"Quality_Answers Only"

Malnutrition in the Elderly

Student Name

Word Count

Instructor

School

Date

Abstract

In spite of several programs, goals, and plans, malnutrition among the elderly remains a significant problem in the United States today. An estimated 25% of the general elderly population is suffering from malnutrition. Without intervention, this problem will only worsen. The elderly population in the United States is estimated to grow dramatically over the next several years. By 2030, it is estimated that approximately 20% of the U.S. population will be 65 years old or older. This growth will result in many more individuals needing proper nutritional care. As such, action must be taken by government, communities, and organizations (e.g. hospitals and nursing homes) to meet the needs of this vulnerable population.

Malnutrition in the Elderly

Background

The elderly are defined as individuals aged 65 and older.1

The elderly are part of every demographic and are present in all regions: urban, suburban, and rural.1-12

Currently, the elderly represent about 12% of the U.S. population.1, 3, 6

The elderly population is expected to grow to over 72 million people by 2030 – representing nearly 20% of the U.S. population.1

This growth could present serious challenges for social services.2

Issue

Malnutrition is defined as the condition that results when the body does not receive the proper amount or balance of nutrients.8

The majority of malnutrition related deaths in the United States occur among the elderly.3

Malnutrition prevalence among the elderly varies.

Among independent and healthy individuals the prevalence is approximately 1%.3-7, 12

The estimated prevalence among the general elderly population as a whole is 25%.3-7 ,12

The prevalence drastically increases among elderly individuals that are hospitalized or that reside in nursing homes to as high as 55 and 85% respectively.3-12

Malnutrition has many clinical manifestations2-12:

Undesired weight loss

Organ failure

Mental impairment

Wasting

Chronic illness

Death.

Malnutrition results in longer hospitalization stays or chronic issues that drive up healthcare costs.3, 5-7

Causes

Lack of access to food.2-7, 12

Many elderly people live near or below the poverty level, and cannot afford to purchase healthy foods.2-7, 12

Many elderly lack the transportation resources to acquire food.2-7, 12

Many elderly individuals struggle with social isolation, and as such, do not have a social support system that can help provide them with food.2-7, 12

Inadequate or unbalanced diet.2-12

Many individuals lack the proper nutritional knowledge to maintain healthy diets as they age.2, 3, 6

The aging process alters a person’s ability to taste and smell food. As such, elderly individuals may have a reduced interest in eating, or may be repulsed by certain foods.2, 3, 6

A lack of staffing and nutrition management programs within hospitals and nursing homes often cause elderly hospital patients or nursing home residents to receive inadequate food intake.7, 9

Often, the catering service for a hospital or nursing home does not interact with a dietician or nutritionist, thereby missing opportunities for valuable nutritional input.7, 9, 13

Medical conditions

Some elderly individuals may suffer from digestive disorders that prevent the adequate absorption of nutrients from food.2-12

The various medications that many elderly people are required to take often interfere with appetite and proper digestion of food.2-12

Elderly individuals suffering from mental health issues such as depression or dementia have a lack of appetite.2-12

Recommendations

Federal Programs

Increase support and funding for programs such as the Older Americans Act Nutrition Program in order to1, 2:

Increase the number of meal delivery organizations

Decrease the size of the waiting list for meal delivery.

Increase access to healthy foods via coupons, vouchers, etc.

Restructure the work force to7, 9, 13:

Employ more registered dieticians and nutritionists

Provide proper training to regular staff.

Include cultural training for working with older populations.

Utilize more home-based screening programs to identify malnutrition cases.1, 2

Utilize home-based nutrition therapeutic services after identification.1, 2, 3

Communities and Incentives

Develop financial incentives for schools, churches, and community centers to develop volunteer programs.

Encourage partnerships between existing nutritional programs and community organizations.

Education

Provide training for the elderly and their families or caretakers regarding2:

Understanding various nutritional needs throughout aging process.

Utilizing the proper foods to maintain a balanced diet

Identifying the warning signs of malnutrition.

Provide training for hospital staff regarding7, 9, 11, 13:

Proper procedures for obtaining nutrition history

Nutrition management skills (e.g. removing inhibiting foods or items from diet, use flavor enhancers, etc.)

Identifying the warning signs of malnutrition.

Organizational Efficiency

Ensure that the cooperation of staff, nurses, doctors, and dieticians, in nutrition management planning becomes the standard procedure in hospitals and nursing homes.7, 9, 13

Develop more effective procedures for identifying malnutrition among patients.1, 2

Facilitate the coordination between the dietician or nutritionist and the catering services.7, 9, 11

Potential Unintended Consequences

Positive:

Improved family relationships.

Job creation.

More efficient healthcare system.

Negative:

Higher taxes for the public.

Increased unnecessary dependency of the elderly on external assistance.

Increased burden on hospital patients from new procedures and tests.

Increased costs (healthcare, transportation, administrative).

Ease of Implementation

Governmental Barriers:

Lack of effective lobbying for the elderly.2

Reduced funding for programs.2

Increases in regulations.

Changes to the laws protecting the elderly.2

Cultural Barriers:

Community:

Desire for independence.

Distrust of government.

Lack of interest in the issue.

Organizational:

Hospital and nursing home workplace environment that are resistant to change.

Staff, physicians, dieticians, etc. avoiding cooperation.

Logistical Barriers:

Lack of qualified staff.13

Lack of communication between various hospital/nursing home departments.

Increasing complications due to health insurance, Medicare, and Medicaid changes.

Elderly individuals without insurance or struggling to meet payment requirements.2

Biblical Applications14

Leviticus 19:32 - “You shall stand up before the gray head and honor the face of an old man, and you shall fear your God: I am the Lord.”

The Lord commands us to hold the elderly in a position of honor.

We must strive to assist them in maintaining their dignity, health, and social integration as they age.

Luke 3:11 – “…Whoever has two tunics is to share with him who has none, and whoever has food is to do likewise.”

Items such as food and clothing are a basic necessity.

No one should lack these items.

As followers of Christ, we must look for opportunities to share with those who are in need, including the elderly.

Isaiah 1:17 – “Learn to do good; seek justice, correct oppression; bring justice to the fatherless, plead the widow's cause.”

This verse directs us to stand up for those who do not have a voice.

Often the elderly are not in a position to voice their needs. We must take up their cause and support their needs.

1 John 3: 16-18 – “By this we know love that he laid down his life for us, and we ought to lay down our lives for the brothers. But if anyone has the world's goods and sees his brother in need, yet closes his heart against him, how does God's love abide in him? Little children, let us not love in word or talk but in deed and in truth.”

Jesus Christ is the perfect model of love, and as Christians, we must seek to emulate Him.

Our love should be selfless, sacrificial, and drive us to action.

The world will judge us by our love for people.

References