The Mature Adult

• Chapter 12:The Mature Adult

• J Pistack MS/Ed

The Mature Adult Stages

• Young adulthood: Ages 18–39• Middle adulthood: Ages 40–70• Older adulthood: Ages 70+

Physical Changes of Aging as It Relates to Nutrition

• Ear/nose/throat: Decreased vision, hearing, sense of taste—How might this effect grocery shopping, cooking, and tasting food?

• Gastrointestinal: How might alterations in metabolism, absorption, and excretion aid older adults in getting the nutrients they require?

Dental Health in the Older Adult

• What effects might dental caries, loss of teeth, gum disease, and dry mouth, often due to decreased salivation or medications, do to decrease older adults appetite or ability to eat?

More Physical Changes

• Urinary: decreased ability to concentrate urine and conserve sodium.

• Musculoskeletal: pain and stiffness in muscles and joints; decreased muscle mass. How might this effect cooking, opening jars, nutritional status?

• Nervous system: decreased blood flow to the brain, sensory changes. Vitamins B and folic acid and essential fatty acids are beneficial

Diseases of the Nervous System

• Alzheimer’s disease• Parkinson’s disease

Nutrition and Dementia

• Clients may lose the ability to self-care, including eating

• Cueing and environmental concerns are part of meeting nutritional needs

• Swallowing difficulties may require thicker textures to eat safely

More Physical Changes

• Endocrine: decreases in substances-insulin, antidiuretic hormone

• Cardiovascular: decreased heart rate and cardiac output

Nutrition and the Older Adult

• Older adults need approximately 5% fewer kilocalories

• Carbohydrates: approximately 45%–65% daily kilocalories

• Fats: 25%–35% daily kilocalories• Protein: 10%–35% daily kilocalories—

important for immune system function

Exercise

• Strength training decreases muscle mass loss, functional decline, and fall-related injuries

• For previously sedentary persons, an exercise routine should be introduced gradually after medical clearance is received

• The National Institute on Aging (2011) recommends that all forms of exercise be included in the older adult’s exercise plan: endurance, strength, balance, and flexibility

Vitamins

• Vitamin E: linked to immune and cognitive function

• Vitamin K: aids metabolism, blood clotting, protects against age-related bone loss

Minerals

• The 2010 Dietary Guidelines for sodium in the older American is an intake of less than 1500 mg per day

• RDA/AI for calcium in women older than age 50 and men older than age 70 years: 1200 mg per day

Water

• Healthy older adults need enough fluid intake to produce about 1.5 liters of light yellow urine in 24 hours

• One of the early signs of dehydration in the elderly is confusion

Common Problems Related to Nutrition

• Osteoarthritis - A chronic disease characterized by progressive degeneration of the cartilage of the joints

• Osteoporosis - A disease characterized by a decrease in bone mass and density, occurring especially in postmenopausal women, resulting in a predisposition to fractures

• Fractures

Nutrition and Pressure Ulcers

• Pressure ulcers may place patients in a hypercatabolic state(An increase in basal metabolic rate and in breakdown of muscle and adipose tissue as a result of injury) requires increased calories to promote healing

• Patients with pressure ulcers will require increased protein to promote a positive nitrogen balance and improve healing rates

Nutritional Care of the Older Adult

• Assessment– watch for marginal deficiencies before they get

out of control– Screening tool are available

• Learning to eat with dentures• Stay vigilent

– Ensure the patient gets all the nutrition they need– Food “tastes better” to the elderly when eaten

with someone

Hospitalization of the Older Adult

• Older adults with dementia will require monitoring: feeding, adequate intake

• Stroke patients may require additional assistance with feeding/eating

• Monitor patients who are NPO for tests/procedures to ensure they receive nourishment as soon as possible