Diet, weight loss, fluid balance, hydration, anemia
Why Nutrition is Important:
Normal Age-Related Changes
Potential nutritional deficiencies:
Older adults are at increased risk if they have any of the following:
Medication-Related Risk Factors
Behavioral Risk Factors
Chemotherapy-related Risk Factors
Surgery-Related Risk Factors
Radiation Risk Factors
1. Screening Questions
3. Screening Tests
1. Monitor weight, recalculate BMI as necessary
2. Monitor dietary intake of foods and fluids:
3. Review patient appetite and current medications; discuss appropriateness/use of appetite-enhancement medications or changes in current medications with LIP (i.e megace- progesterone, dronabinol)
4. Suggest nutritional supplements (i.e Ensure, Scandishake) and dietary modifications to supplement intake and to address medical conditions (constipation, diarrhea, etc.) as appropriate
5. Assess social and environmental support and refer for assistance as appropriate
6. Monitor labs for dehydration, vitamin deficiency, malnutrition (albumen, electrolytes, Vitamin D,Calcium, Iron Studies, HlAC,TSH (T3 & T4), CBC, CRP and discuss with LIP
Hao, R. & Guo, H. (2012). Anorexia, undernutrition, weight loss, sarcopenia and cachexia of aging. European Review of Aging and Physical Activity 9(2), 119-127.
Kathiresan, A.S., Brookfield, K.F., Schuman, S.I., Lucci, J.A. (2011). Malnutrition as a predictor of poor postoperative outcomes in gynecologic cancer patients. Archives of Gynecology and Obstetrics 284(2), 445-451.
Other helpful resources:
Agarwal, K. (2014, April 1). Failure to thrive in elderly adults: management. Retrieved from http://www.uptodate.com/contents/failure-to-thrive-in-elderly-adults-management.
Arenson, C., Busby-Whitehead, J., Brummel-Smith, K., O’Brien, J.G., Palmer, M.H., Reichel, W. (Eds.). (2009). Reichel’s care of the elderly: clinical aspects of aging. New York: Cambridge University Press.
Fass, R. (2014, January 8). Overview of dysphagia, in adults. Retrieved from http://www.uptodate.com/contents/overview-of-dysphagia-in-adults#H17689849.
Heflin, M.T. (2015, July 29). Geriatric health maintenance. Retrieved from http://www.uptodate.com/contents/geriatric-health-maintenance.
Hurria, A. and Cohen, H.J. (2015, May 7). Comprehensive geriatric assessment for patients with cancer. Retrieved from http://www.uptodate.com/contents/comprehensive-geriatric-assessment-for-patients-with-cancer.
Krauss Whitbourne, S. (1996). The aging individual: physical and psychological perspectives. New York: Springer Publishing Company.
Lichtman, S. (2015, August 6). Systemic chemotherapy for cancer in elderly persons. Retrieved from http://www.uptodate.com/contents/systemic-chemotherapy-for-cancer-in-elderly-persons.
Roe, D.A. (1992). Geriatric nutrition. Englewood Cliffs, N.J.: Prentice Hall.
Ritchie, C. (2015, October 22). Geriatric nutrition: nutritional issues in older adults. Retrieved from http://www.uptodate.com/contents/geriatric-nutrition-nutritional-issues-in-older-adults.
Ward, K.T. and Reuben, D.B. (2015, August 6). Comprehensive geriatric assessment. Retreived from http://www.uptodate.com/contents/comprehensive-geriatric-assessment.