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Seniors Living Dangerously at Home

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Seniors Living Dangerously…

It is no secret that most seniors want to stay in their homes for the duration of their lives. Although this may be a good idea for some, it is a bad idea for others. Every week I hear a story that boggles my mind. Just recently I heard the story of prescription theft by neighbor.

Prescription Thief Story…

Jan is 83 and her neighbor next door has helped her carry groceries in her home. This one day, he notices that Jan just got her prescriptions refilled. As he is helping Jan bring in the groceries, he steals her whole bag of prescriptions while Jan was not looking. Jan was traumatized and in pain because her pain medication was stolen.  She told me no longer fell safe in her home.

Basement Squatter Story…

Last month I heard another story of a squatter. John is an 87 year old man. His knees hurt him so he avoids stairs. Because of the stairs, John does not go down to his basement. It turns out that a squatter broke into John’s basement through the window and was living there. The squatter was discovered by John’s daughter who heard noises coming from the basement. John did not hear those noises because he is hard of hearing. When she went down to John’s basement she found a squatter was living there. The basement was trashed, and John’s tools were missing. When police came, they found illegal drugs,  and used needles all over the basement, along with a fire arm.

Question is: Are You Living Dangerously at Home?

Poisoning..

I recently came across some very disturbing statistics while taking a safety class. Did you know that more than 14% of all deaths reported to Poison Centers each year are in persons over 60 years of age. Most of these are from unintentional exposures to medications or household chemicals. One would think that it is young kids that are most prone to ingesting toxic chemicals, however older adults are also at risk. Many seniors have at least some dementia and many experience some loss of vision. These are two of the most common conditions that put the elderly at risk for severe or fatal poisoning.

Falls…

Among older adults over 65, falls are the leading cause of injury death. Falls can result in sprains, fractures, hip fracture, or head injury. As we age, our bones become more brittle. Even a minor fall can result in a broken bone. Frail seniors should avoid stairs, uneven payment, uphill, and downhill walk ways, dark hallways. Climbing the stairs in your home becomes a dangerous and risky en devour for many. In many cases the fall results in a fracture, and could have been avoided.

Mixing Up Medications…

Seniors living at home manage their own medication. Missing a dose, or taking a duplicate dose is easy to do for anyone, however this is particularly detrimental to the elderly. Even one missed dose can result in dizziness and cause a fall. Many seniors suffer vision loss and it is difficult for them to see if they dropped a pill, which inadvertently can cause a missed dose and a setback.

Nutrition…

Poor Nutrition can easily become a problem when a senior lives alone. There is no one to prepare meals, which often results in seniors skipping meals, eating snacks, or high sodium processed foods. Once seniors consistently cut back on meals due to the hassle, their appetite decrease which often leads to severe weight loss, under nutrition, or malnutrition.

Living Dangerously

Living Dangerously

Crime..

We know that unfortunately many criminals target the elderly for a variety of crimes. Thieves are more likely to target an elderly person living alone for a variety of scams and crimes. Seniors living alone are targeted at higher rates by criminals, because the elderly are considered easy targets. People 60 and over are almost 30% of all fraud complaints, the most of any age group. Aside students, the elderly are the most likely to get burglarized. The elderly are targeted not only for material possessions, but also their prescription drugs.

The Takeaway…

Although some seniors are able to safely stay in their home, others are not. I hope this article gives seniors and their families something to think about. Many of the stories I hear are very avoidable, and cause the seniors immense stress and trauma.

Can You Design a One Stop Shop Assisted Living Building?

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Is it Possible to Design an Assisted Living Building to be a One Stop Shop?

The answer is yes, it is possible in theory, however the better question is, can a one stop shop design offer the best quality of life to most of the residents? I would venture to say no, because to design a community to fit your resident’s needs, you have a clear picture of who your resident will be, and design for their needs and preferences.

Who Lives in a One Stop Shop Design Building?

 

Many Assisted Living Communities attempt to be home, for a wide range of seniors, with a wide range of needs. This spectrum includes seniors with no to early mild dementia and no care needs, seniors that require ADL assistance ranging from standby to full assistance, as well as seniors in the late mild to late moderate dementia. Although these communities can market to a broader senior population, are all their residents getting the most of their community? Let’s break the spectrum into 4 groups of seniors and explore this further.

