Dietitians
Help With Care of Elderly
Excerpt
By Lauran Neegaard, Associated Press
WASHINGTON (AP) - The 60-year-old lung disease patient gasped
for breath after certain meals. The culprit: High-calorie meals
loaded with sugar.
Healthy people just breathe a little faster to excrete the carbon
dioxide that's produced by eating sugar. But lungs damaged by
chronic obstructive pulmonary disease - one of the nation's top
killers - can't handle both the extra work and the new pounds.
It's one of numerous little-known diet tips that can make a
big difference in easing chronic diseases that plague older Americans.
But too few doctors have the time or training to deal with nutrition
choices that are making their elderly patients sicker - or even
realize how medications can sabotage a senior's already precarious
diet.
Now they're getting help: Dietitians have joined one of the
largest primary-care physician groups to provide the first at-a-glance
doctors' nutrition guide for the most common killers of elderly
Americans.
Better nutrition isn't a cure, cautions Dr. Albert Barrocas,
a New Orleans surgeon and nutrition professor who offered the
sugar-lung disease example.
But the hope is that the new nutrition guide - linked to more
comprehensive nutrition science at an Internet site - and some
easy-to-use consumer advice will ease seniors' suffering, maybe
enough that some can cut back on prescription pills.
It comes at a time of increased interest in nutrition therapy.
This month, Medicare began paying for registered dietitians to
help treat more than 7 million seniors with diabetes or kidney
disease, illnesses considered among the most influenced by diet.
Some 85 percent of seniors have at least one chronic disease
that can benefit from nutritional interventions. Yet the societal,
economic and physical changes of aging leave them at particular
risk of malnutrition.
A spouse dies and the survivor lacks the will or know-how to
cook healthy meals. Arthritis, heart disease or other ailments
makes cooking a physical challenge. Alzheimer's make patients
forget to eat. And medications can sap appetite or make eating
unpleasant. Antibiotics, for example, can leave your mouth feeling
like ``aluminum foil with fungus on it,'' says University of Tennessee
dietitian Jane White.
Indeed, while being overweight is a big risk for numerous illnesses
like heart disease and diabetes, many seniors can have the opposite
problem - being too thin to battle an illness.
``If you're elderly, I'd rather have you 10 percent overweight
than 10 percent underweight,'' Barrocas says.
The new Nutrition Screening Initiative, sponsored by the American
Dietetic Association and the American Academy of Family Physicians,
provides thousands of doctors a guide to nutrition concerns regarding
eight chronic diseases: cancer, chronic obstructive pulmonary
disease, congestive heart failure, coronary heart disease, dementia,
diabetes, high blood pressure and osteoporosis.
A Web site - www.aafp.org/nsi - links to more comprehensive
information and provides a quick test for consumers to check their
own nutrition risks.
Everyone's heard the ``eat less fat'' mantra for heart disease.
But the campaign's tips include less well known advice for doctors
and consumers:
-Monitor low weight. While 120 pounds may be nice for a 30-something
who's 5-foot-4, that may be dangerously skinny for a 65-year-old.
And losing 10 pounds in six months without trying is a danger
signal. For example, seniors' sudden weight loss can be an early
sign of dementia.
-Some common drugs, such as digoxin for heart failure, are among
the worst appetite-killers.
-Seniors often lose their taste for meats, yet protein builds
muscles and helps the body recover from illness. Remember other
protein-rich foods like beans, peanut butter and eggs.
-The sweet tooth that often accompanies age isn't necessarily
bad. If you're trying to fatten up an Alzheimer's patient who
loves doughnuts, provide them - all calories count to postpone
tube-feeding as long as possible, Barrocas advises. Try bite-size
finger foods; they forget how to use a fork.
-Make sure hypertension patients consume enough calcium, a natural
way to lower blood pressure. All patients at risk for heart failure
should lower salt intake.
-Get adequate fluids, six to eight 8-ounce glasses a day of
water, juice, milk, tea, coffee.
-Many experts recommend vitamin B12 supplements for seniors;
absorption lessens with age.
-Customize patients' dietary advice. Many kidney disease sufferers
need a low-protein diet, for instance, but some have a form of
illness that actually requires a little more protein.
White says seniors need to know there are easy ways to get healthy
foods. Buy pre-washed and cut bags of fresh vegetables and fruits.
Try salad bars, single-serving frozen vegetables, or low-sodium
frozen entrees.
Some Meals on Wheels branches offer to sell the hot meals to
seniors who can afford food but find it hard to fix.
Reference
Source 102
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