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Malnutrition and obesity are both common among Americans over age 65. There are also a host of other medical conditions from which older people and other Medicare beneficiaries suffer that could be improved with appropriate nutritional intervention. Despite that, access to a nutrition professional is very limited. Do nutrition services benefit older people in terms of morbidity, mortality, or quality of life? Which health professionals are best qualified to provide such services? What would be the cost to Medicare of such services? Would the cost be offset by reduced illness in this population? This book addresses these questions, provides recommendations for nutrition services for the elderly, and considers how the coverage policy should be approached and practiced. The book discusses the role of nutrition therapy in the management of a number of diseases. It also examines what the elderly receive in the way of nutrition services along the continuum of care settings and addresses the areas of expertise needed by health professionals to provide appropriate nutrition services and therapy.
Nutrition, defined by Merriam-Webster, is the process of eating the right kind of food so you can grow properly and be healthy. However, making the right food and nutrition choices and finding the best and most accurate nutrition information can be a challenge, especially when a disease or injury is present. There are a wide range of ways that nutrition can be healing, from a simple broth that provides fluids and electrolytes to therapeutic nutrition for diabetes, irritable bowel syndrome, or osteoporosis. Registered Dietitian Nutritionists (RDN) have expertise in disease management and translation of nutrition requirements to foods to consume. However, nutrition care often does not receive the attention in the out-patient setting that is needed to achieve nutrition goals. The purpose of this book is to provide pertinent and concise nutrition care information for Registered Dietitian Nutritionists and other professionals working with individuals outside of the hospital including nurses, pharmacists, and physicians. This book covers screening, assessing, and treating malnutrition; out-patient nutrition care in diabetes, cardiovascular disease, gastrointestinal disease, osteoporosis; and home enteral and parenteral nutrition. In each chapter the reader will learn more about the disease process as well as the management of the disease or therapy. As the number of patients receiving home care nutrition support increases, proper assessment and management of this therapy is crucial, and clinicians need to practice at an advanced level. This book presents advanced and readily applicable information on proper nutrition care of individuals in the outpatient setting and those receiving home nutrition support.
Intro -- Foreword -- Acknowledgements -- Contents -- Part I: Nutritional Care in Geriatrics -- 1: Overview of Nutrition Care in Geriatrics and Orthogeriatrics -- 1.1 Defining Malnutrition -- 1.2 Nutrition Care in Older Adults: A Complex and Necessary Challenge -- 1.3 Malnutrition: A Truly Wicked Problem -- 1.4 Building the Rationale for Integrated Nutrition Care -- 1.5 Managing the Wicked Nutrition Problems with a SIMPLE Approach (or Other Tailored Models) -- 1.5.1 Keep It SIMPLE When Appropriate -- 1.5.2 A SIMPLE Case Example -- 1.5.2.1 S-Screen for Malnutrition -- 1.5.2.2 I-Interdisciplinary Assessment -- 1.5.2.3 M-Make the Diagnosis (es) -- 1.5.2.4 P-Plan with the Older Adult -- 1.5.2.5 L-Implement Interventions -- 1.5.2.6 E-Evaluate Ongoing Care Requirements -- 1.6 Bringing It All Together: Integrated Nutrition Care Across the Four Pillars of (Ortho) Geriatric Care -- 1.7 Summary: Finishing Off with a List of New Questions -- References -- Recommended Reading -- 2: Nutritional Requirements in Geriatrics -- 2.1 Nutritional Recommendations for Older Adults, Geriatric and Orthogeriatric Patients -- 2.2 Nutritional Recommendations for Older Adults -- 2.2.1 Energy Requirement and Recommended Intake -- 2.2.2 Protein Requirement and Recommended Intake -- 2.2.3 Micronutrients and Dietary Fibers -- 2.3 Nutritional Risk Factors in Older Adults -- 2.4 Estimating Intake in Older Adults -- 2.5 Nutritional Status of Older Adults, Geriatric and Orthogeriatric Patients -- 2.6 Summary -- References -- Recommended Reading -- 3: Nutritional Assessment, Diagnosis, and Treatment in Geriatrics -- 3.1 The Nutrition Care Process -- 3.2 Nutritional Screening/Risk Detection -- 3.3 Nutritional Assessment and Diagnosis -- 3.3.1 Nutrition Impact Symptoms -- 3.3.2 Nutritional Diagnosis -- 3.3.3 Etiologic Criteria.
