Elderly - Special Considerations

Question 1

COPD

Answer 1

Combo chronic bronchitis + emphysema
Shortness of breath
Incurable: managed with steroids and 02 mask
Smoking = most common cause
Malnutrition predictor of mortality
Have increased EE
Good nutrition - prevent infection, reduce hospitalisation, accelerate weaning from mechanical ventilation
Practical ideas - all food groups, easy prep foods, 6 small meals/day, don’t fill up on fluid, food fortification

Question 2

Stroke

Answer 2

Major UK cause morbidity + mortality
Malnutrition associated with poor outcomes
Possible problems - perception, spatial defects, hemianopia, ataxia, hemiplegia, aphasia
Prevention - lifestyle advice, anticoagulant control, statin, antihyperintensive measures
Secondary prevention - increase fish consumption, increase F+V, maintain healthy body weight, avoid excess Na, safe alcohol consumption

Question 3

Dysphagia

Answer 3

Inability to swallow food and drink safely
Many conditions - alzheimers, MS, Parkinsons, spinal injury, stroke
Potential consequences - choking, dehydration, malnutrition, chest infections
High risk foods - crunchy or crumbly, stringy/fibrous foods, mixed textures

Question 4

Dementias

Answer 4

Progressive inability to learn, remember, understand + reason
Prevalence -1 in 5 >80yrs, increased risk with age
Diagnosis - assess memory + mental ability, brain scans
Treatment - limited, some medications slow process
Problems - poor recognition food, difficulty chewing
Tips - allow time, one course at time, finger food, supplements, make most of good times