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| [Image: Aids to the Elderly] |
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Introduction
One in eight Americans is 65 years of age or older. This number is growing and will continue to do so with the aging of the baby boomers. The oldest old, people at least 85 years of age, is the fastest-growing segment of America's senior population.
What You Will Learn
You will learn the importance of good nutrition in helping the elderly to:
MyPyramid Plan
The MyPyramid is a tool that guides us in selecting which foods to eat and how much to eat each day to be healthy. We need a variety of foods, especially some from each following groups: grains, fruits, vegetables, milk, and meat and beans. We need to eat in moderation. We can do this by eating the recommended amount from each group. The MyPyramid is a practical guide to choosing healthy, low-fat foods each day. It is available at: www.mypyramid.gov
Changes That May Affect Nutritional Status in the Elderly
Physical and body function changes take place during aging and can result in changes in nutrient needs. These changes can contribute to decreased food intake, unintentional weight loss and malnutrition. Not everyone experiences all these changes. Some of the changes that may occur are listed below.
- Sense of taste.
- Sense of smell.
- Hearing loss.
- Diminished eyesight.
- Poor oral health. A healthy mouth, teeth and gums are needed for elders to eat well.
- Difficulty swallowing.
- Deteriorating mental status.
- Social isolation.
- Lack of transportation to grocery store, medical appointments, etc.
- Access to a nutritionally adequate diet.
- Poverty. Poverty is a strong indicator of malnutrition risk. About 20% of adults are poor. Older women experience nearly twice the poverty rate of older men.
- Fixed income. As expenses increase, seniors may reduce their food intake. Costly medications can decrease the money available to buy food.
- Medications. Some medicines cause dry mouth. Drink more water or suck on hard candy (such as lemon drops) to increase saliva flow.
Why Good Nutrition in Older Adults is Important
Because Americans are living longer, it is important for us all to plan well for a long life. It is never too early nor late to begin. Aging well depends on several factors, some of which include the following: personal health and well-being, lifestyle issues (housing, leisure activities, lifelong learning) and finances. It is important to remember and understand that today's choices do have consequences in later life.
In this lesson, we will focus on only one factor of aging well: health.
Research has shown that nutritional status influences the progress of many diseases and that having good nutritional status can help to reduce the length of hospital stays. Being well-nourished is important for several reasons:
- Health is improved.
- Dependence is decreased.
- Illnesses are shorter.
- Disease progression is delayed.
- Quality of life is improved or maintained.
Nutritional Concerns Based on What Adults Eat
The United States Department of Agriculture (USDA) Continuing Survey of Food Intakes by Individuals (CSFII) provides up-to-date information on food intakes by Americans. This survey indicated that adults have low intakes of fiber, magnesium and zinc. These results could be improved by eating more whole grains, fruits, dark green vegetables and legumes. Consuming low-fat dairy products is important in that it can help to boost calcium levels. The study also found more adults to be overweight than before. Adults' diets could benefit overall by simply decreasing intakes of foods and beverages that are high in fats and sugars. Low activity levels were also shown to contribute to the large numbers of adults who were overweight. For better health, adults should become more active, incorporating activities into their everyday living.
Nutrients to be concerned about:
Vitamin A: Vitamin A needs decrease with age, making toxicity from supplements more common as one ages. Adequate vitamin A can be obtained in the diet alone through several different food sources. Breakfast cereals, juices, dairy products, and other foods are fortified with vitamin A. Also, fruits and vegetables contain beta carotene, and other vitamin A precursors, which the body can use to form vitamin A.
Protein: Protein needs increase with age. A low protein and calorie intake can make a person more likely to get sick and can also make it harder to recover from an illness. Foods that are excellent sources of protein include meat, poultry, and fish. Other good sources of protein includes the following foods: dairy foods, such as milk, yogurt, and cheese, soy products, such as tofu and soy milk, grains, such as rice and bread, vegetables, such as broccoli, corn and potatoes, and beans.
Vitamin D (the sunshine vitamin): Your bones are more likely to break when vitamin D levels are low. Luckily, most individuals are able to receive enough vitamin D through sunshine alone. But, there are some individuals that have been shown to have much lower levels of vitamin D, including African Americans and other individuals with dark skin. This is believed to be due to less formation of the vitamin from the action of sunlight on the skin. Some good dietary sources of vitamin D include dairy products and breakfast cereals (fortified with vitamin D), as well as fatty fish, like salmon and tuna. Some individuals prefer getting their daily intakes of vitamin D from a multivitamin. However, levels found in most multivitamins are too low.
Vitamin B-12, vitamin B-6 and folate: These are believed to prevent some of the declining in cognitive function that is associated with aging. Deficiencies of these nutrients, along with low intakes of vitamin C and riboflavin, may result in poor memory. Folate, along with these other two B vitamins, is believed to play some role in fighting heart disease and some types of cancer. Further research is still needed in this area, however. Folic acid has recently been fortified in several foods making it much easier now, than in past years, to receive adequate amounts from the diet. Good dietary sources of folic acid include: enriched breads, flour, cornmeal, pastas, rice, and other grain products.
Cholesterol: Cholesterol is a wax-like substance. It is made by the liver which acts to link cholesterol to carrier proteins in the body, called lipoproteins, that let it dissolve in blood where it is then transported all through the body. This is because cholesterol plays some essential roles in the body such as: in the formation of cell membranes, some hormones, and vitamin D. Where too much cholesterol can be problematic, very low levels of cholesterol can be as well. Very low levels may be a sign of dying and of decreased mental ability.
