Week 3&4: Older Adult and Biophysical Needs Food and Fluid

Question 1

Why is it important to have food and fluid?

Answer 1

Needs of survival
Food is related to quality of life, happiness, physical and mental functioning, independence

Question 2

How does income interconnect with nutrition?

Answer 2

If a person has low income, it may be hard to afford healthier foods

Question 3

Older adults and income

Answer 3

Older persons’ poverty rates among Canadian Indigenous people and recent immigrants are much higher than in other groups.

Question 4

How does nutrition and transport interconnect?

Answer 4

Available and easily accessible transportation is often a limiting factor for older people to access places where food is sold or served.

Functional impairments make the use of public transportation difficult for some older people.

Question 5

How much water should someone drink if they are 51 years or older?

Answer 5

1500 to 2000 mL normally

Question 6

How much should older adults reduce their sodium?

Answer 6

Reduce by 900 mg

Question 7

Why should older adults reduce their calories

Answer 7

In response to corresponding changes in metabolic rate and a general decrease in physical activity.

Question 8

Why is fluid intake so important for older adults?

Answer 8

Sometimes thirst mechanisms are less responsive (they may not know when they are thirsty)

Question 9

Diabetes Mellitus (DM)

Answer 9

Now simply referred to as type 1 or type 2, is a syndrome of disorders of glucose metabolism resulting in hyperglycemia

Question 10

Type 1 Diabetes

Answer 10

Formerly called insulin-dependent diabetes mellitus

Develops in early life

Result of autoimmune destruction of the insulin-producing beta cells of the pancreas

Genes that are related to type 1 DM have been identified.

Question 11

Type 2 Diabetes

Answer 11

Formerly called non–insulin-dependent diabetes mellitus (NIDDM)

The pancreas makes insulin, but not enough to keep up with the needs of the body.

No genetic influence has been found with the development of type

Question 12

How many Canadians are living with diabetes?

Answer 12

about 1 in 10 Canadians age 20+ years, was living with diabetes.

Question 13

Indigenous people and diabetes

Answer 13

Rates of diabetes in Indigenous populations are three times higher than the general population.

Question 14

Complications Microvascular (Diabetes)

Answer 14

Loss of vision (diabetic retinopathy) & End-stage renal failure from diabetic nephropathy

Question 15

Complications Macrovascular (Diabetes)

Answer 15

Myocardial infarction, Stroke, Heart disease, Chronic kidney disease, Lower limb amputations

Question 16

Goals and treatments for diabetes

Answer 16

Prevent progression of the disease

Maintain glycemic control

focus should be more on the degree of glycemic control and be based on the condition of the person, rather than on a universal number

Question 17

What are symptoms of hyperglycemia

Answer 17

increased thirst and a dry mouth.
needing to pee frequently.
tiredness.
blurred vision.
unintentional weight loss.
recurrent infections (bladder)

Question 18

polydipsia

Answer 18

an increase in thirst.

Question 19

polyuria

Answer 19

frequent urination.

Question 20

polyphagia

Answer 20

a rise in appetite.

Question 21

What are the standards of care for diabetes?

Answer 21

significant skill for the older person → self-monitoring of blood glucose

Daily foot care and foot examination

Standards related to nutrition, exercise, and medications should be reviewed and utilized.

Question 22

Exercise and diabetes

Answer 22

An important aspect of therapy for type 2 diabetes
Decreases blood sugar
Increases insulin production and decreases insulin resistance
Walking is an inexpensive and beneficial way to exercise

Question 23

What medications are associated with diabetes

Answer 23

Type 2 diabetes: oral care

when the blood sugar is over 11.11 mmol/L (and is difficult to control) additional insulin may be necessary

Question 24

Antihyperglycemics

Answer 24

Oral agents
Insulin, including the new inhalant insulin

Question 25

Sulfonylureas and meglitinides

Answer 25

Increase insulin secretion

Question 26

Biguanides or thiazolidinediones

Answer 26

Useful to enhance insulin sensitivity by decreasing insulin resistance

Question 27

Attrition

Answer 27

wearing out of dental surfaces

Question 28

Dentin

Answer 28

exposure → tooth sensitivity

Question 29

Cementum

Answer 29

calcified surface covering roots of root - wearing out = sensitivity

Question 30

Tooth pulp

Answer 30

blood vessels, connective tissue, nerves - exposed = sensitivity

Question 31

Dystrophic inflammation

Answer 31

calcium depositing - plaque/tartar

Question 32

Xerostomia

Answer 32

Dry mouth
By hypofunction of saliva
Greater risk of periodontal disease

Question 33

Gingivitis

Answer 33

Inflammation
Bleeding and pain
Smell
Plaque, calcification

Question 34

Ageusia

Answer 34

Different taste
Hot drinks - damage teeth
Smoking contributes

Question 35

Stomatopyrosis

Answer 35

Burning mouth syndrome” or lips or tongue
Common in women - post menopause

Question 36

Candidiasis

Answer 36

Fungal infection by yeast
White patches - buccal mucosa

Question 37

Mini-Nutritional Assessment Short-Form (MNA®-SF)

Answer 37

A screening tool used to identify older adults (> 65 years) who are malnourished or at risk of malnutrition.
12-14 are considered normal nutritional status;
8-11 indicate at risk of malnutrition;
0-7 indicate malnutrition

Question 38

Clinical Symptoms of Aspiration:

Answer 38

Sudden appearance of respiratory symptoms (such as severe coughing and cyanosis)

Pocketing of food on one side of the mouth.

Question 39

Aspiration Pneumonia: Older Adults

Answer 39

Older persons with pneumonia often complain of significantly fewer symptoms

aspiration pneumonia is under-diagnosed in this group.

Question 40

Symptoms of Aspiration Pneumonia: Older Adults

Answer 40

elevated respiratory rate is often an early symptom

fever, chills, pleuritic chest pain and crackles.