The Design Element of a One Stop Shop. Let’s Break It Down.

I am listing just a few of the preferences as well as needs, for each of the four groups, that a one stop shop building will need to accommodate.

Group 1 (independent senior that still drives some)

  • Large floor plans, full kitchens (this group has no care costs to incur now)
  • Multiple Dining Venues such as a bistro where you can get a sandwich (so they can come and go without missing a meal)
  • Flexible Dining Times
  • A Bar for Happy Hour
  • Computer Classes
  • Lots of Exercise Classes such as dancing and yoga, an Exercise Facility with exercise bikes
  • Lots of different community amenities throughout- completely fine with a multi-story building, if it means more amenities

Group 2 (needs stand by ADL assistance)

  • Less expensive smaller floor plans options (this group is incurring some care costs)
  • Transportation offered by the community
  • Exercise Classes such as chair exercises
  • Multiple Dining Venues
  • Amenities and Activities near their own living quarters

Group 3 (Seniors who need hands on ADL assistance)

  • Less expensive smaller floor plans options (this group incurring the most care costs)
  • Visiting medical professionals (limited mobility makes traveling difficult)
  • Amenities very near to living quarters, as well as mobile amenities that can come to them
  • Amenity areas they can use- this group can no longer enjoy an exercise bike, or a pool

Group 4 (Senior with late Mild-Moderate Dementia)

  • Smaller floor plans to minimize confusion. Also incurring care costs at this level
  • Set meal times in one place (we know structure is key to those with dementia)
  • This one dining area should be fairly close to living quarters to minimize confusion
  • Dementia friendly amenity areas such as a multi-purpose activity room (computer lab or a library are no longer an important amenity for many of these residents. Many of these residents are no longer able to drink so a bar is not important)
  • Visiting medical professionals
  • Smaller building design to lessen the confusion. (this group can no longer safely navigate a large building and find spread out amenity areas)

Is There Some Overlap with Needs and Preferences between Some of the Groups?

Although some of the needs and preference to overlap, there becomes a point that the preference of one group of seniors are the opposite of the preferences/needs of another group of seniors.  Group 1 wants active, spread out amenities, in and outside the community. They want to do these activities in amenity areas through out the building. Group 2’s preferences do somewhat overlap with group 1. However, when you get to group 3 and 4, you notice no overlapping, but on the contrary conflicting needs and preferences. Another area where needs and preferences come to a head for the 4 groups is dining. Group 1 wants flexible dining times and multiple venues. Group 2 may also use these, but when you get to group 3, who is not able to get to these venues without assistance that preference diminishes. In many cases group 3 needs assistance with dining, such as making sure their foods are cut up, salad dressing is open, so a grab and go bistro is no longer a needed amenity. When you get to group 4, you notice a conflicting need with groups 1 and 2.  Group 4 likes to eat at the same time, in the same place, with the same people for the most part. Also notice that the amenity preferences decrease as the care needs increase.  Group 1 are the most active seniors, who also have the most amenity preferences.

 

The Take Away..

There are many areas where design needs and preferences overlap for some groups. They overlap for groups with similar physical and cognitive deficits. Group 1 had some similar preferences as group 2, but very few if any of the same preferences of group 3 and 4. Also once you got to Group 3 and 4, some of the preferences turn into needs due to physical and cognitive deficits.

One building can be designed for a spectrum of needs, but when that spectrum gets too large, some group will be left out from enjoying the entire community. Although it is easier to lease up a building with a larger pool of prospects, it is very difficult to cost effectively design a space that meets such a large spectrum of needs. The design element of a one stop shop is difficult to manage, although this element is a piece of cake compared to the care and engagement piece. It is almost impossible to provide care and engagement in a one stop shop community, and to do it well for everyone.

Visit http://stage-osl.daveminotti.com/category/blog/ to view future posts about providing care and engage00001196852_awment in a one stop shop building.

