Question

Additional Case Study 20-1: Elderly Woman with PEM (adapted 2018 Cengage Learning) Jenny is an $4-year-old resident of a skilled nursing facility. She has osteoporosis and moderate Alzheimer's Disease (AD). At the last care meeting, her family complained that she is not eating well and that she has lost weight. She is 61 inches tall and weighs 92 pounds. Her usual weight is 95 pounds. A review of her recent lab values indicates she has mild protein-energy malnutrition. She is on a low-sodium diet and has no food intolerances that her family knows about. Questions: (adapted 2018 Cengage Learning) 1. What type of nutrition support may be helpful to boost Jenny's oral protein and kcalorie intakes? Give some examples What are nutrition and feeding strategies used for AD? (Think about confusion, choking, changes in independence.) 2. 3. What strategies can be used to manage weight loss in AD?

Answer 1

1) To boost protein and caloric intake Jenny should eat vegetables, fruits, legumes ( beans, peas, lentils).

Increasing plant based foods in diet will help her to eat less saturated fats from meat as well as provide an abundance of proteins.

For Jenny as she is 92 pounds that is 46kg, so her protein intake should be 38.6 grams each day .So to fulfill this need she should eat low fat dairy products,fish, nuts,lean chicken and turkey.

2) Patient having Alzheimer's disease like Jenny it is very important to treat with them very kindly and patiently.

One should allow plenty of time for eating or feeding them.

Some feeding strategies are mentioned below-

First of all make sure that person is comfortable.

Mash food in grinder or give liquid food as patient having swallowing or chewing problem.

Give him/her adequate fluids.

Prepare their favourite food so that they can eat that food with more interest.

3) Management of weight loss requires enabling access to good nutrition.Some strategies can be implemented to prevent malnutrition. One can use oral nutrition supplements such as high energy drinks. To increase the food intake patient should encourage to consume supplements along with their regular food. This supplements should be given in between meals so it will help to minimise appetite suppression. Mostly protein energy supplements should be given to patient.