Nutritional Issues in Long-Term Care

Optimising nutrition in residential aged care: A narrative review

“…A physiological reduction in appetite and energy intake, referred to as the "anorexia of ageing", occurs naturally with progressive aging and usually exceeds the reduction in energy expenditure, resulting in unintentional weight loss mainly in the form of lean body mass (52). Additionally, a multitude of factors often referred to as the "nine D's" (Figure 1) are commonly observed in older adults and are associated with difficulty with self-feeding; social and financial problems; impaired digestion, absorption, and excretion of nutrients; and gastrointestinal symptoms (such as nausea, constipation, vomiting, diarrhoea, loss of appetite, and early satiety); resulting in decreased food consumption and exacerbation of malnutrition (12,15,(53)(54)(55)(56)(57)(58)(59)(60)(61). The use of plastic dishware has been associated with malnutrition due to its potential influence on taste of food items and residents' perception of being in hospital (62).…”

“…Sugar intake was also high and mainly contributed by excessive serves of 'extras' (including cakes, biscuits, confectionery, soft drinks, and ice-cream) (106). Research demonstrates that prescriptive therapeutic diets, often used in aged care for conditions such as diabetes and cardiovascular diseases, may increase the risk of malnutrition due to their restrictive nature (12,107). To prevent excessive intake of sodium, the use of herbs and spices as flavour enhancers is recommended to improve flavour perception that may be affected by age-related sensory deficits.…”

“…Lack of knowledge and awareness, and the inability to identify malnutrition by care staff; rushed and task-focussed eating environments that are often accompanied by little communication and conversation between residents and staff assisting with feeding; and residents' own physical, clinical, and psychosocial issues have been identified as major barriers against the prevention and management of malnutrition in the elderly (7)(8)(9)(10)(11)(12). In a recent poll conducted by the International Association of Gerontology and Geriatrics, RAC experts from eight countries identified "improving nutrition" as one of the top five international research priorities in this setting (13).…”

Assessment of malnutrition in older persons: A focus on the mini nutritional assessment

“…Poor nutritional status is now well established as a major negative prognostic indicator in older persons (1)(2)(3). Weight loss in persons over 60 years of age approximately doubles the chances of dying, regardless of the persons body mass index (4)(5)(6)(7).…”

An Investigation into Equations for Estimating Water Requirements and the Development of New Equations for Predicting Total Water Intake

“…For example, the ability to assess the water requirements for residents in the LTC setting is vital to their ongoing care (Sloane, Ivey, Helton, Barrick, & Cerna, 2008). The provision and/or consumption of inadequate amounts of water may contribute to decubitus ulcers, urinary tract infections, constipation, and dehydration (Castellanos, Silver, Gallagher-Allred, & Smith, 2003).…”