Factors That May Contribute To Altered Nutrition in Elderly

Factors That May Contribute To Altered Nutrition in Elderly
Introduction
Literary periodicals have generally exemplified that elderly are a group of people that are susceptible to nutritional problems. There are many factors that contribute to this problem. Some of the factors which contribute to altered nutrition in elderly group include the following; changes in the gastrointestinal tract, decreased neuromuscular coordination and personal factors for example fixed income, loneliness and susceptibility to health claims.
Changes in the Gastrointestinal Tract

Many changes usually occur in the gastrointestinal tract this include; loss of teeth, reduced production of saliva, diminished taste and smell and increased ability to digest foods. When these changes occur, chewing food becomes painful, and a diet with soft foods is usually advised. Eating pleasure declines when taste and smell are impaired. Some adults prefer strongly flavored foods, while others totally detest food because it has no flavor because of loss of the impairment (Berman Et al. 2007).

Decreased neuromuscular coordination
Neuromuscular coordination usually decreases with age. Usually food preparation and the use of eating utensils are essentially hampered by conditions such as arthritis. Muscles in the lower gastrointestinal tract become weaker as age advances and the result is constipation which is a common problem among elderly. Other functions which are also impaired by age advancement include; nutrient absorption, kidney failure and renal function usually discontinue functioning or constrain the other body parts function to some individuals. Fluid and electrolyte balance is difficult to maintain, especially during illness.

Personal Factors
The personal factors to health claims are fixed income, loneliness and susceptibility. Fixed income makes the elderly to often exist on a low budget that prevents ample and adequate food supply. This income deficit affects housing and facilities, limiting cooking frequency and food storage. Elderly people also get lonely and this factor affects their eating trends to a great extent. Elderly persons living alone lose appetite and their desires to cook or eat diminish. Lonely people become apathetic, depressed, and fail to eat. Health claims: Many of the elderly are hoaxed to purchasing foods and supplements from health food stores, derived from advertisements which claim that the foods have curative power and may in fact retard the aging process. The elderly are mainly emaciated due to progressive loss of weight resulting in a low BMI of 16/m3.This involves general wasting away of the body tissue as a result of severe malnourishment.

Roles of the RN in assessing risk factor for altered Nutrition in the Health Care Setting
The main role of RN in a health care setting usually is regular assessment of nutritional status of the patients. This entails the carrying out of comprehensive nutrition assessment that involves examining clients to determine their chances of developing protein energy malnutrition. They monitor’s the response to nutritional intervention. This is usually achieved through periodic nutritional assessments, monitoring weight gain and BMI in response to therapy to determine adequate dietary intake, quality of patient’s life, functional status, and complications of nutritional support measures among others.

RN administers nursing diagnosis. This also include documentation of weight, determining of body fat composition by skin fold measurements, calculation of body mass index as a ratio of height, performing nutritional assessment, exploring the importance and meaning of food with the patient, assessing knowledge regarding nutritional needs and level of activity or other factors, ability to read food labels (Norton, 1984).
Nursing interventions that need to be implemented to overcome the 3 problems identified.
Sole dinning (social isolation); Nurses should encourage the patients to eat food in groups; this is as it increases the ability to eat more food since eating is a social activity. Also the food can be served attractively to increase the patient’s appetites. The nurse intervention on overcoming the problem of anorexia includes: serving the patients with foods at the right temperatures, and with foods that are spiced or herbs added, by offering small servings of food frequently, providing an opportunity for oral hygiene before meals which stimulates salivation thus increasing patient’s appetite.

Impaired swallowing; The nurse interventions that need to be implemented to overcome the problem of impaired swallowing include: keeping the client in a sitting position or semi-sitting position for at least an half and hour before eating, encouraging the patient to use his tongue or finger to sweep retained food from the cheek and repeat the swallowing technique.

Planning and teaching that should be initiated for a client who will be discharged
A client who is emaciated the family members or those who are taking care of him are taught by the nurse on several activities what is required to be done to assist in weight gain while discharged. These include: taking a rest after taking a meal, by disguising extra quality of calories meals by fortifying foods with powdered milk, gravies or sauces, eating of small amounts of food frequently, eating a variety of foods from small amounts and gradually increasing in terms of number of servings or serving sizes.

Those who are obese, prior to their discharge they are advised to use fats, oils and sugar sparingly. Also, to practice eating food in small amounts frequently as compared to large amounts sparingly. The client is also advised to refrain from junk foods and alcoholic beverages consumption. The patients should gravitate toward increment of intake of fiber in the diet from fresh fruits, vegetables and whole grains (Sharkey Et al. 2002). The patient should be advised to participate in regular exercises that help to raise metabolic rates while suppressing appetite. Those patients suffering from anorexia, the family members and care givers are taught on how to serve the patient with foods at the right temperatures, foods that are spiced, offering food in small servings frequently.

References
Berman, A., Snyder, S & Kozier, B & Erb, G. (2007). Best Practice In Providing Nursing Care Related To nutrition in Elderly Client. Upper Saddle River: Prentice Hall
Norton, L. (1984). Residential Location and Nutritional Adequacy among Elderly Adults. Journal of Gerontology. 39(5): 592-595
Sharkey, J., Branch, L., Zohoori, N & Giuliani, C. (2002). Jan Busby-Whitehead and Pamela S Haines inadequate Nutrient Intakes Among Homebound Elderly And Their Correlation With Individual Characteristics And Health-Related Factors. American Journal of Clinical Nutrition. 76(6): 1435-1445

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