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    Over the course of history, different types

    of food have serve as poisons, potions,

    panaceas for health, potency, long lifeand love.

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    Hippocrates (father of medicine)

    reflected his commitment to the

    importance of diet in a statement fromthe Hippocratic Oath.

    I will apply dietetic measures for the

    benefit of the sick according to my ability

    and judgement; I will keep them fromharm and injustice.

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    Cato, the elder- roman statesman Ate a large amount of cabbage in the belief it

    had special healing properties.

    Pliny the elder- roman scholar Ate the foot and snout of the hippopotamus to

    enhance sexual potency.

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    Chinese physician of the 6th century BC-

    prescribe a certain foods for clients to

    stimulate the yin( female principles) andthe yang( male principle) to keep the

    person healthy.

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    Food and diet are manipulated to: Enhance athletic performance

    Carbohydrates are avoided to burn fat for

    weight loss

    Supplements are taken to replace the vitamins

    and mineral missing from fad diets

    Comfort foods

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    In our society is a: Social Centerpiece

    Source of comfort Symbol of celebration

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    Decrease in lean body weight As a person ages, body fat increases while the

    muscle and bone weight (or lean body weight)

    decreases.

    This leads to a decrease in energy expended

    during rest, and hence the need for fewer

    calories and more protein.

    Loss skeletal muscle Lead to decrease strength and mobility leading

    to falls and affecting metabolism

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    Functional impairments It often leads to malnutrition

    Conditions that result in sob, pain, or limitedmobility affects individuals ability and

    desire to eat.

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    Loss of taste and smell The elderly often complain of a decreased

    ability to taste and enjoy food. Taste budsdecrease in number and size, affecting sweet

    and salty tastes in particular.

    About 40 percent of people 80 years or older

    appear to have difficulty identifying commonsubstances by smell.

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    Oral Cavity Changes The majority of the elderly suffer bone loss and

    disease in the tissues around the teeth, as they

    grow older.

    Older people hence tend to choose foods that

    are easy to chew, leading to reduced

    consumption of fresh fruits and vegetables

    high in dietary fiber.

    Some elderly people may wear ill fitting

    dentures making chewing difficult.

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    Decrease in liver and kidney function

    The size and function of the liver decreasessteadily with aging. The content ofglycogen and

    vitamin C in the liver decreases, and its

    ability to synthesize protein is diminished.

    Alcohol becomes more toxic to the liver as its

    ability to detoxify ethanol decreases.

    The kidneys also decrease in size and function.The number of kidney nephrons decreases

    and the membranes thickens, decreasing the

    ability of various substances to pass through.

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    Thirst regulation Is often affected, making Dehydration a

    prime risk among elders

    x Isotonic dehydration- results from the loss of

    sodium and water (GI illness)xHypertonic Dehydration- results when water

    losses exceed sodium losses (fever, limited

    fluid intake)\

    xHypotonic dehydration- can occur withdiuretic use when sodium loss is higher than

    water loss.

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    Poverty

    Social Isolation

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    Nutritional Screening Is an Abbreviated assessment of nutritional risk

    factors to determine which clients are in need of

    a more comprehensive nutritional assessment

    and nutritional interventions.

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    DISEASE

    Any disease, illness or chronic condition

    which causes you to change the way you

    eat, or makes it hard for you to eat, puts

    your nutritional health at risk.

    EATING POORLY

    Eating too little and eating too much both

    lead to poor health. Eating the same

    foods day after day or not eating fruit,

    vegetables, and milk products daily will

    also cause poor nutritional health.

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    TOOTH LOSS/MOUTH PAIN

    A healthy mouth, teeth and gums are

    needed to eat. Missing, loose or rottenteeth or dentures which dont fit well, or

    cause mouth sores, make it hard to eat.

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    ECONOMIC HARDSHIP

    REDUCED SOCIAL CONTACT

    MULTIPLE MEDICINES

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    INVOLUNTARYWEIGHT LOSS/GAIN

    Losing or gaining a lot of weight when

    you are not trying to do so is an importantwarning sign that must not be ignored.

    Being overweight or underweight also

    increases your chance of poor health

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    ELDERYEARS ABOVE AGE 80

    Most older people lead full and

    productive lives. But as age increases,risk of frailty and health problems

    increase.

    NEEDS ASSISTANCE IN SELF CARE

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    Is a comprehensive evaluation of clients

    nutritional status and typically includes

    data collection.May be performed as a result of an

    identified risk on nutritional screening

    or when the risk status is obvious without

    preliminary screening.

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    Include: No. of meals/snack/day

    Chewing/ swallowing difficulties

    GI problems or symptoms that affecting eating

    Oral health/ denture use Hx. of dse/surgery

    Use of meds

    Appetite, meal prep, meal preference

    Food recall ( to estimate the no. of calories, amt.of protein and detect any food intake pattern)

    Food frequecy- final means of assessing dietary

    patterns

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    Height and wt.Ideally client is weighed in the morning wearing

    light clothing

    Broad bladed Caliper- use to measure the clients

    ht if unable to stand

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    Used when the clients are unable to

    ingest, digest and absorb nutrients

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    Use in Condition

    which the client is

    unable to swallow

    (CVA, multiplesclerosis)

    Use when there is

    obstruction in

    UGI(Cancer)

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    Consist ofintravenous solutionthat includes:

    Dextrose Amino acids

    Vit/minerals

    Indicated when theGIT cannot be used

    for enteral feeding orcannot absorbadequate nutrients.

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    Label originally to infants who did not

    gain weight and grow despite the

    absence of diseases.

    In older adult- characterized by refusal to

    eat, loss of weight and lean body mass

    and subsequent malnutrition.

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    Physiologic changes associated in aging

    Medical factor

    Social factor

    Economic factors

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    Correcting the malnutrition through the

    use of:

    diet oral supplement

    Specialized nutrition as necessary

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