An estimated 90 percent of oncology patients in the United States receive treatment in outpatient cancer centers and clinics. This change from the older model of inpatient care has important implications for overall quality of care for oncology patients and nutritional care in particular. Amidst growing concern about access to oncology nutrition services, combined with growing recognition of the importance of providing nutritional care to optimize oncology treatment outcomes and maximize quality of life among both patients and survivors of cancer, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in March 2016 to explore evolving interactions between nutritional care, cancer, and health outcomes. Participants explored how health outcomes and survival of cancer patients in outpatient cancer centers are affected by current standards for nutritional services, nutritional interventions, and benefits associated with oncology patient access to medical nutrition therapy. They also studied the cost of outpatient nutritional care and assessed costâ€"benefit relationships between oncology nutrition services and health outcomes and survival. This publication summarizes the presentations and discussions from the workshop.
As the number of patients receiving home care nutrition support increases, proper assessment and management of this therapy is crucial, and clinicians need to practice at an advanced level. This second edition provides practical nutrition care information for professionals working with individuals outside of the hospital including registered dietitians, nurses, pharmacists, and physicians. It covers screening, assessing, and treating malnutrition; outpatient nutrition care in diabetes, cardiovascular disease, gastrointestinal disease, and home enteral and parenteral nutrition. Each chapter describes the disease process as well as the management of the disease or therapy. Key Features Presents practical information on proper nutrition care of individuals in the outpatient setting and those receiving home nutrition support New information on GI tests and procedures; gastroparesis/pancreatitis, parenteral lipids, and bariatric surgery Expanded chapter on short bowel syndrome and malabsorptive disorders Additional information on feeding options including an overview of oral, oral supplements, and enteral and parenteral nutrition Teaches the user additional information on disease processes as well as the management of the disease or therapy
The U.S. population of older adults is predicted to grow rapidly as "baby boomers" (those born between 1946 and 1964) begin to reach 65 years of age. Simultaneously, advancements in medical care and improved awareness of healthy lifestyles have led to longer life expectancies. The Census Bureau projects that the population of Americans 65 years of age and older will rise from approximately 40 million in 2010 to 55 million in 2020, a 36 percent increase. Furthermore, older adults are choosing to live independently in the community setting rather than residing in an institutional environment. Furthermore, the types of services needed by this population are shifting due to changes in their health issues. Older adults have historically been viewed as underweight and frail; however, over the past decade there has been an increase in the number of obese older persons. Obesity in older adults is not only associated with medical comorbidities such as diabetes; it is also a major risk factor for functional decline and homebound status. The baby boomers have a greater prevalence of obesity than any of their historic counterparts, and projections forecast an aging population with even greater chronic disease burden and disability. In light of the increasing numbers of older adults choosing to live independently rather than in nursing homes, and the important role nutrition can play in healthy aging, the Institute of Medicine (IOM) convened a public workshop to illuminate issues related to community-based delivery of nutrition services for older adults and to identify nutrition interventions and model programs. Nutrition and Healthy Aging in the Community summarizes the presentations and discussions prepared from the workshop transcript and slides. This report examines nutrition-related issues of concern experienced by older adults in the community including nutrition screening, food insecurity, sarcopenic obesity, dietary patterns for older adults, and economic issues. This report explores transitional care as individuals move from acute, subacute, or chronic care settings to the community, and provides models of transitional care in the community. This report also provides examples of successful intervention models in the community setting, and covers the discussion of research gaps in knowledge about nutrition interventions and services for older adults in the community.
"The Essential Pocket Guide for Clinical Nutrition is a quick-reference guide for dietitians, students, and other health professionals actively engaged in clinical nutrition, providing them with immediate access to evidence-based information on nutritional assessment, nutrition support, and nutrition considerations for specific diseases such as cancer, cardiovascular disease, diabetes, and pulmonary disease. Using the latest nutritional guidelines, the authors utilize a consistent chapter format that includes sections on disease process, treatment and nutritional intervention, and patient education, making it easy to find relevant information"--