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Dignity, malnutrition and comfort in later life
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Food and Nutrition in Later Life -The Vital Ingredients
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One size does not fit all…..
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4
11.5%
17.1%
24.4%
33.1% 33.1%
30.4%
26.6%
12.3%
20.9%
25.2%
30.2%31.4%
33.7%
28.4%
0%
5%
10%
15%
20%
25%
30%
35%
16-24 25-34 35-44 45-54 55-64 65-74 75+
Prev
alen
ce o
f obe
sity
Men Women
Adult obesity prevalence by ageHealth Survey for England 2010-2012
Patterns and trends in adult obesity
Adult (aged 16+) obesity: BMI ≥ 30kg/m2
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Malnutrition
The Nutrition Screening Week surveys(BAPEN 2013) indicated that the proportionof underweight individuals (BMI < 20 kg/m2) admitted to hospital rises steeply above theage of 70 years..
Older people accounted for most of the malnutrition in hospital (62%)
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In older years chronic disease and ill health can create dietary challenges
93% of malnutrition is in the community
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Psychological and Social Well Being
Psychological well-beingHow happy or content we feel with life
Social well-being A sense of involvement with other people and with our communities
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Diet quality can play a central role in maintaining cognition and well-being
Shatenstein et al, 2012 Experimental Gerontology. Haveman-Nies et al, SENECA study Age and Ageing 2003.HALCyon Programme
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Specific nutrients affect ourwell being and function
Folate
Zinc
Vitamins B12
Omega 3 Fatty Acids
Selenium
(Abouh-Saleh and Cooper, 2006, Levitan et al, 2000, Nowak et al, 2005, Williams et al, 2005,Bodnar and Wisner, 2005, Bamber et al, 2007)
Vitamin B6
CHO
Energy
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Preservation of cognitive abilities is central to the maintenance of independence and quality of life among older adults
Shatenstein et al, 2012 Experimental Gerontology
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Kuh et al, HALCyon Programme Public Health 2012 HALCyon Programme
Crucial elements of ageing well
Feeling Useful Being socially engaged
Being productive
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Towards the end of life
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Conclusion - one size does not fit all
• Good nutrition can help to combat chronic disease, manage weight and function
• Under-nutrition predisposes to disease and adversely affects its outcome. This has important economic implications but can adversely affect mood, happiness, comfort.
• Older people and partner agencies with a remit for older people’s health should be provided with consistent and appropriate messages concerning nutrition in later life.
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Do we listen to our clients?
• Do we know what is good for older people?• In chronic disease and life limiting conditions
we need to be aware that food can create considerable anxiety, misunderstandings, become a battle ground.
• Do we take into consideration all the challenges around food?
• Do we address beliefs and values?• Do we aim to improve QoL or nutritional status?
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Malnutrition, dignity and later life.
•Do we really cater for the individual needs of our ageing population?
•If diet is a habit of a lifetime - are individuals able to enjoy what they have habitually eaten when in a care home, nursing home?
•Do individuals feel engaged in the preparation and choice of meals?
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Creating the Right Environment