Mrs. Baxter is an 83-year-old female who has lived with her daughter for the pas

Question

Mrs. Baxter is an 83-year-old female who has lived with her daughter for the past five years. She has a history of osteoarthritis, hypertension, hyperlipidemia, and occasionally episodes of constipation. She is taking Celebrex for arthritis, Lipitor for hyperlipidemia, Capoten for hypertension, Paxil for depression, a daily multivitamin, and Milk of Magnesia and Dulcolax suppositories as needed for the constipation. Her eyesight is poor, but she is not blind. She ambulates well, but her mental capacity has been deteriorating significantly over the past 6 months and she has difficulty remembering one day from the next. Because of her conditions and the family’s inability to provide adequate attention at home, she was admitted to a long-term care facility one month ago.

Since admission to the long-term care facility, Mrs. Baxter has not been eating well and has lost 8 pounds. She often sleeps through her meals or refuses them, insisting she is not hungry. She has had a difficult transition to the facility, and often cries when her daughter visits, asking to be taken home. Other than her daughter’s occasional visits, she has had no other visitors.

Mrs. Baxter has dentures but refuses to wear them. She states that they have become too loose and will fall out if she tries to eat with them. She doesn’t eat any fruits or vegetables because she finds them hard to chew. She was placed on a soft diet, but stated that she was unable to eat many of the foods.

1.             What is the relationship between nutrition and osteoarthritis?

2.             What other tools might be used to assess Mrs. Baxter’s nutritional status?

3.             What factors may be contributing to her occasional bouts of constipation?

4.             Use the DETERMINE Checklist below to determine the risk of malnutrition in Mrs. Baxter.

•     Disease

•     Eating poorly

•     Tooth loss or oral pain

•     Economic hardship

•     Reduced social contact

•     Multiple medications

•     Involuntary weight loss or gain

•     Needs assistance with self-care

•     Elderly person older than 80 years

Explanation / Answer

What is the relationship between nutrition and osteoarthritis?

It has remained recommended that osteoarthritis is a metabolic illness in which fats fundamentally subsidize to the pathophysiology of cartilage dilapidation. Nutritional extended cable omega 3 PUFA might disturb articular cartilage configuration and look to have helpful effects in osteoarthritis. In a US unit of persons with, or at great hazard of, knee osteoarthritis, there was a noteworthy converse association amid entire n-3 PUFAs and patella femoral cartilage damage.

What other tools might be used to assess Mrs. Baxter’s nutritional status?

Discerning neuro-degeneration of the elderly enteric nervous system be able to chief to gastrointestinal indications such as dysphagia, abdominal reflux and constipation. Caloric reduction can stop neuronal damage, signifying that régime may inspiration the aged gut. Esophageal motility might decrease the decrease of neurons in the mesenteric plexus in elder individuals. Gastric motility is reduced with elderly but the small intestine is genuine.

What factors may be contributing to her occasional bouts of constipation?

Abridged gastric acid oozes have a cumulative occurrence with elderly. Hypo-chlorhydia happens due to long-lasting gastritis. Therefore, proton pump inhibitors are regularly used for protracted stages in older individuals foremost to repressed acid oozes. Events such as vagotomy and stomach resections cause condensed acid levels. The general decrease in acid secretions inclines the gut to small bowel bacterial over growing.

Use the DETERMINE Checklist below to determine the risk of malnutrition in Mrs. Baxter.

There are age connected variations in the intestinal tract. The struggle is that with oldness it can be problematic to reject compulsive issues such as diabetes, pancreatitis, liver illness and malignancy, meanwhile these influences will have probable opposing effects on the intestine.

The dietary commendations are the subsequent:

-drop weight, if overweight, rather collective with workout;

-decrease plasma cholesterol by nutritional resources;

-at slightest for a experimental era, upsurge intake of extended chain 3 fatty acids rather by consumption oily fish twofold a week;

-purpose for a benign level of sun exposure, consume rich vitamin-D nutritional foundations or take vitamin D additions;

-upsurge vitamin K consumption by consumption of green leafy vegetables.

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