Nutritional Support for Elderly Patients

Physiology of Aging that Affects Nutrition of the Elderly

The changes in the ability to smell and to taste food, occurring with aging, influence the intake of food among the elderly patients. As an individual reaches the age of 70 and older, the ability to smell as well as discriminate between different types of smell diminishes (Jones, Duffy, Coull, & Wilkinson, 2009). The decline in this sense affects one’s enjoyment of food, something that influences appetite resulting in the reduction of dietary food intake. According to Jones et al. (2009), the diminishing of smell and taste among these people is worsened by the medications they receive in the health care facilities. Some of the drugs that the elderly patients take are antihypertensives, antibiotics, antidepressants, and analgesics. Therefore, the impairment in functional status of the smell and taste senses substantially impacts the nutrition among the elderly people.

The influence of aging on the oral cavity negatively affects the nutrition of the elderly individuals. Mastication becomes a reality when the elderly people experience the degradation of their lips, teeth, salivary glands, and the tongue among others. Nigam and Knight (2008) explain that with aging, mandibular and maxillary bones shrink because of the decreased skeletal calcium content that results in the erosion of tooth sockets and the subsequent loss of teeth. The absence of teeth is enough to make chewing a difficult exercise for the older persons. As a result, these people may either reduce their oral intake of food or opt for the more refined ones that mostly lack fiber. Their nutrition status worsens further upon the consumption of foods that lack fiber, something that can lead to constipation. Furthermore, xerostomia is common in the aged individuals, which makes chewing a difficult task to accomplish. Once chewing is compromised, then food intake and nutrition are affected.

Similarly, the impact of aging on other digestive systems, including the stomach and the gut’s accessory glands, impairs the nutrition among the elderly individuals. The aging process is associated with the diminishing of the stomach elasticity, making this organ unable to accommodate much food (Nigam & Knight, 2008). Atrophic gastritis, which is common among the aging individuals, results in hypochlorhydria and low production of gastric enzymes (Bhutto & Morley, 2008). It promotes the mal-absorption of essential minerals, such as iron and calcium, in addition to impairing the normal digestion of orally taken food. In addition, aging affects the liver, an organ with the responsibilities of metabolizing chemicals such as drugs. Due to the reduced efficiency of the liver among the aged people, the side effects of drugs can worsen their nutritional status. Bhutto and Morley (2008) further assert that motility reduction is an outcome of the aging gastrointestinal system among the elderly people. This occurrence may explain why constipation and fecal incontinence are common among the elderly patients, although medications can produce the same side effects or worsen the already existing anomalies.

More so, energy requirements and metabolism diminish proportionally with aging. For the aging individuals, it is normal for their lean body mass to decline, resulting in various changes within their body compositions. Thus, Chernoff (2013) asserts that body energy requirements and basal metabolism rates considerably diminish with aging. It is likely that the oral intake of food also reduces. Such a thing may affect their nutritional status because it may be difficult to meet the body's micronutrient requirements with the reduced oral intake. This creates the need for nutrient supplementation, which is a hard thing to implement.

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Factors that Affect Nutrition of the Elderly Patients

The changes in physiology are a huge factor influencing the nutrition of the elderly patients. The reduced gastrointestinal mobility and mastication functions of the oral cavity promote a low intake of food. At the same time, atrophic gastritis that comes with aging limits the production of gastric secretions, leading to poor digestion and sequent absorption of vital nutrients. Therefore, aging among the elderly patients is a huge factor influencing nutrition.

Low socioeconomic status among the elderly is a powerful force that affects their nutritional status. According to Jones et al. (2009), poverty affects the choice of foods and dietary intake. For example, poor people can consider basic healthy foods such as fruits, fish, and vegetables a luxury. In some cases, the elderly may opt for cheap foods from the market, which are not nutritious and important in the promotion of their health, just because of poverty. Such practices can deny them the necessary nutrients to maintain and lead a healthy life. Those who are sick may also fail to receive better health care services that may include nutritional care. Due to all these factors, the socioeconomic status plays a huge role in the nutrition of the aged population.

Finally, various health conditions and the subsequent medications aimed at treating these conditions significantly affect the nutritional status of the elderly. Some conditions are capable of reducing an individual's appetite, enhancing diarrhea, and vomiting as well as other complications. For instance, depression and dementia in the elderly result in appetite loss that impacts food intake (Jones et al., 2009). The elderly patients also receive medications whose side effects negatively affect their nutrition. Genser (2008) explains that some of the side effects caused by both prescribed and over the counter medications include an altered sense of taste and smell, constipation, fatigue, anorexia, and diarrhea. In some cases, these drugs interact with the nutrients, and this inhibits nutrient absorption (Genser, 2008). Therefore, medications and diseases negatively affect nutrition among the elderly patients.

Elderly Nutritional Requirements

Older people need to take an adequate amount of carbohydrates, proteins, and lipids to suffice normal body functions. The elderly require a lesser amount of energy than the younger adults do because of their low muscle mass and physical activity (Chernoff, 2013). More so, they should consume less fat because the excess intake is associated with cardiovascular conditions, obesity, and diabetes. Since this part of the population has a reduction in the muscle mass, it is of great importance to consume more proteins per kilogram body weight than the younger adults (Jones et al., 2009). Therefore, the elderly people should ingest all the macronutrients only that the need to regulate their amounts accordingly.

Vitamins and minerals are also a nutrition requirement for the elderly. The intake of vitamin C in the form of vegetables and fruits helps the anti-oxidative functions of the cell and wound healing (Pillsbury, Miller, Boon, & Pray, 2010). Folate and vitamin B2 promote cell division and enhance healthy nerve cell functioning. Similarly, calcium intake is important since this mineral promotes bone mineralization and prevents rapid osteoporosis that is a common phenomenon among older people (Surmenev, Surmeneva, & Ivanova, 2014). Furthermore, the elderly require the adequate intake of iron for the formation of hemoglobin (Pillsbury et al., 2010). In the elderly females, the requirements of iron are lower than in younger females because of menopause. Therefore, micronutrients are necessary for the elderly people for them to lead a healthy life.

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Conclusion and Recommendations

The elderly individuals are at risk of malnutrition because of many factors that influence their body. The aging process affects various parts of their bodies, especially the gastrointestinal system. The effects of aging on this system impair not only the digestion of food but also the absorption of the nutrients. The situation is worse for the elderly patients because the disease processes and the medication therapies they receive worsen their nutritional status. However, the elderly should take all the food nutrients just like the younger adults, only the amount may vary because of various circumstances. 

This essay recommends that the elderly patients and individuals should be viewed as the groups at risk for malnutrition, hence the need to assess their nutritional status and give appropriate therapy early enough. It is important to determine the exact cause of malnutrition among the patients and solve it by modifying or eliminating the cause. Having a proper diet among the elderly people keeps their bodies healthy and promotes early recovery from a disease whenever they are sick. 

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