Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly
Nutrition Assessment
While poor nutrition is not a natural concomitant of aging, older adults are at risk for malnutrition due to physiological, psychological, social, dietary, and environmental risk factors.
Allied considerations
Related issues include assessment of oral health (including dentures), thyroid function, alcohol intake, and bowel habit, as constipation can lead to reduced appetite.
Older people are more likely to have B12 or folate deficiency due to diet, malabsorption or chronic inflammation, and may be difficult to detect clinically.
Also of value are assessment of mood (loss of appetite as a marker of depression) and cognition / function (inability to prepare or obtain adequate diet). Loss of appetite can also be a feature of dementia but generally only in the very late stages. Unless dementia is severe a change in appetite is more likely a marker of an acute illness, behavioural/psychological symptoms of dementia or undiagnosed systemic problem (eg constipation or malignancy).
Food is much better than supplements: it is nutritionally complete (contains proteins, carbohydrates, fats and all the vitamins and minerals we need), offers much greater variety and tastes nicer.
Never use supplements as a sole source of nutrition. Patients must be eating food too. ( See the Nutrition handouts below for Patients and Caregivers),
Oral protein and energy supplementation does result in weight gain and may also slightly improve survival in undernourished older people.
Medications to stimulate appetite are unlikely to be effective.
Decisions about supplemental feeding in patients unable to take this orally (ie by enteral tube feeding) are complex, and should be reached by consultation between GP, dietician, physician and surgeon..
The effects of increased forced nutrition may be negligible (and possibly harmful) in advanced frailty and dementia.
Practical Guidelines To Help the Elderly With Nutrition
As elderly individuals continue to age, nutritional habits become more important and vital to their overall health than ever before.
When the elderly eat nutritious meals, they can maintain sharp minds and alertness, increase their energy levels, and increase their overall lifespan.
1. Establish a healthy menu that contains food an elderly individual should be eating.
An elderly person should be eating foods that are high in vitamins and nutrients, especially if they expend less energy on a daily basis and do not require a high caloric intake
The elderly person's diet should include a variety of foods from the food pyramid that include fruits, vegetables, grains, and foods rich in protein and calcium; such as tuna, beans, nuts, eggs, milk, yogurt, and cheese.
2. Establish a healthy, daily eating schedule.
Eating healthy and nutritious foods throughout the day can help maintain an elderly person's high energy and metabolism levels.
Verify that an elderly person eats breakfast, lunch, and dinner daily without skipping any of these meals.
Allow an elderly person to eat snacks that are high in nutrition between major meals; such as fruit, almonds, raisins, cottage cheese, or peanut butter, instead of potato chips, sweets, and other types of junk food.
3. Determine the health challenges an elderly individual may be facing.
Some elderly individuals can lose their sense of taste or appetite due to prescriptions drugs, and certain medical conditions will affect digestion, absorption and elimination of certain foods and nutrients.
Consider the individual's medical condition and medications in determining individual dietary do's and don'ts.
4. Obtain the supplements or appliances needed to accommodate an elderly person's challenges.
These items can potentially enhance an elderly person's eating experience, especially if health challenges make certain eating tasks difficult.
Use a blender to turn fruits into smoothies or cook vegetables using a steamer if an elderly person has difficulty chewing certain fruits and vegetables such as apples or broccoli.
Buy flavoring that is higher in nutrition than processed sugars or table salt to spice up and enhance the flavors of foods; such as olive oil, garlic, soya sauce, herbs and spices.
5. Arrange for an elderly person to eat meals with other people.
In most cases, elderly individuals will enjoy their meals more and become more health-conscious when they can eat meals with friends, family, and other company.
Enroll an elderly person in a senior meal program or adult day care center to provide them with companionship during mealtimes.
6. Try new recipes or meals to keep an elderly person interested in nutrition.
This can prevent an elderly individual from growing bored with eating or from losing their appetite in certain dishes they eat repeatedly.
Ask an elderly person about the types of meals they would like to try, then see to it the meals are cooked using nutritious ingredients or healthy cooking methods.
7. Verify that the elderly person has access to healthy meals at all times.
In the event that an elderly person is immobile or restricted to their homes, the need may arise to arrange for food delivery or hire a homemaker to prepare meals.
8. Create a fun and enjoyable eating environment for an elderly person.
An elderly person may be more inclined to eat if they enjoy the atmosphere and surroundings.
For example, play their favorite music during meals, or eat outside in nice weather conditions.
Nutrition - 100 Calorie Boosters
These boosters are approximately 100 calories each and can be added to any appropriate meal or eaten alone.
NHS Foundation Trust - South Sussex Partnership University.
Nutrition - Fortified Diet
The following dietary changes can be tried to help prevent weight loss and encourage weight gain.
NHS Foundation Trust - South Sussex Partnership University.
Nutrition - Nourishing Drinks
Nourishing drinks do not replace meals but sipping on them between meals, or drinking one instead of eating a snack, can be both enjoyable and beneficial.
NHS Foundation Trust - South Sussex Partnership University.
Nutrition - Supplement Drinks
Supplement drinks are designed especially for people who are unwell and need an extra source of nutrition.
NHS Foundation Trust - South Sussex Partnership University.
This Read More page is an extension of Nutrition Assessment
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The Nutrition Assessment is one of 5 sub-domains of the
Medical Assessment
Back To : Medical Assessment
The Medical Assessment is one of 8 domains of the
Comprehensive Geriatric Assessment (CGA)
Back To : Comprehensive Geriatric Assessment