1. Nutrition: Key to Healthy Long Term Care Presented to HOTWAGS June 11, 2008 Suzy Weems, PhD, RD, CSSD, LD

2. Good Nutrition: Essential to Successful Aging Essential for –Health –Functionality –Positive quality of life Nutrition ‘s role may be –Preventative –Management

3. Good Nutrition: Essential to Successful Aging Nutrition facilitates healthy aging by –Lowering the risk for diseases –Improving / maintaining mental function –Improving physical function –Socially engaging in life

4. Nutrition Intervention Lowers Risk for Disease 80% older population have 1 chronic disease 50% have 2 or more chronic diseases Average 75 year old has 3 chronic diseases and takes 5 prescription drugs 9 out of 10 of these have a condition that could be improved through nutrition intervention –52 – 168 million folks are hypertensive –54 – 164 million have high cholesterol levels –132 – 330 million are diabetic

5. Nutrition Intervention – Mental Function Cognition –Nutrients Vitamins B-6, B-12, Folate Minerals – Iron Water –Food sources Lean protein Fruits Vegetables Whole grains Attitude

6. Nutrition Intervention – Physical Functional Dentures GI tract changes Change in body mass Muscle mass Fat mass Water Loss of bone Posture Security with activity

7. Nutrition Intervention – Physical Eyes –Retinal degeneration β-carotene Dark green or yellow/orange fruits and veggies –Visual acuity Fruits Vegetables Phytochemicals + vitamins

8. Nutrition Intervention Brain –Short term memory B-6 + Ascorbic acid –Problem solving Riboflavin + folate + Ascorbic Acid + B-12 –Dementia Thiamin + niacin + zinc –Brain tissue degeneration Pyridoxine α-tocopherol

9. Nutrition Intervention – Social Spouse / significant other –Person –Pet –Plant Congregate Meals Meals delivered

10. Specific Challenges for Optimizing Long Term Nutritional Care Eating – Food is a basic need –Mechanical issues Appetite – Meet sensory needs –Taste –Feel –Smell Restrictive diets –Balance the Benefits & Risks

11. Specific Challenges for Optimizing Long Term Nutritional Care Polypharmacy –Drugs –Herbs –Supplements Psychological -- depression Balance –Quality of Life & Nutritional Status

12. Solutions /Strategies Dentition –Check with dentist –Alter food texture Chop Steam Stew Grate or grind hard foods –grated carrots & raisin salad

13. Solutions /Strategies Osteoporosis –Weight bearing exercise + calcium rich diet Milk – skimmed or buttermilk Yogurt Cheese Lots of green ‘leafies’

14. Solutions /Strategies Challenges with visual acuity –Bright distinct colors – food –Contrast on plate –Big print –Magnifying help with labels

15. Solutions / Strategies Challenges with hearing –Check hearing –ASK for info –Check with the ‘waiter’

16. Solutions / Strategies Challenges with smell / taste –Variety of food flavors –Special diet? Try Lemon juice Vinegar Dill Curry –Reawaken senses to fresh, flavorful foods with texture

17. Practical Strategy – Eat Food Lean Protein – –Muscle Mass / Function –+ iron, zinc, B-12, B-6 –+ calcium, riboflavin, B-12

18. Practical Strategy – Eat Food Fruits –+ vitamin C –+ β-carotene & other carotenoids –Potassium –Fiber

19. Practical Strategy – Eat Food Vegetables –+ vitamin C –+ β-carotene & other carotenoids –Fiber

20. Practical Strategy – Eat Food Whole Grain –+ vitamin E –+ thiamin, riboflavin, niacin –Fiber –Incomplete process Selected Fats (nuts, oils, etc) –Omega – 3 fatty acids –Vitamin E

21. Take Home Message Good Nutrition is a major determinate for successful aging Good Nutrition is essential for –Health –Independence –Quality of Life Message – –Food is the key

22. Or... The better choice