Malnutrition and Older People: - PowerPoint Presentation

Slide1

Malnutrition and Older People:Training Slides

Adapted (with permission) from the ‘Essentials in Care’ module of the E-Learning for Healthcare Programme.

Covering:

What is malnutrition

Common signs and symptoms of malnutrition

Why older people are more at risk of malnutrition

What to do if someone is malnourished

Daily living equipment and technology that can help with preparing meals and eating food

Support in Staffordshire

Malnutrition – The Facts:

Losing weight as we get older is

not

part of the ‘normal ageing process’.

Poor nutrition (malnutrition) could be to blame.

Malnutrition is a serious condition. It is caused by a lack of nutrients in our diet, either due to a poor diet or problems absorbing nutrients from our food.

In the UK,

over a million people

over 65 suffer from malnutrition. Most

of these people live in their own home.

Being malnourished can make medicine less effective. Making it harder to recover from illness.

Malnourished people see their GP more often. They go to hospital more often and stay in hospital for longer.

Signs and symptoms of malnutrition:

Unplanned weight loss (causing clothes, dentures, belts or jewellery to become loose)

Low body weight

Lack of interest in eating or drinking

Tiredness

Muscle weakness (increasing the risk of falls)

Feeling down or feeling like they ‘can’t be bothered’

Getting ill more often and taking longer to recover

Confusion and forgetfulness

Feeling cold and finding it harder to warm up

Why older people are more at risk of malnutrition:

Activity:

Think about the different factors (physical and social) that can make older people more at risk of malnutrition.

Think of some ideas to help address these issues.

Feedback.

Why older people are more at risk of malnutrition:

There are many factors that can make older people more at risk of malnutrition, including:

Reduced appetite

Reduced sense of taste and smell

Gum shrinkage

Dry mouth

Difficulty digesting food

Ability and manual dexterity (moving your hands)

Motivation

These will now be discussed in more detail…

Reduced appetite:

We need less food/energy as we age. Our metabolic rate decreases, so our appetite reduces.

Metabolic rate is the amount of energy our body needs, just to keep us alive and our organs working properly e.g. breathing, digesting food, repairing cells, etc.

People with more muscle tend to have a faster metabolism. This is because

muscle cells

use

more energy

than

fat cells

.

But as we age, we tend to lose muscle and gain fat, which slows our metabolism down and reduces our appetite.

Medication, constipation, pain and feeling ill can also affect appetite.

Top tip:

If someone has a reduced appetite, or feels full easily, then offer drinks

after

meals.

Sense of taste and smell reduce with age:

Between the age of 40 and 50 the number of taste buds we have decreases, and the rest begin to shrink!

After age 60, it becomes harder to distinguish between different tastes e.g. sweet, salty, sour and bitter.

After age 70, our sense of smell begins to fade.

This can change the pleasure we get from food and drink. Food preferences can also change.

Top tip:

Encourage people to try stronger tasting food and drink, or experiment with new ones!

Gums shrink with age:

This can cause dentures to become loose and poorly fitted.

Gums can become sore and ulcerated from the rubbing.

Fruit and veg is often left out as a result.

Top tips:

Encourage people to visit the dentist if they’re having issues.

Encourage the use of dental floss to clean in between teeth.

Switching to an electric toothbrush can help people who have trouble brushing.

Tinned fruit may be easier to eat than fresh fruit.

Dry mouth:

We produce less saliva (spit) as we age.

Many drugs can cause a dry mouth.

Older people may find it more difficult to chew and swallow their food, as saliva is needed to moisten food. Saliva also helps us to digest food.

Top tips:

People can moisten a dry mouth by chewing sugarless gums or sucking on sugarless sweets.

Simply drinking more water can help. Get them to try holding the water in their mouth for a few seconds before they swallow.

Alcohol and drinks high in caffeine can dry out the mouth, so should be drank in moderation. Tobacco is also drying.

Difficulty digesting food:

Common in older age, due to less saliva production and slower metabolic rate.

Top tips:

People should avoid fried, fatty, spicy and very sweet foods. They are more difficult to digest.

Larger meals may be harder to manage. 3-4 smaller meals should be tried instead.

Eating small nutritious snacks in between meals may help to ease acidity and heartburn.

Drinking more water helps us to digest food.

Ability and manual dexterity (moving your hands):

Food choice can be affected by ability:

Does the food need cutting up or scooping?

Can they transfer food from their plate to their mouth easily?

Do they have to rely on someone else to eat?

Do they have a tremor?

Can they hold and use a knife and fork or spoon?

Do they have arthritic hands, wrists or elbows?

