Lesson 3.06 Frail Elderly

Nutrition Needs and Their Risk Factors

The nutritional needs of the frail elderly can be difficult to address. The digestive tract is usually quite worn down, meaning that nutrient and fluid absorption is impaired. Chewing may also be a problem because of lost teeth and/or poor dentures, etc. Because of these problems, malnutrition and dehydration become major issues to contend with. In addition, many elderly people are on some type of prescription medication. While they may be necessary, these can cause further nutrient depletions and dehydration problems.

Let's take a look at some of the strategies and key factors that can be applied in elderly health care.

Fluids and hydration: This is the most important and most basic nutritional requirement. Good quality water is very important to maintaining hydration. Electrolyte replacement beverages can be used successfully as well. Non-caffeinated tea (cold or hot) is also very useful and can even be therapeutic to some degree. Green tea is a wonderful beverage that has low amounts of caffeine but has very high levels of antioxidants.

Easily absorbable nutrient dense foods: Liquid nutrition drinks may be of great help because they don't need to be chewed and can be absorbed through the gastrointestinal tract much easier. Protein shakes, green food drinks with powdered algae and vegetables and liquid or powdered multivitamins all can be part of a strategy to get nutrients absorbed into the body.

Concentrate on getting good fats: Getting plenty of unsaturated fatty acids is very important to all the systems of the body, especially the nervous system and brain. Focus on omega-3 and DHA fatty acids for improved memory and cognitive function.

Concentrate on easily absorbed protein: Protein can be difficult to digest, especially red meat, poultry or other meat foods. Whey protein is the most absorbable and most effective protein source. Goat's whey is the best type of whey protein. This can be used in the form of a shake to ensure good quality protein absorption.

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Dietary and Weight Management

Weight management and dietary control can be increasingly difficult in the elderly. Weight loss due to malnutrition often becomes the biggest problem during this time of life. The challenge is to get enough dense calories and fluids into and absorbed by the body.

Interestingly, many of the conditions at the extreme end of life are not so different from the extreme beginning of life. This is true for the diet in many ways. Liquid foods, softer foods, and vitamin and mineral supplements can all be important parts of addressing the special needs of the frail elderly.

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Signs and Symptoms of Possible Nutritional Deficiencies in the Elderly

• Leg cramps/twitching muscles: This is usually a sign of potassium and/or magnesium deficiency and can easily be corrected with diet and/or supplement adjustments.
• Eyesight problems: The key nutrients to increase are vitamin A, beta-carotene, taurine, lutein, and the herb bilberry.
• Weight loss: Focus more on easily absorbed foods such as; whey protein, softer foods, hot grain cereals, powdered green foods, and healthy fats.
• Headaches: Often a sign of dehydration. To re-hydrate give four ounces of water every fifteen minutes for up to four hours. Also use a good electrolyte replacement beverage.
• Low energy: Often a sign of B-complex vitamin deficiency. Add a good multi vitamin or a B-complex vitamin supplement two to three times a day with food.
• Memory problems: Often aided by B-complex, adding essential fats (omega-3 and DHA), and the herb Gingko Biloba.
• Bone loss: Adding good quality calcium along with weight bearing exercise can stop or begin reversing this condition. This has been proven in clinical studies even in very elderly people. Best forms of calcium are microcrystalline hydroxyapatite, citrate, and Krebs cycle forms.
• Osteoarthritis: This condition happens because people lose their ability to produce more cartilage. This happens because of a breakdown in what is called the methylation pathway, which produces cartilage. This can be helped with the supplements glucosamine sulfate, MSM, and omega-3.
• High blood pressure: Often associated with mineral deficiencies. Focusing on getting plenty of potassium, calcium, magnesium and sodium from sea salt forms can be helpful. Dr. Majid Ali, a highly respected pathologist recommends a pinch of Celtic brand sea salt in a glass of water two times a day as a high blood pressure remedy. Regular table salt is considered to be an imbalanced form of salt because it does not have all of the other trace minerals that are naturally occurring in sea salt.
• High cholesterol: Cholesterol must be kept within a safe range. Nutritional strategies for controlling cholesterol include policosinol, omega-3, red yeast rice, niacin, plant sterols, and gugulipids.
• Hardening of the arteries: Soft pliable arteries are very important to everyone's health. Nutrients that are involved in keeping arteries pliable are; arginine, vitamin C, bioflavonoids, lysine, and proline.

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Community Support and Living Arrangements

Community support is a very important part of helping the frail elderly live. The families of the elderly do their best to support them and in turn the families need the support of community services that are available. There are many local, state and federal assistance programs available to help families handle this difficult stage of life. Some of the options available to the frail elderly and their families are:

• In-home aides: This is used when a person needs someone to come in for the day and assist with dressing, meals, and light house chores.
• In-home day nursing care: When short shifts or day shifts are needed during daytime hours only.
• In-home twenty-four hour nursing: When a person needs around the clock nursing assistance and wants to remain at home. This is provided in shifts.
• Assisted living facilities:When a person begins having difficulty remaining at home and chooses to leave their home to enter a facility, usually comprised of small apartments within a complex. These facilities are staffed with aides and nurses and on call doctors. These facilities have communication devices that allow the residents to call for assistance.
• Nursing homes: These are available when extensive medical care is required around the clock. These individuals either have severe medical conditions or simply require a lot of medical and nursing assistance due to there advanced age.

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Frail Elderly Health Risks

Some of the health risks associated with the frail elderly are:

Cancer: Cancer can happen at any age, however, the older we get the chances of getting cancer increase. One of the primary things to do to prevent cancer is to keep a diet high in antioxidants. Taking antioxidant supplements can be very helpful in addition to dietary steps.

Menopause: This is a condition or process that all women go through. It comes on sometime between the ages of forty-five and sixty, but usually around fifty or so. Menopause is defined as the time when there have been no menstrual periods for twelve consecutive months. It is the end of fertility. Practicing sound nutritional habits can make this process easier to go through. Herbal therapies have been used successfully for centuries to assist women going through this phase.

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