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Older Adults (65+) (Health Issues (Stroke: reduced cerebral blood flow…

- - - - Ischemia (85% of all strokes)
        
        also called a "mini-stroke"
        
        created symptoms of a stroke, but then went away because clot dissipated
      - Hemorrhagic Stroke
    - - F - face look uneven?
        
        A -arm one arm hanging down
        
        S-speech -slurred speech
        
        T-time-call now!
- - - - " Multi Nutritional Assessment (MNA) by Nestle
      - DETERMINE Your Nutritional Health
        
        DETERMINE is an acronym for the Q's asked
        
        Use points for assessment
  - - - decreased thirst
        
        kidney's inability to concentrate urine
        
        voluntary avoidance of fluids
      - Seven signs and symptoms
        
        upper body & muscle weakness
        
        speech difficulty
        
        dry mucous membranes (nose/mouth)
        
        longitudinal tongue furrows
        
        dry tongue
        
        sunken appearance of eyes
    - - Increases in RHR
        
        susceptibility to UTI
        
        Pneumonia
        
        pressure ulers
        
        confusion, disorientation, dementia
        
        fecal impaction
    - - 1 ml/kcal with minimum of 1500 ml/day
      - beverages other than h2o contribute fluids + nutrients
    - - Reasons for voluntary dehydration
        
        slows body systems down
        
        less body fluid production
        
        causes natural loss of appetite, constipation
        
        may increase levels of confusion & drowsiness
        
        Comfort Care:
        
        ice chips
        
        morphine for pain
        
        Ativan for anxiety
- - - - Toxicity & liver damage (not usually deficient)
        
        Can eat beta-carotene to form into vit. A as needed
    - - Factors that put older adults at risk:
        
        skin changes
        
        limited exposure to sunlight
        institutionalization/homebound
        
        certain medications interfere
  - - - ~40% of older adults have low B12 levels
        
        may be due to low HCl & pepsin
        
        or inadequate intrinsic factor production
        
        make less IF as you age
      - Synthetic/Purified B12 is much better absorbed
        
        not bound to protein
        
        need for IF is completely bypassed in the synthetic form
    - - Needs decrease after menopause
        
        RDA for women decreases to 8 mg/day (level of a man)
        
        most older adults consume excess (can contribute to oxidative stress)