T/F: Improvements in health & subsequent longevity throughout the 20th Century have resulted in TREMENDOUS growth in the size of the elderly population.
*Functional changes can AFFECT their nutritional status INDIRECTLY*
7 Social & Psychological Factors of Older Patients that AFFECT Nutrition:
1.) Poverty
2.) Living arrangements
3.) Finances
4.) Transportation
5.) Social interaction
6.) Depression
7.) Living alone
2 Types of Living Situationsof Older Patients:
1.) Free-living homebound elders
2.) Nursing home residents
Medications & Older Patients: (2)
Elderly people use MANY prescription & over-the-counter drugs
INCREASED RISK of drug-drug & drug-nutrient interaction
Alcohol Abuse & Older Patients: (4)
Alcohol abuse is a RISK FACTOR in elders
Alcohol abuse may be a RESPONSE to stress, unwanted changes in life situations, depression, & social isolation
it PROVIDES calories, but LITTLE nutritional value
may SUBSTITUTE alcohol for MORE nutritious foods in the diet
6 COMMON Oral Conditions that have Nutritional Complications in Older Patients:
1.) Root caries
2.) Periodontal Disease & Diabetes Mellitus
3.) Oral Cancers
4.) Tooth loss & Osteoporosis
5.) Dentition status (Dentures)
6.) Xerostomia
T/F: Vertical dimensions of the jawbone DIMINISH with age.
TRUE
Screening Older Patients for Nutritional Risk: (2)
Dental team members are IMPORTANT allies in screening older patients for health risks, including nutrition issues
COMMON oral complications that affect nutritional status such as Xerostomia, impaired taste, or difficulty chewing & swallowing can be QUICKLY identified with the use of oral health screening tools
2 Ways to IMPROVE the Nutritional Status of Aging Patients:
1.) Dietary guidance
3.) Supplements
Supplements for Elder Patients: (2)
Supplements can INTERACT with medicines
Elders should be ENCOURAGED to eat a balanced, nutritious diet & may take daily multivitamin/mineral supplements that contain NO MORE THAN100-200% of the DRI for the nutrients contained
Older adults should eat a diet that EMPHASIZES 3 Things:
1.) Nutrient-dense foods
2.) HIGH-fiber foods
3.) CONTROLS calories
T/F:Dental health professionals are in an IDEAL position to IDENTIFY nutritional problems & counsel elderly patients.
TRUE!
T/F:Elders may be at GREATER RISK for nutritional problems than younger patients.
TRUE!
T/F: Dental hygienists should ROUTINELY screen older patients for nutritional risk factors.
TRUE!
T/F: Oral conditions may CONTRIBUTE to nutritional problems & vice versa.
TRUE!
Modified Food Pyramid for 70+ Adults:
Supplements: Vitamin B12, Vitamin D, & Calcium
Fats, Oils, & Sweets: use SPARINGLY
Dairy: > or EQUAL TO 3 servings
Vegetables: > or EQUAL to 3 servings
Meat/Beans/Nuts: > or EQUAL to 2 servings
Fruit: > or EQUAL to 2 servings
Grains: > or EQUAL to 6 servings
Water: > or EQUAL to 8 servings
7 Tricks to IMPROVE flavor for Elders:
1.) Plan meals that include a WIDE palette of colors & shapes for eye appeal, & a VARIETY of textures & temperatures for tongue appeal
2.) Perk up food flavors with small amounts of intense-flavored ingredients such as sharp cheese, toasted nuts, or fruity olive oil
3.) Try a spoonful of cheese sauce, a shaving of sweet butter, or a drizzle of creamy dressing to add luscious flavor to bitter vegetables & salad greens, & promote absorption of fat-soluble nutrients
4.) Enhance natural flavors of foods with reduced, concentrated stocks, monosodium glutamate (MSG), flavored vinegars, zesty condiments, or an extra dash of herbs or spices
5.) Stave off taste fatigue. Encourage older adults to ALTERNATE between bites of food with DIFFERENT tastes, temperatures & textures
6.) Try shakes made with coffee or chocolate extracts to MASK bitter tastes from medications
7.) Be adventurous! Expand tastes to enjoy a variety of foods.
Dietary Suggestions for Difficulty Chewing or Swallowing:
Dairy: eat cottage cheese, yogurt instead of hard cheeses
Meat: substitute fish, eggs, peanut butter, tofu for hard-to-chew meats; cut into small pieces
Fruits & Vegetables: use cooked, canned fruits & vegetables; cut into small pieces or puree foods
Grains: avoid breads with hard crusts; use pasta, rice, cooked cereals
Other: avoid seeds & nuts that tend to slip under dentures
Dietary Suggestions for Impaired Taste or Appetite:
Dairy: use flavored milk & yogurt; add powdered milk to foods to increase protein & calorie intakes
Meat: chew thoroughly; add herbs & spices instead of salts
Fruits & Vegetables: choose ripe fruits & raw vegetables with skins
Grains: use whole grains such as rye & pumpernickel
Other: wine BEFORE a meal may stimulate the appetite when used in moderation
Dietary Suggestions for Xerostomia:
Dairy: add milk or yogurt to moisten dry foods
Meat: add broths, gravies, & sauces
Fruits & Vegetables: use soups & stews with HIGH water content
Grains: moisten breads, cereals with milk or broths
Other: use candy or gum with non-nutritive sweeteners INSTEAD of sucrose-containing products; drink plenty of fluids
Dietary Suggestions for Food Intolerance:
Dairy: use milk in SMALL amounts; use MORE cheese, yogurt, buttermilk, greens
Meat: use LESS fatty, fried meat; prepare by broiling, baking, stewing
Fruits & Vegetables: use cooked vegetables, fruit, sauces
Grains: choose PLAIN breads & cereals; other as tolerated