Creating an Enabling Environment is Key to Providing Dementia Care

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How does Dementia effect a person’s ability to enjoy their hobbies and participate in activities?

Dementia gets worse over time. Although symptoms vary, the first problem many people notice is forgetfulness severe enough to affect their ability to function on a daily basis and to enjoy hobbies. One example is playing cards. A person with dementia will likely begin to forget the rules of a card game they have played their whole life. They may mess up during the game, which will usually cause them to avoid a card game they have played their whole lives all together. Aside from general forgetfulness, people with dementia often find that they lack the motivation to do anything. This loss of motivation can be attributed to general apathy or that certain activities have no value if they cannot be carried out as before.  Repeated difficulty doing hobbies that used to be easy is also a painful reminder of the progression of the disease. Lastly but in my opinion most importantly, there is the issue of personal pride which causes masking, which is not wanting to show others that one cannot do something well or is forgetful. Even those who carry on with their usual activities sometimes lack the motivation or the incentive to get started due to the brain changes that come along with dementia. Family members often find it difficult to deal with apathy, particularly if the person with dementia has always been a fairly active person. In order to understand how Dementia and apathy are related, please visit my previous blog post http://stage-osl.daveminotti.com/apathy-is-a-main-the-road-block-of-dementia-care-at-home/
What does creating an enabling environment for a person with Dementia mean?
The first step is to know what type of activities or hobbies a person enjoyed prior to the dementia.  Activities that are related to or connected with past hobbies are often easily accomplished as they bring a sense of familiarity. The second step is to align the type of activity to the stage of dementia. Over simplifying activities for someone with more capabilities is just as detrimental as not simplifying them at all.
Real Life Example: Lets take a puzzle activity. You are working with Jane who has mild dementia, who loves puzzles, and has done them all of her life. You present Jane with a 25 piece puzzle. She finishes it quickly and wonders why you brought her such a “child like” puzzle. This further effects Jane’s self esteem and reminds her that the world notices her cognitive deficits and has started treating her as a child. On the other hand you are working with John, who has moderate dementia, who also loved puzzles. You bring John a 200 piece puzzle. He struggles and struggles with it and after 10 minutes give up in frustration. The solution would have been to give the Jane the 200 piece puzzle and to give John the 25 piece.
What if you are working with a new person and are not sure of their current abilities?
Lets take the above example of Jane and John and puzzles. If you are not sure of their abilities you bring several puzzles to both. In Jane’s case, if you see her quickly putting it together, you tell her that she is doing a great job, and that you knew that puzzle was too easy, and that you brought another one and put the 200 piece in front of her. In John’s case, as soon as you notice that he is struggling you tell him that it appears that there are pieces missing from that puzzle, and you have one for him that has all the pieces, at which point you take out the 25 piece puzzle. It is very important to say that there is something wrong with the puzzle so that John does not feel that you changed puzzles because he could not do the first one.
What is another example of creating an enabling environment?
Choosing a simplified version of an activity, or an easier game or version are also ways of creating an enabling environment. Simplifying an activity or a game by removing some of the steps.
Real life example: Jenn used to be a chef and has cooked her whole life. She has given up cooking on her own but loves to participate in cooking activities. Jenn is in the moderate state of dementia.  You have a cookie recipe that makes cookies from scratch by first making dough and then baking the dough. In order to enable the environment for Jane, you take that same recipe but you remove the more difficult steps such as those steps where the dough is made and you start with the dough being in front of Jenn.  You have now created a simplified version of a hobby that Jenn can do and she will get the same final cookie as she would have if the cookie was made from scratch.
Many do not realize that time awareness is part of an enabling environment but it is..
Many people with dementia loose track of time in general. They also have trouble remembering appointments as well as at what time activities take place. Because they start forgetting and missing activities and appointments, many times they stop attempting to go to any of these appointments or activities. To create an enabling environment, you must take the remembering out of their minds. Instead of telling them in advance, scheduling future events or appointments, you tell them in the moment right before the appointment or activity. You also reassure them, that you will get them for the each activity, not because they will forget, but because you want to. This will take the stress of remembering out of the equation and help foster more participation in hobbies and activities.
1503696303319The Take Away…
Creating an enabling environment takes on many forms. Some of these forms are tangible activities and some are communication styles. It is important to know that creating an enabling environment is not a skill that most people naturally have. It is not a skill that you make up as you go. It is imperative to surround a person with dementia with those who understand dementia, and have received specialized training and have experience with things such as creating an enabling environment and communicating with a person with dementia. Continuing dementia education is a great way to learn the skills to engage a person with dementia. Join us at the Orchard at Tucker, 2060 Idlewood Rd, Tucker GA 30084 on Thursday, January 4th at 6:00 pm for our monthly Live & Learn Dementia Education Forum. For more information call 404-775-0488 or download http://stage-osl.daveminotti.com/wp-content/uploads/2017/12/Live-Learn-Dementia-Educational-Forum.pdf

