Complete a nutritional assessment and dietary profile on an older adult, including fluid intake and elimination. Determine the nutritional status of this older adult; does this person meet the dietary requirements each day or are they lacking in nutrients?
Write a 1-2 page paper outlining the nutritional status of the person you interviewed. Your paper should include nutrients of excess, nutrients lacking, and ways to improve on each of these. It should also include hydration status as well as ways to combat dehydration and constipation specific to this patient.
Living on a fixed income can abate the nutritional efforts of some older adults. Processed foods have a longer shelf life and are easy to prepare and cheaper than fresh foods — all of which make them appealing to older adults. Most processed foods are not nutrient dense and usually contain transfats, excessive sodium, and preservatives that are detrimental to the body. Community resources are available for older adults who are homebound. Meals on Wheels is an organization that delivers food to elderly patients. Eighty-five percent of seniors who use this service say it helps them eat healthier, and 87% say it helps improve their health. To learn more about Meals on Wheels (MOW) go to http://www.mowaa.org
Medications prescribed for acute and chronic illnesses can decrease appetite and cause nausea, leaving an older patient feeling fatigued. If the proper nutrients aren’t ingested during a period of acute illness, a vicious cycle starts. Nutrient dense foods fight illness and injury. Without proper nutrition these patients will continue to deteriorate over time. Maintaining proper nutrition during times of illness is of the utmost importance for this population.
As the body ages, physiologic changes occur that may influence an older patient’s activity level and nutrient intake. The body starts to lose muscle mass and strength, and this includes the muscles of heart and lungs. A decrease in muscle mass puts an older patient at risk for falls and fractures. Eating nutrient dense foods can help maintain muscle mass, preventing fractures and illness associated with aging.
Dehydration in the older adult is extremely common. As the body ages the thirst mechanism becomes less sensitive. Older adults do not recognize the symptoms associated with dehydration but rather label them as symptoms of aging. These common symptoms include headache, fatigue, loss of appetite, dry eyes and mouth, and dark colored urine. In the older adult, dehydration can lead to electrolyte imbalances, confusion, renal failure, and even death. Extra care should be taken to educate a patient who is taking a diuretic medication (often referred to as a ‘water pill’ by this generation), since they are at high risk for dehydration. It is also important to educate older patients about the importance of caffeine avoidance in the later years of life. Caffeine promotes water excretion and can be found in common beverages such as coffee, tea, and soda, as well as chocolate. Prevention of excess water loss and promotion of fluid intake are vital for the aging population.
Since the older adult is at high risk for malnutrition, dehydration, and illness, nutrient intake screening should be a priority. Here is an excellent tool to use when assessing the nutritional status of an older patient. This tool can help you determine if an elderly patient you are caring for is at risk for malnutrition.
Disease (night eating syndrome and binge eating disorder) Any disease, illness or condition causing changes in eating habits
Eating poorly Eating too little or too late can lead to poor health
Tooth loss/pain Poor oral health can interfere with eating healthy foods
Economic hardship Choosing to buy food or pay bills can interfere with eating habits
Reduced Social Support Not having contact with people on a regular basis may have a negative effect on health and wellness
Multiple Medicines Medicine can cause side effects that interferes with healthy eating
Involuntary Weight loss/gain Unintentional weight loss or gain is a health concern that predisposes patients to malnutrition
Needs assistance in self care Difficulty walking, shopping or cooking can increase the risk for malnutrition
Elder above age 80 The risk of health problems for older adults increases the chances of malnutrition
Obtained from the Nutritional Screening Initiative at http://www.healthcare.uiowa.edu/igec/tools/nutrition/determineNutrition.pdf
And discuss social concerns and barriers for an older adult to maintain adequate nutrition. Include patient teaching and nursing interventions for prevention of nutritional deficits as well as the consequences of inadequate nutrition and hydration for the elderly.