UNIT TEN FCS-FNL-8. Students will explain the nutritional requirements of the aging individual.

1. UNIT TENFCS-FNL-8. Students will explain the nutritional requirements of the aging individual. a. Describe the biological aspects of aging and life expectancy in relation to current demographics in the U.S. b. Compare nutrient needs of the elderly with middle age adults, being certain to focus on the nutrients of concerns such as water, vitamin B6, vitamin B12, folate, vitamin D, calcium, and zinc. c. Identify medications commonly used by the elderly and the potential of medications to impact nutritional status. d. Describe food assistance programs for the elderly.

2. What do we think of when we hear the term “ELDERLY”? • Old • Wrinkles • Can’t hear • Dentures • Medicine • Senile • Can’t drive • Bingo, Bridge, and other Card Games • Senior Discount • Canes and wheelchairs • Medicare • Mothballs • Grey hair • Retirement/Nursing Homes • Memory Loss • “When I was your age, I had to walk 10 miles to school in the snow…”

3. Reflect… • Why do you think we stereotype the elderly this way? • What can we do to change these stereotypes? • Which stereotypes do think will change because of technology? • Why is it important to focus on nutrition and wellness of the elderly?

4. Did You Ever Stop to Think… • This age group is rapidly increasing. The “Baby Boom” generation is now entering (or already entered) the age 65 and above category. • The need for elderly caretakers will increase • Many elderly people live alone and make nutrition decisions without guidance • Physical and mental handicaps can impede proper nutrition • New medications are being developed to help the elderly

5. Aging • The process of “getting older” actually starts at age 30 • The “Older Adult” category is considered anyone 65 and older

6. Body Composition • Sarcopenia • Loosing skeletal muscle mass and strength • There is a decrease in lean muscle mass, especially in the legs • Muscle tone will change and strength will decrease • Sarcopenia can be slowed with exercise

7. Sedentary Lifestyles • Because of fear of falling and muscle weakening, many older adults chose not to exercise • It is wise for older adults to get about 30 minutes of exercise a day • This can be done without going to a gym • Strength- lift food cans • Balance- Standing in doorways (using frame for support when shaky), sitting in a chair and lifting feet into the air • Stretch- Tia Chi, Yoga, stretch bands for the back of doors

8. How could an elderly person not be able to physically provide themselves with proper nutrition? (refer to previous information)

9. Loss of Interest in Food • Dysgeusia (Dis-gish-a) • Loss of taste • Hyposmia (Hi-pos-mia) • Loss of smell • Xerostoma (Zero-stoma) • Dry mouth • Decrease in salvation • Dentition • Loss of teeth • Hard to eat meat, fresh fruits and vegetables • Swallowing • Changes in textures of foods • Indigestion can lead to acid reflux…causes changes in throat area

10. Why would an elderly person not be interested in eating? (refer to previous information)

11. Digestive Issues • Achlorhydria (A-clor-hydra) • Decrease in the digestion of protein • Affects the absorption of B-12 • As decreases more antacids are taken • May also block absorption of Calcium and Iron • Delayed gastric emptying • May feel “full” longer • This will disrupt the eating schedule and may not assure meals are eaten

12. Digestive Issues, Cont. • Digestive functions slowing • Constipation • Sometimes caused by a decrease in liquid intake due to loss of thirst mechanism (not enough water); also poor fiber intake (reverts back to inability to eat fresh fruits/vegetables) • Colon muscle weakens • Diverticulosis • Pouches of the lining of the colon that bulge out • Diverticulitis • Occurs when the pouches become inflamed • Poor fiber intake in younger years can contribute to the chances of developing diverticulosis/diverticulitis

13. Why would digestive issues interrupt the eating patterns of an elderly person? (refer to previous information)

14. Chronic Diseases in Older Adults • Heart Failure • Cardio Vascular Disease • Hypertension (High Blood Pressure) • Seen more in African American descent (especially GA population) • Kidney Failure • Beginning at the age of 40, the kidneys decline every year • Diabetes • Older adults become less sensitive to insulin production in their bodies

15. How would common chronic diseases interfere with the healthy diet of an elderly person? (refer to previous information)

16. Other Medical Issues With Older Adults • Vision loss due to old age AND diabetes • Age-related Macular Degeneration • Loss of vision in the center of the vision field • Glaucoma • Vision loss due to improper eye pressure • Cataracts • The lens of the eye becomes opaque (cloudy) and if left untreated it will cause blindness • Retinopathy • When the blood vessels to the retina become damaged

17. Other Medical Issues With Older Adults, Cont. • Memory loss and issues with processing/cognition may make it difficult for older adults to cook or feel comfortable in a kitchen

18. How would medical issues with the eye or the brain affect the nutrition of an elderly person? (refer to previous information)

19. Important Nutrients for Older Adults • Since the body has stopped growing, required calorie intake is about 30% less than Middle Adult years • Many older adults have trouble producing vitamin D • Older adults stay out of the sun or completely cover up when in sunlight • Read labels for Vitamin D fortified products • Calcium is important for osteoporosis prevention