Final Stages of Nutrition Therapy Development for Dementia Residents

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What is Nutrition Therapy and who can benefit from it?

Eating and enjoying a meal is part of our everyday life and important to everybody, not least to people living with dementia. A healthy diet and nutrition is fundamental to well being at any stage of life and to helping to combat other life-threatening diseases. We believe it plays as important a role in relation to dementia progression, and a resident’s quality of life. Under-nutrition is common among older people generally, particularly common among people with dementia. Under nutrition tends to be progressive, with weight loss often preceding the onset of dementia and then increasing in pace as the disease progresses. The mechanisms underlying weight loss and under nutrition in dementia are complex, multi factorial, and unique to each person. Common reasons include reduced appetite, increased activity, the need for a modified diet and, decreased nutrient absorption. For some forms of dementia, it may be that central regulation of appetite and metabolism is disturbed as an inherent feature of the disease. Although we can’t avoid these symptoms which lead to malnutrition and under nutrition, we can manage them with a variety of Nutrition Therapy Options. Orchard at Tucker’s Nutrition Therapy Program is designed to help combat under nutrition and bring back the joy of eating to those who have lost it.

We are in the Final Testing Stages..

After many months of work with our team and partnering dieticians, Orchard Senior Living is in the Final Testing Stage of our 4 Part Nutrition Therapy Program.  Today’s enriched smoothies were a huge hit. These enriched smoothies are designed to help those in the moderate to severe stage of dementia, who have lost significant weight in the last 6 months, and for whom all other care and environmental modifications have failed.  Each 4 oz pretty glass delivered 240 calories, 9 grams of Organic Protein, and so much more. Most importantly each glass looked and tasted amazing!picc (2)

Orchard at Tucker’s Nutrition Therapy Program Coming in nt22018..

Elevated Emotions Even Without Memory while Living with Dementia

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Which last longer for those with Dementia or Alzheimer’s Disease? Memories or Emotion?

Have you seen long lasting emotions in a loved one with Dementia or Alzheimer’s after the memory causing the feelings have faded? I have on many occasions. Although I have seen it live on so many occasions, there is now science behind it. It’s no surprise that people with Alzheimer’00000s have trouble recalling memories. It is, after all, the hallmark symptom of the disease. However, a new study has found that events can have a longer term and profound effect on how they feel even if they do not remember the particular event.

The Study..

A new University of Iowa study further supports an inescapable message: caregivers have a profound influence—good or bad—on the emotional state of individuals with Alzheimer’s disease. They may not remember a recent visit by a loved one or having been neglected by a loved one, but those actions can have a lasting impact on how they feel. University of Iowa researchers also showed individuals with Alzheimer’s disease clips of sad and happy movies. The patients experienced sustained states of sadness and happiness despite not being able to remember the movies.

The Emotional Life of those with Dementia and Alzheimer’s Disease….

These studies confirm that the emotional life of those with dementia and Alzheimer’s disease last far beyond the tangible memory of an event, regardless if the event was good or bad. “This confirms that the emotional life of an Alzheimer’s patient is alive and well,” says lead author Edmarie Guzmán-Vélez, a doctoral student in clinical psychology, a Dean’s Graduate Research Fellow, and a National Science Foundation Graduate Research Fellow.

