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CD Week 30 Nutrition & Dementia in the Elderly. Dietary Guidelines: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n33.pdf - See Wk 9: Diet and Nutrition. - Particularly :. http://moritzcycling.com/eer.cgi. Measures. Height weight tables BMI body weight(kg)/height (m 2 )
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Dietary Guidelines:http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n33.pdf - See Wk 9: Diet and Nutrition. - Particularly :
Measures • Height weight tables • BMI body weight(kg)/height (m2) • Waist / Waist to Hip Ratio • Body Fat • Skinfolds • Electrical Impedance • Buoyancy • DEXA (Dual Energy X-Ray Absortiometry Scan)
Where do older Australians live? Australia’s Welfare 2009 , pg88 http://blackboard.nd.edu.au/webapps/portal/frameset.jsp?tab_id=_2_1&url=%2Fwebapps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_4124_1%26url%3D
92% private • Family, group or lone-person household • 27% of these live alone • 66% of these live in family households (mostly single family) • 84% of people with dementia in the community sometimes or always require assistance with core activities. 93% receive some type of assistance with the condition. • 8% non-private: • Hotel/motel, guest house, cared accommodation (hospital, aged care home, supported care at retirement village) • Proportion increases with age • 1 in 2 residents with dementia (50%) needed high-level care with the ADLs compared with 30% of residents without dementia
Likelihood of living in cared accommodation increases with age • 5% of ALL older people • 31% of 85+ • 2008 – 60% of residents • were 85+
What assists or impedes the ability for older Australians meeting the recommended dietaryguidelines? • Assist– community services (Meals On Wheels), deliveries, family/friends, A.C Facility, supplements. • Challenge- poverty, remoteness, mobility, access, laziness, reversion to ethnic food patterns of consumption, dentition/swallowing, diseases re eating/digestion, cognitive decline, hand function, inability to physically prepare food, living alone/loneliness.
Disease states associated with poor nutrition include: • Cardiovascular disease Elevated blood pressure Elevated cholesterol levels • Diabetes • Some cancers • Musculoskeletal and arthritis To reduce falls/fractures important for good muscle mass and reduced osteoporotic fractures.
Demographic changes occurring in Australia and other demographic changes:
Dementia in Australia • More females 63% than males 37% have • dementia (AIHW 2011). • 222,100 Australians (1.0%) had dementia • in 2011. • By 2031expected to project more than • 464,000(1.6%) • From 2000-2009, dementia rose from 7th to • 3rdleading cause of death in Australia • Dementia is already the single greatest cause of disability in older Australians. • It is one of the fastest growing sources of major disease burden, overtaking coronary heart disease in its total wellbeing cost by 2023. • Australia faces a shortage of more than 150,000 paid and unpaid carers for people with dementia by 2029.
Dementia internationally Fun Facts • The dementia epidemic is worldwide, more prevalent in developed countries • The total estimated worldwide costs of dementia were US$604 billion in 2010 • These costs account for about 1% of the world’s GDP (gross domestic product) • If dementia were a country, it would be the world’s 18th largest economy • If it were a company, it would be the world’s largest, exceeding Wal-Mart (US$414 billion)
Important features in the design of an aged care facility for dementia residents? • Falls prevention: Rails, steps, even surfaces, rugs, slippery/wet, footwear, obstacles/clutter. Chairs for rest. Avoid sharp corners/edges. Shower chairs/hoses. Toilet commodes/raised seat/ alert system. • Staff awareness
Important features in the design of an aged care facility for dementia residents? • Monitors/technology – contained area, microchipping, identification • Physical condition – skills – balance retraining & maintenance. Ex classes. Chairs for rest • Cognitive maintenance – games, skills, etc –puzzles/papers/ipads • Social interaction – common rooms, personal belongings & familiarity, visitor friendly,
Fall Prevention Strategies in people with dementia From week 26, the risk factors for falls in elderly: • History of previous falls • Psychoactive medications • Cognitive or functional impairment • Environment impairment • Balance or gait problems • Loss of muscle strength • Impaired vision
V: Alzheimers /DementiaWimo, A., Prince, M. (2010) World Alzheimer Report 2010: The Global Economic Impact of Dementia. London : Alzheimer’s Disease International (ADI )www.alz.co.uk/research/files/WorldAlzheimerReport2010ExecutiveSummary.pdf