dietary Concerns of Older Adults Author: Alexandra Glebowski Posted Date: July 23, 2016 8:27 PM Status: Published Overall Rating: • 1 • 2 • 3 • 4 • 5 The older adult faces many challenges trying to maintaining proper nutrition. As the energy requirements decline so does the RDA. The average America woman ages 50-59 require 1750 k/cal per day where as women between 70 and older only require 1525 k/cal per day (“Bookshelf Online: Williams’ Essentials of Nutrition and Diet Therapy,” n.d.). As we age the body slows down. Things become more difficult to do, simple things like swallowing or proper mastication. It is important for the aging person to understand what is important for their body at the latter half of life. The older adults with chronic health problems faces challenges of inadequate nutrient supply. It is important for the person to seek professional care when evaluating their nutrient intake. It is also important for the person not to exceed the UL of nutrient needs. This can happen so simply too. For example a person may be told they are low in a specific nutrient, this person already takes a multi- vitamin but now thinks they need to take a separate pill specific to what they were low in. This person faces exceeding the UL of this nutrient and could face further complications. It is so important for the elderly population to stay up to date with their health screenings. A professional should assess the client's ability to obtain and use essential nutrients and to evaluate client's laboratory studies (“Nursing Interventions and Rationales,” n.d.). Older adults also need to pay attention to macronutrient nutrition. A person should attain 45%- 65% of their total energy from carbohydrates. With the older population constipation is a big concern. With so much of the total energy relying on carbohydrates the older population needs to focus on a diet of legumes and whole grains. Also high fiber foods should be eaten to help reduce the dependency of laxatives. Laxatives contribute to imbalance of electrolytes. The elderly also need to pay attention to fat intake. Attaining more essential fatty acids and focus on good fats for consumption and help maintain weight. Gaining weight seems to be problematic for this population and consuming healthy fat and help maintain weight and also aids in digestion. Lastly, protein intake for the elderly is important for building and maintaining muscle mass. It is said to increase protein amounts in this population to parallel the age- related muscle loss. As a healthcare provider the healthy body weight for age and height should be used to determine nutritional needs. Also referring to a dietitian for complete nutrition assessment (“Nursing Interventions and Rationales,” n.d.). Hydration is critical in this population. The hypothalamus alters thirsts mechanisms and kidneys are less able to conserve water to compensate for loss(“Bookshelf Online: Williams’ Essentials of Nutrition and Diet Therapy,” n.d.). Other changes like medication and disease can alter fluid intake. These changes can really cause harm. For example changes in fluid amounts can influence effects of medications. It is important to be alert for food- nutrient- drug interactions. Reduction of fluid can also impair cognitive function. The person and care giver should monitor fluid intake. They should also be vigilant of signs and symptoms of dehydration. As a care giver trying to get client to consume adequate hydration can be difficult. Get creative. Offer small volumes of liquid before meals like liquid appetizers (“Nursing Interventions and Rationales,” n.d.). References: Bookshelf Online: Williams’ Essentials of Nutrition and Diet Therapy. (n.d.). Retrieved July 18, 2016, from https://online.vitalsource.com/#/books/9780323185806/cfi/6/26!/4/2@0:0 Nursing Interventions and Rationales: Imbalanced Nutrition: less than body requirements. (n.d.). Retrieved from http://nursinginterventionsrationales.blogspot.com/2013/07/imbalanced- nutrition-less-than-body.html (Post is Unread) [Show More]

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