The Take Away…

Despite the considerable amount of research aimed at finding new treatments for Alzheimer’s, no drug has succeeded at either preventing or substantially influencing the disease’s progression. Against this foreboding backdrop, the results of this study highlight the need to implement new care giving techniques and care models aimed at improving the well-being and minimizing the suffering for the millions of individuals afflicted with Alzheimer’s. These studies prove that traditional thinking about the emotional life of someone with Dementia and Alzheimer’s Disease is lacking immensely. Traditional thinking still tries to convince people that if they don’t remember it does not matter. At the Orchard at Tucker, we feel it Not Only Matters, but it Matters More. Although these studies are wonderful, we see the importance of emotion based care each and everyday by watching our residents.

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Preference Centered Therapeutic Diets in Dementia & Alzheimer’s Care

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puree5What is a Therapeutic Diet?

A therapeutic diet is a diet that controls the intake of certain foods, liquids or nutrients. It is part of the treatment of a medical condition and are usually prescribed by a physician and planned by a dietician or a nutrition specialist. A therapeutic diet is usually a modification of a regular diet with items added or subtracted from a diet. Therapeutic Diet is modified or tailored to fit the nutrition needs of a particular person.
Types of Therapeutic Diets? There are many more than listed below..
  • Nutrient Modification Diets such as renal diet, low salt diet, diabetic diet
  • Texture Modification Diets such as puree diet, mechanical soft diet, liquid diet
  • Food Allergy or Food Avoidance Diet such as gluten free or lactose free diet
  • Supplemental Diet where additional supplements or fortification is added

What is a Preference Centered Therapeutic Diet?

A diet that takes into account the resident’s clinical condition or limitations, in conjunction with personal  preferences, when there is a nutritional indication. It is designed based upon resident’s preferences and desires for their quality of life. Residents goals are also at the center of a preference centered diet. Residents must be provided with all of their nutritional options, detailed description of the need for therapeutic diets, and the consequences and risks associated with not following the recommended diet. A resident needs to be provided with every alternative available, as well as the recommended time frame for the diet.

Examples of a Preference Centered Therapeutic Diet?

Example 1.

Dan has been exhibiting chocking during his meals following his stoke. He has undergone a full evaluation by his doctor and speech therapist who both deemed Dan has dysphagia. Following this diagnosis Dan was prescribed a puree diet. His care partners then started turning his usual meals into puree form. Dan was presented with pureed steak, carrots, pork, and other foods he used to enjoy before the diet restriction. Dan has not enjoyed those pureed meals and has lost 20 pounds in one month. One of the care partners noticed that Dan will eat puree items that naturally come in puree form such as mashed potatoes, smoothies, yogurts and puddings. After these observations, a nutrition specialist created a menu for Dan that includes only puree items in their natural form. Additional flavors of mashed potatoes and yogurt along with other naturally puree foods were ordered in order to fill up Dan’s week with a healthy diet with a variety of choices.

Example 2.

Angie has heart disease. After an examination, Angie’s doctor placed her on a salt restricted diet. Following these orders, Angie has refused to eat most foods and lost 15 pounds. She complained that her food tasted bland and she did not want it. Angie’s care partners contacted her doctor and explained the dilemma and requested that the doctor look into liberalizing Angie’s diet. Angie was also explained in detail the risks and consequences of putting salt back into her diet with her current heart disease. Knowing all the risks, Angie deemed that at 90 years old her Goal was not prolonging longevity, but having the best quality of life. It was her preference to add salt back to her diet, understanding the risks. Her doctor felt that Angie and her family understood the risks and liberalized her salt intake. Angie gained 10 pounds the following month. She was able to enjoy her food again.

The Take Away..

Although therapeutic diets are sometimes necessary and beneficial to a resident’s health, a preference centered therapeutic diet just enhances the benefits buy focusing on the residents’ goals, desires, preferences, along with their nutritional needs and doctor’s orders. All five components work together to create a therapeutic diet that is beneficial to residents’ health yet minimally negatively impacts their desires and quality of life.

The Subtle Signs of Swallowing Problems for Those with Dementia and Other Diseases

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How does swallowing actually occur?

