can make a positive impact on our aging population Meridith - - PowerPoint PPT Presentation

Geriatric Nutrition: How Dietitians can make a positive impact on our aging population

Meridith Paterson, MS, RDN,CSG, LDN

patersonmm@upmc.edu West Virginia Academy of Nutrition and Dietetics

Learning Objectives

• Recognize the challenges of the aging

population and the direct impact on nutrition

• utcomes.
• Understand the role the dietitian in improving

not only nutrition but quality of life as well.

• Understanding the importance of learning

each individual’s needs and wishes and not a

• ne size fits all approach.
• Learning Codes: 4190, 5100, 5430

Challenges of the aging population….

Aging Population

• Between 2012 and 2050, the United States

will experience considerable growth in its

• lder population (65 years and older).
• From 43.1 million (2012) to 83.7 million (2050)
• Baby Boomers are a significant contributing

factor to the increase in the older population.

Ortman, Jennifer M., Victoria A. Velkoff, and Howard Hogan. An Aging Nation: The Older Population in the United States, Current Population Reports, P25-1140. U.S. Census Bureau, Washington, DC. 2014.

Challenges Facing the Elderly

• Physical Changes
• Cognitive Changes
• Environmental Changes
• Financial Changes

Physical Changes

• Common changes noted:

– Vision Impairment – Hearing Impairment – Taste Bud changes – Sense of smell – Sleep Disturbances – Oral Changes (tooth loss, dentures, implants) (May also have physical changes related to medical condition/ disease process)

Cognitive Changes

• “Slowing down”
• Forgetfulness
• Memory may be effected related to dementia,

depression, delirium and other medical conditions.

Oral Care

• Approximately 25% of those 65 years and older

have no natural teeth.

• Diet and nutrition intervention for older adults

with compromised oral integrity must target individual needs based on current diseases and disabilities.

• Dietetics practitioners must address oral health

as part of nutrition diet and screening, assessment, intervention, and monitoring of

• lder adults.
• Position of the Academy of Nutrition and Dietetics: Oral health and Nutrition. 2013;113(5).

Environmental Changes

• No longer to be able to maintain their home
• Moved to new environment (Apartment,

move in with a family member, SNF, PCH)

• May require giving up driver’s license
• Giving up independent activities (cooking,

shopping, going to church, etc.)

Financial Changes

• May have went from two incomes to one

income due to death of spouse or partner.

• Income may not cover current expenses

(utilities, food, medicine, car, etc.)

• Increase cost of prescriptions

Direct impact on Nutrition

• Food insecurity
• Isolation
• Depression
• Chronic diseases
• Dependent of others- decrease in

independence

• Oral hygiene (ill fitting dentures, mouth sores,

thrush)

Other areas to consider

• Education Level (Can they read?)
• Evaluate the basics:

Do they have a working kitchen that is accessible to them? Do they have support (family/ friend/ church) to help? Can they manage their finances?

The role of the Dietitian…

Role of the RDN

• To look at the entire picture when it comes to

nutrition

• Think outside the box
• Look at each person individually and nutrition

plan should not be a one size fits all approach.

EOL Nutrition Issues

Dietitian's Role

• Active role in educating and advocating for
• ur patients. Dietitians are part of the

palliative/ hospice team.

• The dietitian should talk with the patient and/or

family member about wishes prior to a crisis. Be Proactive!

• Schedule family meetings to discuss what the

patient would want so that everyone is on the same page.

• The goal is to provide an opportunity for patient

to discuss his/ her wishes and to provide comfort and dignity at the end of life by honoring what they would want.

To Feed or Not to Feed?

• Dietitian to educate patient and/or caregiver
• n palliative and/or EOL nutrition related

issues and provide support.

• Tube feedings, IV hydration, MBS studies
• Issues surrounding feeding at the EOL.
• The “waiver” to go against what is

recommended- is this valuable to complete?

Dietitian’s Role

• Liberalize diet ( this can be difficult for family

members- diabetics)

• Assess for constipation which may be related

to pain medication, decrease mobility, inadequate fluid intake

• Medications which may have negative effect

(i.e. vitamins/ minerals may increase GI distress) recommend to discontinue any unnecessary medications

EOL Strategies

• Offer comfort/ pleasure foods (encouraging

family members to provide favorite foods)

• Assess oral hygiene (for the demented patient

cleaning their mouth before and after meals)

• Offering smaller portions
• Offering one food at a time
• Monitoring for pain and constipation

Conclusion

“To make a difference in someone’s life, you don’t have to be brilliant, rich, beautiful, or

• perfect. You just have to care.”

Mandy Hale

Questions???