Bone density decreases with age, increasing the risk of fractures.
A minimum of 1000 mg of calcium is needed daily (more for those with osteoporosis).
After age 30, height can decrease by 1 cm per decade.
60% of the diet should be carbohydrates, 12-13% protein, and 30% fat.
Older adults often consume insufficient protein due to its cost, opting for cheaper, less nutritious foods.
Fiber is crucial for gut health.
Recommended daily fiber intake: 25-50%.
Calcium absorption requires Vitamin D.
It's better to take calcium in divided doses (e.g., 500 mg twice a day) with 1-2 hours between doses.
Recommended daily servings:
Grains: 6 servings (restaurant portions can equal 5 servings).
Vegetables: 3-5 servings.
Fruits: 4 servings.
Dairy: 2-3 servings minimum.
Poultry/Meat: 8-9 servings.
Fish/Seafood: 2-3 servings, but limit due to mercury content.
Nuts, seeds, and beans can be used as protein sources, aiming for 5 servings weekly.
Fats and oils: approximately 3 servings.
These recommendations are based on a 2000-calorie diet.
Educate older adults on calcium-rich food sources and consider a nutritionist consult especially if they need specific guidance.
Osteoporosis
Bone mass decreases with age due to increased absorption and decreased bone formation, leading to a higher risk of fractures.
Type 1 Osteoporosis: Most common in postmenopausal women due to estrogen loss. Estrogen is crucial for bone strength.
Type 2 Osteoporosis: Occurs in both men and women due to aging.
Risk Factors:
Family history.
Inactivity/immobility.
Low calcium intake (below 80 mg/day).
Excessive alcohol and caffeine consumption (compete with calcium absorption).
Celiac disease and other bowel issues (affect nutrient absorption).
Low birth weight or body weight.
Hyperparathyroidism (impacts calcium absorption).
Early menopause (due to estrogen loss).
Prevention:
Avoid tobacco.
Regular exercise (even walking).
Limit caffeine and alcohol.
Hormone replacement therapy (HRT) for menopausal women to help with bone health.
Ensure adequate Vitamin D and calcium intake.
Maintain a safe environment to prevent falls.
Importance of Exercise
Lack of exercise leads to physical decline.
High-intensity progressive resistance training can improve muscle strength and size in older adults.
Physical therapy can help individuals regain strength and mobility after illness or surgery.
Exercise helps well-being and reduces the risk of depression.
Consult a physician before starting a new exercise program.
Physiological Changes Affecting Nutrition
Decreased average blood circulation.
Increased threshold for thirst sensation (for sugar and salt).
Decreased number of taste buds.
Decreased peristalsis, gastric secretions, and saliva production.
Decreased stomach capacity and stomach emptying.
Diminished sense of smell or taste.
Increased indigestion.
Decreased hunger and appetite.
Increased need for protein intake with illness or surgery as they're more prone to joints replacement. Increase protein intake before surgery to improve recovery.
Hygiene in Aging
Good hygiene and grooming are essential for self-esteem.
Adapt hygiene practices to changes in the aging body.
Factors Affecting Hygiene:
Increased skin dryness.
Decreased skin elasticity.
Increased sensitivity to temperature.
Decreased sense of smell.
Decreased physical movement.
Nail changes.
Tooth wear and tear.
Decreased saliva production.
Immunity in Aging
The thymus gland shrinks after adolescence, impacting T-cell maturation.
T-cell numbers don't decrease with age, but their function declines.
This reduces the immune system's ability to fight off infections, increasing the risk of infection and reducing the effectiveness of immunizations.
It can also lead to autoimmune issues.
Infections in the Elderly
Infections in older adults can be difficult to diagnose because they may not exhibit typical symptoms like fever.
The body's response to infection is often muted.
Septicemia (systemic infection) is a significant risk.
Subtle signs to watch for:
Subnormal temperatures.
Increased pulse rate.
Unexplained dehydration.
Loss of appetite.
Confusion or cognitive changes.
Respiratory Infections:
May not cough as effectively.
Increased respiratory rate.
Loss of appetite.
Urinary Infections (UTIs):
Pain is an important indicator.
Incontinence or worsening of existing incontinence.
Changes in urine color and smell.
Skin Infections:
Redness, pain, and tenderness in affected areas.
Chronic Illnesses in Aging
Aging is a normal process; illness is a pathological one.
Chronic illnesses are more prevalent in older adults, affecting all aspects of their lives.
95% of healthcare dollars for older Americans are spent treating chronic illnesses.
Financial challenges:
Meeting healthcare expenses.
Rising medication costs.
Polypharmacy (multiple medications) is common, potentially leading to drug interactions and side effects that require additional medications.
Sleep Disturbances in Aging
Sleep patterns change with age, but the need for sleep does not decrease.
Central nervous system controls sleep-wake cycle.
Two main types of sleep: REM and non-REM (with 3 stages of non-REM).
Sleep disturbances:
Tend to sleep less than 8 hours per night, with increased awakenings and insomnia. Breaking up sleep with small bladders or aches and pains.
Decreased stage 3 and REM sleep.
Early awakenings and daytime fatigue.
Strategies for better sleep:
Maintain a consistent routine.
Create a comfortable sleep environment (temperature, noise, lighting).
Address pain and discomfort.
Avoid large meals, caffeine, and alcohol before bed.
Daytime naps are okay.
Exercise early in the day
Avoid sleep medications (tranquilizers, sedatives) as a first resort.
Adapting to Aging
Address adjustments associated with aging.
Factors affecting adjustment to retirement:
Limited income.
Preference for younger workers.
Health issues.
Geriatric Syndromes: Common health conditions in older adults, even without chronic illnesses
Adaptive Measures:
Home modifications (grab bars, clear pathways).
Lifestyle adjustments.
Nighttime Falls
Add night lights or keep a bathroom or hall light on all night.
Put on glasses even on a quick trip to the bathroom.
Sit a moment before rising and get up slowly to improve balance.
Use a walker, cane, or other assistive device even at home for improved safety.
Reduce Muscle Strength Effects
Remove clutter and provide a clear path to a favorite chair, a chair that is high enough to get up from easily.
Electrical cords are a well known hazard that can easily be secured with tape near the edge of a rug.
Use higher seating.
Clear pathways.
Secure electrical cords.
Medications Considerations
A medication organizer can help avoid double dosage.
This is important since older adults process medications through their system more slowly than younger people.
Because many older adults take more than one prescription plus over the counter drugs, the risk of drug interaction is increased.
A medication reviewed by a pharmacist or physician will reduce this risk.
Unsafe Climbing Considerations
Keep dishes, canned goods, and cooking utensils at eye level reduce the need for unsafe climbing.
Wear comfortable but secure footwear to improve balance.
Reduce the need to climb, and use safe footwear.
Bath Time Considerations
Use a tub mat and dry off inside the tub or shower. A bath stool can make this easier
Use a detachable grab bar for security and a large bath mat with non skid backing.
Reduce slippery surfaces and install and use grab bars.
Step Considerations
Increase the contrast between different levels.
Keep walkways clear of debris to reduce the risk of falling.
Fall Prevention
Pay attention to and discuss any side effects of medications such as dizziness or confusion with your doctor.
Have vision checked and wear corrective lenses if prescribed.
Improve balance through daily walks, stretching exercises, and exercises while sitting.
Wear supportive low heeled shoes and use walkers and canes as prescribed by your doctor to reduce risk.
Reduce clutter and debris, improve lighting both inside and outside, and mark level changes with contrasting tape.