The oral phase of swallowing requires a complex interplay of chewing, food bolus formation, and push of the bolus to the back of the throat for the process of swallowing and movement to the esophagus and stomach. Multiple facial and oral muscles, such as the tongue, are responsible for this phase. Once the food bolus is to the back of the throat a series of muscular contractions occur to move the bolus into the esophagus and away from the airway. The airway is temporarily closed as the food bolus is pushed past the tracheal opening and into the esophagus. The food bolus then makes its way to the stomach through another series of coordinated muscular contractions within the esophagus.

Sounds Complicated Right? It is and lots can go wrong..

Due to the complexity of the swallow mechanism, a multitude of problems that can arise. The most common cause of oral dysphagia (swallowing trouble) is stroke, with up to 45 percent of stroke patients develop swallowing problems following the stroke. Other neurological diseases such as Parkinson’s disease, Multiple Sclerosis, Dementia, and Alzheimer’s disease are known to cause swallowing difficulties. Lesions, re flux conditions, and cancer have also caused swallowing troubles but to a lesser extent.

There are obvious and less obvious signs of swallowing difficulties…

Everyone knows that if a person coughs up food or gags while eating, they likely have swallowing troubles. However there are other more subtle signs that can go easily unnoticed such as long breaks between bites, being horse, drooling, frequent heartburn,  and acid re-flux.

What can happen if these subtle signs are ignored?

If subtle signs are ignored they can result in choking, where food partially or fully obstructs a person’s airway, aspiration or inhalation of food or liquids, oral secretions or gastric secretions into the airway and lungs. Also gastric secretions may be inhaled without bacteria causing aspiration pneumonia. A person may aspirate not only food or fluids that are introduced into the mouth but also their own saliva or any gastric secretions, which may be re-fluxed into the airway.

What can be done?

In a community setting, all care partners must be trained to carefully observe each resident for not blatant signs such as chocking, but for the subtle signs such as drooling, and long pauses and usually get confused for something other than swallowing challenges. When a person lives alone, the signs of swallowing trouble usually go ignored until they end up in the hospital. In many setting, little attention is paid to dining room observation. Orchard at Tucker understands the importance of monitoring these subtle symptoms and finding the problem while it is minor,Nutella-Stuffed-French-Toast-with-Strawberries and before it causes a resident irreversible harm.

Transition Care Giving is Essential in Dementia Care

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Transition and change in general is hard on everyone…

Have you ever moved into a new house? Started a new job? If you answered yes than you can recall your first week.  Do you recall how stressed out you were with the change? Change of location, change of routine is hard on everyone, however having Dementia and Alzheimer’s makes change about 10 times harder.

Transitioning While Having Dementia? About as Hard as Sky Diving While Being Afraid of Heights..

Dealing with an aging loved one that has dementia or Alzheimer’s can be very stressful, especially when it is time to move that senior into an Assisted Living or Memory Care Community. Many families see how important a familiar environment is to their loved one. Being in a familiar place with a familiar daily routine is something that many with Dementia come to rely on. Families worry about the stress that can happen with their loved one during the transition. Stress is escalated in seniors whose cognitive capacity is limited by their Dementia or Alzheimer’s disease. This is a very real fear. Depending on the progression of disease, changes can be very upsetting and disruptive to the patient. Seniors suffering with progressive degenerative brain disease cannot frame their fears and anxiety with logic, as the rest of us can.  A change in environment can often cause tremendous stress for the senior.

What is Transitional Care?

A private duty caregiver meets the senior prior to the move into a community and accompanies them to the community. The caregiver than spends between 4-12 hours each day for 3-14 days with the senior. They accompany them to activities and trips. The caregiver helps a senior learn their new environment. The caregiver stays with the resident for the scheduled hours. The caregiver is there at arm’s length if a senior gets anxious, confused, or stressed out. The amount of hours and days of transitional care depends on the seniors’ cognitive level,  as well as their stress and anxiety threshold.

Why is Transitional Care Important?

