Malnutrition in the Elderly with Dementia Essay

What is Malnutrition?Malnutrition is a state of nutrition (under or everywhere nutrition) in which a lack of protein, energy and different alimentarys causes measurable unseemly effects on tissue and/or dead body form, composition, function or clinical let outcome. We will focus on under nutrition as a nutritional concern. The main cause for concern among previous(a) hatful in the UK is that they atomic number 18 not feeding enough to maintain vertical nutrition. Among the population of previous(a) lot in occupantial care at that place are many to a greater extent underweight people than there are overweight or obese people, and in old era world underweight poses a far greater hazard to health than being overweight. The most recent information on the nutritional status of senior(a) people in Britain was reported in the National Diet and victuals Survey (NDNS) of people aged 65 years and over in 1998. In this survey, 3% of men and 6% of women sustenance at main o ffice were underweight, while comparable figures for those in occupantial care were 16% and 15% respectively.It is suggested, however, that risk of undernutrition is still not adequately identified in older people and that undernutrition is often associated with hospitalisation and poor health status.1 The level of undernutrition among older people with dementia in residential care is plausibly to be even higher, with estimates that as many as 50% of older people with dementia puzzle inadequate energy inhalants. Undernutrition is tie in to change magnitude mortality, increased risk of fracture, increased risk of infections and increased risk of specific nutrient deficiencies leading to a variety of health-related conditions that after part greatly affect the reference of life. Disease whoremonger also exert a potent determine on malnutrition as medical conditions can reduce victuals economic consumption and impair digestion and absorption of nutrients as well as affect how the body metabolises and utilises them.The causes of undernutrition in older people in residential care are often multi-factorial low income, living alone, limited mobility, and lack of facilities and social web can lead to undernutrition before admission, and this is often exacerbated by depression, bereavement and confusion. Factors that have been associated with undernutrition in care situations imply lack of palatability of food and opinionated timing of meals, lack of assistance with eating or redness of independence in eating, lack of acceptability of food provided to ethnic minorities and lack of sentience of the need for assessment and documentation of older people at risk of undernutrition.Malnutrition can be significant if a person has a BMI of slight than 18.5 kg/m2 had unintentional weight loss greater than 10% at heart the last 3-6 months a BMI less than 20kg/m2 and has had unintentional weight loss greater than 5% within the last 3-6 months People are als o at risk of becoming malnourished if they have eaten very little or nothing for more than 5 days and/or this pattern is likely to continue. Worryingly, more than 1 in 4 of all adults admitted for a hospital stay, to a mental unit or a care nucleotide is at risk of malnutrition. It is a well-documented fact that worldwide, the elderly population is increasing, and with it, the relative incidence of malnutrition. Malnutrition is associated with significantly increased morbidity and mortality in independently living older people, as well as in nursing domicil residents and hospitalised patients. Prevalence of malnutrition amongst the elderly population 35% in adults over 80 years of age 25 35% in adults 60 80 years 25% in adults less than 60 years of ageCauses of MalnutritionThere are many causes of malnutrition. These can include Reduced intake Poor appetite due to illness, food aversion, nausea or distressingness when eating, depression, anxiety, side effects of medication or drug addiction inability to eat This can be due to investigations or being held zilch by mouth, reduced levels of consciousness confusion difficulty in feeding oneself due to weakness, arthritis or other conditions such as Parkinsons Disease, dysphasia, vomiting, ugly mouth conditions, poor oral hygiene or dentition restrictions impose by surgery or investigations Lack of food availability pauperism poor quality diet at home, in hospital or in care homes problems with shopping and cooking Impaired absorption This can be due to medical and functional problems effecting digestion & stomach, intestine, pancreas and liver /or absorption Altered metabolism Increased or changed metabolic demands requirements related to illness e.g. cancer surgery, organ dysfunction, or treatment Excess losses Vomiting diarrhoea nutrient fistulae stomas losses from nasogastric losses tube and other drains or skin exudates from burns People at risk of MalnutritionAs we have seen, the groups most vulnerable to malnutrition include People just dispatch from hospital Elderly people (16% in residential care) People with cancer and other long-term conditions People recovering from surgeryRisk factors more specific to the elderlyDementia and other neurological disorders Alzheimers disorder Other forms of dementia Confusional syndrome Consciousness disorders ParkinsonismConsequences of MalnutritionMalnutrition can often go undetected and when left untreated, it can have serious consequences on health, which include Increased risk to infections Delayed tease healing Impaired respiratory function Muscle weakness and depressionDetection of MalnutritionThere is no alternative to measurements of weight and height, along with other anthropometric measures in specialist circumstances. These measurements can then be used with the following questions Has our resident been eating a normal and varied diet in the last just about weeks? Has our resident experienced intentional or unintentional weight loss recently? Rapid weight loss is a concern in all patients/residents whether obese or not Can our residents eat, swallow, digest and shine up enough food safely to meet their likely postulate? Does our resident have an unusually high need for all or some nutrients? Surgical stress, trauma, infection, metabolic disease, wounds, bedsores or history of poor intake whitethorn all contribute to such a need Does any treatment, disease, bodily limitation or organ dysfunction limit out residents ability to handle the nutrients for current or future needs? Does our resident have excessive nutrient losses through vomiting, diarrhoea, surgical drains etc? Does a global assessment of our resident suggest under victuals? Low body weight, loose fitting clothes, fragile skin, poor wound healing, apathy, wasted muscles, poor appetite, altered taste sensation, altered bowel habit. interchange with relatives may be important In the light of all of the above, can our resident meet all of their requirements by voluntary choice from the food available? Understanding that asking these questions take a significant hail of time and expertise, a number of screening tools have been developed to economic aid you identify whether our residents are at risk of malnutrition.Given the high preponderance of malnutrition and lack of proper management of patients/residents in various settings, performing a routine nutritional screening should result in early appointment of patients/residents who might have otherwise been missed. A screening tool should patron establish reliable pathways of care for patients with malnutrition. Screening for malnutrition (and the risk of malnutrition) should be carried out by healthcare professionals with appropriate skills and training.