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Nutrition Challenges of the Dementia Patient.

Nutrition Challenges of the Dementia Patient. Nutrition Challenges of the Dementia Patient. Why is this topic important Nutrition Challenges of the aging adult The added challenges with the dx . of dementia Recommendations What is the “state” looking for Hot research topics.

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Nutrition Challenges of the Dementia Patient.

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  1. Nutrition Challenges of the Dementia Patient.

  2. Nutrition Challenges of the Dementia Patient • Why is this topic important • Nutrition Challenges of the aging adult • The added challenges with the dx. of dementia • Recommendations • What is the “state” looking for • Hot research topics

  3. Why is this topic important? • Changes in nutritional requirements • Changes in caloric needs • Vitamin D, B12,B6 and calcium • The population is growing

  4. Nutritional challenges of the aging adult • Cytokine • Sarcopenia • Decreased saliva production • Changes in dentition • Absorption • Peristalsis slows down • Vision loss • Incontinence • Diminished taste and smell • Social isolation/ loneliness • Sedentary lifestyle • Depression • Poverty/ decreased income • Medications

  5. Added challenges with the dx. of dementia. Stages of dementia • Stage 1: No impairment • Stage 2: Very mild decline • Stage 3: Mild decline • Stage 4: Moderate decline • Stage 5 Moderately severe decline • Stage 6: Severe decline • Stage 7: Very severe decline

  6. Added challenges with the dx. of dementia. • Increased agitation or restlessness • Inability to verbally communicate • Problems visually distinguishing between food, plates and other items on the table. • Loose ability to use utensils, condiments, etc. • Unable to recognize food as something to eat. • Confusion about meal times and/or ifthey have already eaten.

  7. Added challenges with the dx. of dementia. • Increased problems dealing with distractions -Too many people -Too much clutter -Incorrect lighting -Feels rushed • Loss of brain signals • Activity level (high or low) • Spatial awareness • Overeating • Paranoid thoughts • Hoarding

  8. Recommendations • Medical and dental exams prn • Artificial saliva • Medication reviews • Evaluate the full person

  9. Recommendations • Make sure the resident’s glasses are clean • Visually distinguish items at the table and review the plate • Talk “meal time” up • Omit unnecessary utensils and codimets • Give one food item at a time • Provide finger food • Provide foods in mugs • 6 small meals • Provide nutrient dense foods

  10. Recommendations • Adjust consistency • Use step-by-step instructions • Use hand over hand feeding • Proper positioning • Encourage self feeding ( even if they are messy) • Reapproach • Instead of the normal clothing protector use an apron they like • Try to make food moist • Post meal times

  11. Recommendations • Turn off the radio or TV • Provide calm unhurried atmosphere • Avoid loud and abrupt movements • Be conscience of other’s behaviors • Make sure lighting is adequate • Encourage family to bring in favorite foods • Music and books prior to meals

  12. It is important to remember that a person with dementia is still an adult. They are not trying to be difficult. The resident often can not help a behavior and changes are not personal. What works one day may not work the next.

  13. What is the “state” looking for? • Small frequent meal • Noting wishes stated on MOLST • Encouraging not forcing • List of avenues tried • Feeding assistance • Maintaining food temps • Reassessment of nutritional needs • Changes in chewing and swallowing ability • Adaptive equipment • Attentiveness to meals

  14. Hot Research Topics • Could a “brain pacemaker” work for people with Alzheimer’s • Effect of high carbohydrate diets • Correlations between insulin resistance in the brain and early Alzheimer’s. • Could microwave popcorn cause Alzheimer’s • Alcohol – Bad for the brain?

  15. Hot Research Topics • More women than men have Alzheimer’s: Could it be in our genes? • Can vitamins ward off Dementia? • Benefit in longer term use of Aricept? • Skin cancer drug shows possible benefit in Alzheimer’s. • Can coconut oil treat Alzheimer’s? • Is eating fish still good for your brain?

  16. References Allard J, Current Opinion in Clinical nutrition & Metabloic Care: (2001)Vol 4 Issue 4 , pp 293-294, Nutritional status and the elderly: the challenge ahead. Alzheimer’s Association (2012) Seven stages of Alzheimer’s. www.alz.org Alzheimer’s Society (2011) Food for Thought. www.alsheimers.org.uk Amella,E.J. (2007). Assessing nutrition in older adults. Try this: Best Practices in Nursing Care to Older Adults. Retrieved form www.hartfordig.org/publications/trythis/issue_9.pdf. Morley JE,Silver AJ. Nutritioal issues in nursing home care. Ann Inern Med 1995:123:850-859 Russell R, The Joural of Nutrition Vol131 no.4 2001. Factors in Aging that effect the Bioavailability of Nutrients. Zagaria M, U.S. Pharmacist 2010: Nutrition in the Elderly

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