Many seniors whose cognitive abilities are hampered by Dementia and Alzheimer’s, have heightened levels of anxiety. They also experience higher levels of stress in many situations. They also retain less new information, which makes change this much harder. The transitional care giver is there to help lessen the stress of transition by being there with the senior to guide them one on one. Once the senior is settled in their new home, the caregiver remains a part of their care plan until they have become accustomed to their new surroundings.  A transitional care taker may start out by spending 12 hours with the senior for the first 3 days. After the 3 days, they spend 8 hours for the next 4 days. After the first 7 days, the hours go to 4 hours for the next 3 days. After that the hours go to 4 hours a week. Each senior is different, however it is recommended that transitional care giver hours get cut slowly based on the seniors’ needs. It usually takes about 30 days to get adjusted to a new community and getting a transitional caregiver involved softens that blow.

Do Communities Offer Transitional Care?

Some corporate giants like Brookdale do have their own agencies. Most smaller companies partner with an agency so that transitional care is provided by a caregiver that is not employed by the company. Orchard Senior Living now has a sister company Peach Home Care which provides transitional caregivers and private duty caregivers to residents.

Dementia Care Combined with Comprehensive Nutrition Care

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What is Comprehensive Nutrition Care?

Comprehensive Nutrition Care is a creative and comprehensive way to provide care. It takes a complete approach to nutrition care with the purpose of supporting individuals with chronic or life-threatening disease, and healthcare providers who support them, to better manage their health through optimal nutrition.

Why is Nutrition Care Needed for Dementia Care?

Eating and enjoying a meal is part of our everyday life and important to everybody, not least to people living with dementia. A healthy diet and nutrition is fundamental to well being at any stage of life and to helping to combat other life-threatening diseases. We believe it plays as important a role in relation to dementia progression, and a resident’s quality of life. Under nutrition is common among older people generally, particularly common among people with dementia. Under nutrition tends to be progressive, with weight loss often preceding the onset of dementia and then increasing in pace as the disease progresses.

In what ways are the elderly susceptible?

  1. Age related changes in the gastrointestinal tract combined with changes in diet and immune system reactivity affect the composition of gut microbiota, leading to increased numbers of bad bacteria, decreased number of beneficial bacteria such as anaerobic lactobacilli and bifidobacteria.
  2. Osteoporosis is a disease which is characterized by decreasing bone density and increasing fragility of bones due to microexps21585_THCA153054D10_15_4b-architectural deterioration which increases the risk of fracture. Osteoporosis is exacerbated by malnutrition, low weight, poor intake of vitamin D and calcium, and in women, low levels of sex hormones.
  3. Older people need higher quantities of some nutrients, for example, calcium, vitamin D and vitamin B12 due to dementia and other physiological changes making absorption of nutrients more difficult. Studies show that calcium, vitamin D, folate, iron and vitamin B12 are the most important micro nutrients in which deficiencies commonly occur in older people.
  4. Physiological changes to the digestive system affect appetite which can affect nutrient intake. Protein energy malnutrition is common among older people with estimates that 1 in 10 people over 65 living in the community are malnourished. These numbers triple for the elderly with dementia.

     

How to Prevent Malnutrition in the Elderly with Dementia?

In order to prevent malnutrition in an elderly person with dementia, functional foods need to be added to their diet. Due to the age related changes that can make it more difficult for older people to obtain the nutrients they need from their diet, functional foods can have a role to play in improving nutrient intake.

What is a Functional Food?

Functional food is a conventional food product modified in some way to give a health benefit above and beyond basic nutrition. Functional foods can also be designed to fight a certain health condition. Functional foods are generally considered to be those food products which provide a specific health benefit over and above their basic/traditional nutritional value. Examples of functional foods are breakfast cereals with folic acid, yogurt with additional probiotic, vitamin D and calcium fortified orange juice are just a few examples.

The Takeaway..

An elderly person with dementia that has lost weight and is exhibiting symptoms of malnutrition, needs abundant additional assistance to get out of the malnutrition danger zone. Because of the chemical and physical changes, nutrition therapy may be the only option to help them stay healthy and thrive. Nutrition Therapy is a daily ongoing person centered care program that can change lives.