Nutrition and the Older Adult

Nutrition and the Older Adult Conditions and interventions Angie stiegemeyer, MA,rD,LD, BSN,RN Southeast Missouri State University

Health-sense of well-being Quality of Life-measure of life satisfaction Medical Nutrition Therapy-treatment of nutritional aspects of disease

Topics Covered Cardiovascular Disease (CVD)/Heart Disease Stroke Hypertention Diabetes/DM Osteoporosis Constipation Osteoarthritis Alzheimer’s Disease Underweight Elder Abuse End of Life Care

Nutrition for CVD Decrease amount of fat Reduce cholesterol intake Increase fiber, F & V Limit Sodium Exercise Maintain Healthy Weight Reduce Stress Smoking Cessation

Stroke • Reduced blood flow to brain • Etiology • Blocked arteries • Easily clotting blood cells • Effects • Deprive brain of oxygen-nerve cells die • Differing levels of paralysis

Stroke • Risk Factors • Hypertension, high chol., DM, smoking, family hx, obesity • S/S: FAST • F-Facial weakness • A-Arm & Leg Problems • S-Speech Problems • T-Time to call 911 • Nutrition • Normalize blood pressure

Hypertension • Systolic 140mm Hg or higher AND/OR Diastolic 90 mm Hg or higher • Effects- excess tension on vessels & organs • Wears them out before normal aging process • Kidney damage • Risk Factors • Excess alcohol intake, high sat. fat intake, overweight & obesity, low calcium intake, smoking

Nutrition for Hypertension DASH Diet Weight management Moderate alcohol intake Limit sodium Adequate calcium, potassium, magnesium

DM • 1/5 over 65 • Greater risk for CVD • Effects • Amputations • Macular degeneration • Vision loss • Neuropathies • Increased platelet aggregation • Increased infection • Decreased healing

Nutrition for DM • Diagnosis and criteria for mgmt same as younger adult • If kidney disease, limit protein (0.8-1.0 g/kg) • MVI • Assess cognitive function and create appropriate care plan • Asses Hemoglobin A1C • Below 7% is goal

1 135---------6% 170---------7% 205--------8% 240--------9% 275--------10% 310--------11% 345-------12%

Osteoporosis • Porous bones • 80% women • Bone density greatly declines after menopause • Effects-falls & fractures • Wrist, spine, hips • Kyphosis

Osteoporosis • Nutrition • Calcium • Vitamin D • Exercise • Limit caffeine • F & V • Limit sodium • Limit SSRIs

Chronic Constipation • 2 or less BM Q Week • Etiology • Medications • Diseases-Parkinson’s, cancer, DM,IBS • Risk Factors • Dehydration • Medications • Mineral supplements

Chronic Constipation • Treatment • Exercise • Fluid • Fiber • Foods • psyllium • Avoid laxatives if possible • Bowel Retraining

Osteoarthritis Etiology-cartilage loss, hardening of soft tissue, inflammation, changes in synovial membrane Pain in joints-most common in knees & hips

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

Alzheimer's Disease • Dementia-memory impairment • Plaques & Tangles in brain • Effects • Confusion • anxiety • agitation • loss of oral muscular control • impairment of hunger & thirst mechanisms • chewing & swallowing difficulties

Alzheimer's Disease • Treatment • Safety • Maintain nutrient dense diet • Plenty of time • Focus on eating • Serve finger foods • Encourage drinks

Nutrition forUnderweight & Unintentional Weight Loss Adequate kcals 1-1.5 g/kg protein 1 mL/kcal fluid Nutrient dense foods Added fats Added kcals Boost, Ensure

Elder Abuse Abuse, neglect, exploitation 1-800-392-0210 (For suspected elder mistreatment in the home and in long-term care facilities)

End of Life Care • Respect patient & family’s wishes • Collaborate & Refer • Palliative care, Hospice • Compassion & Empathy

Nutrition and the Older Adult