Introduction
Geriatric comes from the Greek word “Geron” meaning “old man”. It is a branch of medicine that deals with the care of the old people and aged with regards to their health. Old age is not a disease but a biological process that no one can avoid. It is a process that begins with birth and ends with death from the quotation of king II (1965) in his principles of nutrition. “ it is not enough to survive through the years from 60 to 80 years they should be years of health, enjoyment and mental vigor.
Aging should be a period devoid of nutritional non communicable disease. Unfortunately, the wide spread of malnutrition in the population and with the association of decline in functional status, impaired muscles function, decreased bone mass, poor wound healing and coupled with life style is seriously contributing to the nutritional problems of the geriatric. But with dietary management, these problems can help in preventing nutritional related disease.
What is nutritional geriatric?
Nutritional geriatric are changes associated in the normal ageing in the nutrients of the elderly. The nutritional needs the nutritional needs of the elderly varies and are determined by different factors including specific health problems and related organ system which comprises of an individual level of activity, energy expenditure calorie requirements, the ability to access, prepare, ingest and digest food and persons food preferences. The nutritional requirement of the geriatric is similar to that of the younger people.
Though they usually needs fewer calories and lesser food intake because of their low physical activity compare to the younger people. Most elderly people are at risk for developing malnutrition as they get older because some lack access to good food as a result of poverty and disability.
What are the nutritional problems of the geriatric
Nutritional problems of the geriatric are related to the presence of chronic disease and to the normal decrease in organ function that occurs with time. These can lead to a number of complications, including weakened immune system, lower energy levels osteoporosis, diabetes, taste etc. the following are some of the nutritional problems of the geriatric.
Malnutrition: malnutrition is an impairment of health resulting from a deficiency excess or imbalance of nutrients in the diet. The most important cause of malnutrition during old age are, poverty, in ability to move around easily, cumulative effect of chronic diseases knowledge og adequate preparation of meals.
Dehydration: Dehydration is common in the elderly for a number of reasons. The elderly have reduced ability to conserve water, are less sensitive to their thirst and may avoid drinking water because of overactive bladder problems. They are more likely to lack proper hydration during illness. Mild to moderate complications from dehydration include consumption, headache. Dizziness, low blood pressure and severe kidney failure.
Decreased sensitivity to taste: The geriatric often have trouble recognizing salty and bitter taste which can lead to high blood pressure. This is because they usually retain their ability to appreciate sweet taste.
Loss of teeth: With advancing age leads to several dental problems. Many elderly are partially or totally toothless. As a result, chewing becomes extremely difficult. Liquid or soft cooked mashed foods are preferred by them. However, such foods may not supply sufficient nourishment and supplement may be necessary.
Weight loss and weight gain: Both weight loss and weight gains are problem of the elderly related to nutrition. The geriatric have reduced metabolism as such burn fewer calorie. A slow metabolism coupled with reduced physical activity can lead to obesity, likewise limited access to food, decreased appetites, medical problems can cause weight loss.
Decreased immunity: The responsiveness of the human immune system has been shown to decrease with age. The deficiency of a number of nutrients has been linked to minimal function such as vitamin A, vitamin D, iron etc.
Dietary management of geriatric
In view of the nutritional problems of the geriatric discussed above, the diet and nutrients needs of the elderly are different from the younger adult. The following are the dietary management of the geriatric.
Energy: Energy requirement however, declines with increasing ages, particularly if physical activity is restricted. As a person ages the basal metabolic rate decrease. Energy intake should be reduced in view of reduced physical activity and metabolism. The calorie intake should be adjusted to maintain the body weight constant while in cases of obese, the calorie intake should be adjusted to reduce the body weight gradually until it balance.
Protein: High quality protein should be included in the diet. Replace red meat, processed meat with fish, chicken ,diary plant based protein sources will be real benefit to their overall health.
Carbohydrate: Most of our energy comes from carbohydrate, care should be taken to reduce the amount of sugar and refined cereals in the diet and include whole cereals or grains, pulse fruits and vegetables. Emphasis should be placed on reducing the intake of saturated fat and choosing poly saturated fat sources particularly omega-3- fatty acids found in fish, soy, linseed, canola seed and oil. Fats like butter, ghee and refined also should be reduced. Fats source of omega-3-fatty acid has been said to help in conditions such as hair loss, poor kidney function and painful joints
Fiber: They should eat foods rich in fiber. Dietary fiber can prevent or lower the risk for heart disease, stroke, constipation and diabetes. Dietary fiber such as green leafy, vegetables, pulse and fruits oranges, grape, pine apple etc.
Vitamins and minerals: The elderly should eat foods rich in vitamins A, C and D. the ability to synthesize vitamin D by the skin decreases with age. Older people are recommended to take supplement containing log of vitamin D as well as foods source of vitamin D e.g. Oily fish, liver, egg. Sunshine is the best source of vitamin D, 15 -20 minutes spent outdoor will help in preventing vitamin D deficiency. Those confined indoors should be given vitamin D supplement. While calcium helps to maintain good bone health. Therefore, it is advisable to increase the intakes of calcium rich foods like milk and milk products, green leaf, vegetables and sesame seeds calcium helps to reduce the risk of osteoporosis.
Fluids: As age advances, the body loses some of its ability to regulate fluid levels and their feelings or thirst is no longer reliable. Being dehydrated can show up as reduced output urine, constipation ,dry gums etc. Adequate fluid intake is important, this enable the kidney to function well to eliminate waste solids. A minimum of 6 – 7 cups of fluid daily is required.
Dietary guidelines for the geriatric
Eating a variety of food is important not only to the geriatric but everyone. If they eat well, they are likely to feel healthy, stay active for longer and protect them against illness. Below are some dietary guidelines for the geriatric.
- Foods rich in protein, vitamin and mineral should be included.
- Fat promote weight gain. Fat particularly saturated fat should be limited or avoided.
- Soft well cooked foods are preferred
- Fried and concentrated food should be avoided
- High fiber diet including green and white grains are to be included in their diet
- Food should be less salty and spicy
- Eat variety of nutrients foods
- Plenty of fluids and semi solid foods should be included in the diet
- Limit alcohol intake
- Be physically active on a daily basis like taking a walk, cychy will help strengthen muscle and improve balance
Conclusion
One of the most important things we can do for the geriatric population is to ensure a good dietary intake. Important risk nutrient include, protein, calcium, vitamin and dietary fiber which most of the elderly are not getting it. The best way to ensure a good dietary intake is by increasing the intake of grain, fruits and vegetables, fish, nuts, lean protein sources. No man has the power to stop the passing of time but every man has the power to make ageing more healthy and less harmful. The fitness and nutritional decisions made earlier in life set the stage for continued health and happiness.
