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Monday, 6 March 2017

Malnutrition in our Elderly

Undernutrition or malnutrition is a term which describes the various health conditions caused by the body not receiving enough energy (food) or nutrients. Undernutrition can affect people in a variety of ways; they can become too short for their age (stunted); dangerously thin (wasted); and deficient in vitamins and minerals (micronutrient deficient).

Our aim is to end hunger, achieve food security and improved nutrition in our elderly by recognising why this occurs and retraining staff to understand it better and deal with it far more appropriately than they currently do.

Despite being easily preventable, undernutrition claims the lives of millions each year, making it the single largest killer worldwide. This is a very concentrated problem, with only 24 countries accounting for 80% of all cases of undernutrition, and the largest killer of our elderly and vulnerable in Care.

Many older adults are at risk for developing malnutrition, the lack of adequate nutrition to maintain health. The main cause of malnutrition in older adult is inadequate food and nutrient intake. A poor appetite or problems with chewing and swallowing may lead to lower food intake.

Good nutrition is critical to overall health and well-being — yet many older adults are at risk of inadequate nutrition and it is preventable.

Problems caused by malnutrition
·         Malnutrition in older adults can lead to various health concerns, including:
·         A weak immune system, which increases the risk of infections
·         Poor wound healing
·         Muscle weakness, which can lead to falls and fractures

In addition, malnutrition can lead to further disinterest in eating or lack of appetite — which only makes the problem worse.

Causes of Malnutrition

The causes of malnutrition might seem straightforward — too little food or a diet lacking in nutrients. In reality, though, malnutrition is often caused by a combination of physical, social and psychological issues. For example:

Health concerns. Older adults often have health problems, such as dementia or dental issues, that can lead to decreased appetite or trouble eating. Other factors that might play a role include a chronic illness, use of certain medications, difficulty swallowing or absorbing nutrients, a recent hospitalization, or a diminished sense of taste or smell.

Restricted diets. Dietary restrictions — such as limits on salt, fat, protein or sugar — can help manage certain medical conditions, but might also contribute to inadequate eating.

Limited income. Some older adults might have trouble affording groceries, especially if they're taking expensive medications.

Reduced social contact. Older adults who eat alone might not enjoy meals as before, causing them to lose interest in cooking and eating.

Depression. Grief, loneliness, failing health, lack of mobility and other factors might contribute to depression — causing loss of appetite.

Alcoholism. Too much alcohol can interfere with the digestion and absorption of nutrients. Nutrients might also be lacking if alcohol is substituted for meals

The Signs of Malnutrition

The signs of malnutrition in older adults can be tough to spot, especially in people who don't seem at risk — but uncovering problems at the earliest stage can help prevent complications later.

Medications. Many drugs affect appetite, digestion and nutrient absorption.
Red flags. In addition to weight loss, malnutrition can cause poor wound healing, easy bruising and dental difficulties.
Weight loss. Help monitor his or her weight at home. You might also watch for other signs of weight loss, such as changes in how clothing fits.
Eating habits. Spend time during meals at home, not just on special occasions. If one lives alone, find out who buys his or her food. If they are in a hospital or long term care facility, visit during mealtimes.

Making a BIG Difference

Even small dietary changes can make a big difference in an older adult's health and well-being. For example:

Engage doctors. If the person is losing weight, work with his or her doctors to identify — and address — any contributing factors. This might include changing medications that affect appetite, suspending any diet restrictions until the person is eating more effectively, and working with a dentist to treat oral pain or chewing problems. Request screenings for nutrition problems during routine office visits, and ask about nutritional supplements. You might also ask for a referral to a registered dietitian.

Encourage the person to eat foods packed with nutrients. Spread peanut or other nut butters on toast and crackers, fresh fruits, and raw vegetables. Sprinkle finely chopped nuts or wheat germ on yogurt, fruit and cereal. Add extra egg whites to scrambled eggs and omelettes and encourage use of whole milk. Add cheese to sandwiches, vegetables, soups, rice and noodles

The one chefs forget - Restore life to bland food. Make a restricted diet more appealing by using lemon juice, herbs and spices. If loss of taste and smell is a problem, experiment with seasonings and recipes.

Plan between-meal snacks. A piece of fruit or cheese, a spoonful of peanut butter, or a fruit smoothie can provide nutrients and calories.

Make meals social events. Drop by during mealtime or invite your loved one to your home for occasional meals. Encourage your loved one to join programs where he or she can eat with others.

I know, in some people this next part can be difficult, especially when they have become restricted in movement. Encourage regular physical activity. Daily exercise — even if it's light — can stimulate appetite and strengthen bones and muscles.

Consider outside help. If necessary, hire a home health aide to shop for groceries or prepare meals. Also, consider Meals on Wheels and other community services, including home visits from nurses and registered dietitians. Your local Area Agency on Aging or a county social worker also might be helpful.

And remember the one things Care Providers don’t want to know - identifying and treating nutrition issues early can promote good health, independence and increased longevity.
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