20. Important Nutrients for Older Adults, Cont. • Meat products provide many nutrients • Many older adults do not eat meat products because they are hard to chew and can become lodged in dental work • Important source of iron (needed for blood) • Vitamin B12 • Older adult vegans are at serious risk for deficiency, therefore a supplement may be recommended. • Vitamin B6 • Needed for hemoglobin also helps maintain blood sugar levels • Not as much of a need for protein as before since there is very little growth (tissue building)

21. Important Nutrients for Older Adults, Cont. • Folate (Part of the B Vitamin Family) • Found naturally in foods such as meat, but especially green leafy vegetables • Helps produce and maintain cells; older adults need it to help produce red blood cells and prevent anemia • Zinc • A mineral found in meats • Aids in immune function and wound healing

22. Important Nutrients for Older Adults, Cont. • Water • Water consumption is extremely important for older adults • Many lose the thirst mechanism and do not realize that they are thirsty • Dehydration sets in • This is twice as difficult for the elderly to recover from • Water is needed to lubricate joints which helps with arthritis

23. Important Nutrients for Older Adults, Cont. • Antioxidants should be consumed by eating red, blue and yellow foods (do not rely on supplements) • Vitamins A and C for memory • Lutein for the eyes • Phytochemicals • Disease preventing chemicals found in plants • Green tea for memory and inflammation • Blueberries and plums (also contain antioxidants) • Grapes (also contain antioxidants)

24. Medications for Older Adults • Older adults make up a large part of the total population of prescription medication consumers • Most older adults do not know how to properly take their medications causing overdoses or under doses • Proper medication consultations should be provided to older adults at the pharmacy • Other concerns • Adverse drug reactions • Drug-drug reactions • Drug-nutrient reactions • Labels on meds; can’t read or understand

25. Common Prescriptions • Cardiovascular Drugs • (Common) Lipitor • Decreases LDL (bad cholesterol), triglycerides (VLDL), and reduces fatty deposits…in turn reduces the chance of a stroke and heart attack • (Common) Zocor • Same as Lipitor, but it has a slightly different chemical makeup and it is available in generic forms….saves $ • (Common) Crestor • In addition to lowering LDL, it increases HDL (good cholesterol) which can actually reverse fat deposits • Fatty foods should be avoided while taking this medication

26. Common Prescriptions, Cont. • Blood Thinners • (Common) Coumadin • Blocks Vitamin K cycle, decreases the “stickiness” of platelets • Do not take aspirin, Vitamin E, Garlic, Fish Oils, or Ginko because they will increase the risk of bleeding • Risk of excess bleeding during surgery • Green leafy vegetables contain significant Vitamin K, which will reverse the effects of blood thinners

27. Common Prescriptions, Cont. • Antiarthritics • Prevent/Help with arthritis • Steroids • Stomach upset and GI bleeding, “roid rage”, retaining fluid, and cause a “moon face” (full, swollen face) • Must taper off steroid use so that the body will start producing its own normal level of steroids again

28. Common Prescriptions, Cont. • Antacids • Used to settle stomach/acid reflux • Made from calcium carbonate and are a good source of calcium for people who do not drink milk • Depression Medication • Older versions can cause drowsiness and weight gain • Newer versions can have a quicker onset of action and can decrease weight without causing drowsiness

29. Age Dependent Pharmacokinetics • Absorption • GI system slowing down • Drugs may not work properly when not absorbed properly • Doses may need to be changed and adjusted • Distribution • If a person is overweight, the drugs may stay in the system longer…also doses may not be strong enough • Liver function and liver disease will affect how drugs are processed • Grapefruit interferes with MANY drugs! Check with the pharmacist • Excretion • Kidney failure/loss of a kidney • Drugs will stay in system longer

30. NEW Elderly Medication • Create a NEW medication for the elderly • Include • A hand drawn picture of a medication bottle • Name of medication • Company • Description of medication purpose(s) • Creative information to influence the elderly to buy your medication!

31. Food Assistance Programs for the Elderly • Home delivery services • Meals on Wheels • Senior Centers • Age and county qualifications • Nutritious meals at very low cost or donation • Usually do not deny anyone who qualifies • They can also socialize and leave the house • Farmer’s Markets • Usually have incentives for seniors • Gets them excited again about purchasing fruits/veggies

32. You tell me…. Using what knowledge you know about the elderly and their nutrition, why would they need food assistance programs? List SEVERAL well thought reasons

33. MAGAZINE COVER • Create a magazine cover for an older adult (elderly) magazine • YOU create the magazine title and content • Can be for a male, female or both • Content blips should include: • Importance of Exercise • Chronic Diseases • Common Medications • Important Nutrients for Older Adults • Any other information you wish to include that we covered in class • So……Ideas Could Include: • 88 ways to NOT look 88! • Simple exercises to help prevent Sarcopenia • Hand drawn is a requirement!! You may use only ONE photo or ONE magazine picture