Top tips:

Daily living equipment and technology can really help people to stay independent for longer.

E.g. Adding foam tubing to cutlery can make handles easier to grip. High-sided plates can help to reduce spillages when eating one-handed.

Motivation:

Can be affected by: low mood, tiredness, lack of appetite and getting less enjoyment from food.

Some people feel that they ‘can’t be bothered’ cooking for one.

Time: Older people may require longer to eat and can become de-motivated if food becomes cold, or if they are being rushed.

If people have difficulty feeding themselves, they may feel embarrassed eating in front of others.

Top tips:

Daily living equipment and technology can really help people to stay independent for longer.

E.g. Stay warm plates and bowls can help to keep food warmer for longer. Foam tubing on cutlery can help people to eat by themselves, without help.

Nutritional needs of older people:

Although we need less food/energy as we age, o

lder people still need a

nutrient rich diet.

“Older people need so little… but need that little so much”.

For

healthy muscles and bones

, older people need:

-

Calcium:

Makes our bones strong and rigid (which can help to prevent

falls and fractures)

-

Vitamin D:

Helps our bodies to absorb calcium. Older people may have

lower Vitamin D levels due to not getting out into the sunlight as often.

This is particularly true for people who are housebound.

-

Protein:

Important for muscle strength.

What to do if someone is malnourished?

“Make every mouthful matter”

Encourage them to have:

Fortified meals.

High energy snacks.

Fortified milk.

By using the

3, 2, 1 a

pproach to meal planning.

‘Fortified’ means adding extra nutrients to food/drink.

Speak to a GP if you’re concerned about someone being malnourished.

The 3, 2, 1 approach:

Aim for

3

fortified meals

a day

(breakfast, lunch and evening meal)

+

At least

2

high energy snacks

each day

+

Use

1

pint of

fortified milk

a day

3 fortified meals a day:

E.g.

Add

1 tablespoon of grated cheese or cream to potatoes, soups or casseroles.

Add

2 teaspoons of butter to potatoes and vegetables.

Add

full fat mayonnaise or salad cream to sandwich fillings or salads.

Add

fortified milk or cream to porridge and breakfast cereal.

2 high energy snacks a day:

E.g. Cheese with buttered crackers.

Toast with butter and jam/ peanut butter/ chocolate spread/ cheese.

Full fat yoghurt.

Mini pork pie, sausage roll, cocktail sausages, mini scotch egg, quiche.

Nibbles e.g. nuts, crisps, chocolates, sweets, crumpets, teacakes, cheese, biscuits and fruit.

1 pint of fortified milk a day:

Milk is a nutritious drink.

Fortifying milk makes it even more nutritious.

It doubles the goodness, without doubling the amount!

To fortify

, add 4 tablespoons of dried milk powder to a pint of full fat milk. Mix well.

For more information, visit the

‘Malnutrition Treatment’

page of the NHS Website.

Daily living equipment and technology to help with preparing meals and eating food:Daily living equipment and technology can help people to keep their independence.

There are lots of affordable products out there that can really help.

Some things can even be bought from supermarkets or high street shops.

Staffordshire County Council’s

‘Happy at Home’

webpage gives information on daily living equipment and technology. On the ‘Interactive House’, click on the ‘Kitchen’, which includes a section on ‘Food preparation’.

Examples of daily living equipment and technology to help with preparing meals and eating food:

Automatic can openers

Bottle/jar openers

Foam

tubing (placed

on cutlery) for easier gripping

Non-slip trays, non-slip tray liners, and trays with carry handles (to carry food safely)

Talking tins (voice recording of what’s in tins)

Non-slip table mats

Peelers and graters with extra grip

Trolleys (to move food and drink)

Slip resistant grips for knives

Lightweight saucepans

Talking/large screen display kitchen scales and measuring jugs

Wire mesh baskets to place in saucepans (so don’t need to lift heavy pans full of boiling water)

Chopping boards/ spreading boards (helps with buttering bread) and work stations that hold food in place

Bowls and plates with high sides/plate guards (easier to eat one handed, provides a ‘wall’ to push food against, reduces spillages)

Stay warm plates and bowls (keeps food warmer for longer)

Angled cutlery (helps if restricted movement at shoulder, elbow or wrist)

Support in Staffordshire:Everyone Health Staffordshire:Provide free support with: Falls Prevention, Physical Activity, Stopping Smoking, Social Isolation and Loneliness, Weight Management and NHS Health Checks.

Some restrictions apply.

Visit the

Everyone Health

website for more information,

or call: 0333 005 0095.