Beta carotene (forms vitamin A), vitamin C and vitamin E: These are all antioxidants. Beta carotene is a precursor for vitamin A. But, unlike toxicity which can occur with too high of a vitamin A intake, this is not the case with beta carotene. Beta carotene is essentially safe at all levels. Adequate levels of vitamin C can be consumed from the diet. Excellent food sources of vitamin C include citrus fruits or citrus juices, berries, green and red peppers, tomatoes, broccoli, and spinach. Many breakfast cereals are also fortified with vitamin C. These compounds can all help prevent the formation of cataracts of the eye, which can help prolong eyesight.
Protein, vitamin E, zinc and other nutrients are believed to help improve immune function or one's ability to fight disease.
Water is important for the body to function as it should. Dehydration is a major problem in older adults, especially in those 85 and older, and especially in blacks and in men. There are several factors that can contribute to decreased intakes of fluid in older individuals. These can include the following: loss of sense of thirst, medication side effects, difficulty in getting to or in using the toilet, or fear of being unable to control one's bladder. It is important to find ways of incorporating water throughout the day as to prevent dehydration.
How to Improve Diets of the Elderly
- Follow the USDA MyPyramid Plan.
- Eat more whole-grain bread and cereals.
- Eat more fruit.
- Eat dark green vegetables.
- Eat more lean meat, legumes, and other meat alternates.
- Drink more skim and low-fat milk, and eat more skim and low-fat dairy products.
- Decrease intakes of foods high in fats and sugars that provide few other nutrients.
- Drink more water throughout the day.
- Include nutritious foods that are enjoyable and chewable.
- Follow any special diets prescribed by the doctor.
- Eat meals at regular times.
- Try eating smaller meals. They may be better tolerated.
- Make snacks count!
- Follow instructions when taking medicine. Some medicines must be taken after eating or with milk. If medicine is not taken as prescribed, you may become sick.
- Eat a snack before getting out of bed in the morning if your blood pressure tends to drop when you get up. Also, to help stabilize your blood pressure, sit on the side of the bed for a few minutes before getting up.
- Exercise!
Physical Activity
Research shows that there are advantages to both aerobic and weight-bearing exercise. Older Americans are shown to be less likely to participate in fitness activities. These activities can be important to older Americans. Walking and weight training has been shown to improve an older person's balance and ability to walk. This makes them more independent and less likely to fall and be injured. Also, regular physical activity that is done several days each week reduces the risk of developing several illnesses.
Regular physical activity improves health by reducing risk of:
- Premature death
- Premature heart disease death
- Developing diabetes
- Developing high blood pressure
- Developing colon cancer.
Exercise also reduces feelings of depression and anxiety, helps control weight and helps build and maintain healthy bones, muscles and joints. Exercise helps older adults become stronger and better able to move without falling.
Exercise does not have to be strenuous in order to achieve health benefits. Older adults who have been inactive for a while can begin exercise programs by doing short intervals of moderate physical activity (5-10 minute intervals). Gradually, they can build up to the desired amount of exercise. Both muscle-strengthening and aerobic activities should be included in the exercise program. Stronger muscles can help reduce the risk of falling and can help to improve one’s ability to perform the routine tasks of daily life. Among adults aged 65 years and older, walking and gardening, along with yard work, are some of the most popular physical activities.
It is important for seniors who want to begin an exercise program to first consult their doctors before beginning the program!
Products for Greater Home Independence
There are products that make it easier for older Americans to prepare and eat food. Some of the available products are given below:
Easy jar opener
Utensils with thick handles
Liquid level indicator
Need More Help?
- Call the Eldercare Locator, a toll-free telephone service that puts callers in touch with information about state and area agencies serving the elderly in their communities. You can reach the Eldercare Locator by calling 1-800-677-1116 , Monday through Friday, 8:00 a.m. to 7:00 p.m. The Eldercare Locator is a public service of the U.S. Administration on Aging. The Eldercare Locator’s Web site is: http://www.n4a.org/programs/eldercare-locator/resources/
- Participate in research-based educational programs sponsored by the LSU Agricultural Center's Louisiana Cooperative Extension Service. The LSU Agricultural Center's Web site location is: www.lsuagcenter.com
- Participate in the Food Stamp Program, if qualified and not already doing so. You can first check your income with the Federal Poverty Income Guidelines to see if the income guidelines are met. The Department of Health and Human Service’s Web site location is: www.os.dhhs.gov
- Participate in feeding programs for senior citizens or the USDA commodity food distribution program if you meet the qualifications. Commodity foods are distributed quarterly. The Department of Health and Human Services' Web site location is listed above.
- Participate in church, community or hospital sponsored activities for senior citizens.
- Participate in meetings sponsored by the American Association of Retired Persons. The American Association of Retired Persons' Web site location is: www.aarp.org
- And, lastly, this is a site that is designed to help seniors get the help they need from the government: www.seniors.com
Summary
Because Americans are living longer, it is important to plan for a long life. The keys to enjoying later life are understanding and planning for what lies ahead. It is never too early nor too late to begin. Aging well and leading a quality life depend on personal health and well-being as well as lifestyle choices such as housing, leisure activities, volunteering and life-long learning. Today's choices do have consequences in later life.
To promote health, eat according to the USDA Dietary Guidelines and the USDA Food Guide and exercise!
Assignments
1. Role play. Complete the Determine Your Nutritional Health Checklist with an elderly person. This will help the person to realize that he or she may be at risk for nutritional problems. Use the word DETERMINE to help remember the warning signs of nutritional problems. Total that person's score. Offer suggestions
D = Disease
E = Eating poorly
T = Tooth loss/ mouth pain
E = Economic hardship
R = Reduced social contact
M = Multiple medicines
I = Involuntary weight loss/ gain
N = Need assistance in self care
E = Eighty (80) years old or older
2. Practice giving this lesson. Pretend you are at a senior citizens feeding site. You want them to know how important nutrition is to their health and well-being.
3. Role play. Explain the Eldercare Locator to someone.