Question

Case Study

You work as an inpatient nutritionist in an assisted living facility. Martha Smith is a resident of the facility. She has lived there for 2 months and this is your first visit with her.  Martha is 5'9" tall and weighs 120 pounds. She has impaired mobility, attends meals in the dining room, but otherwise does not go out from her room, other than to watch movies in the recreation room or to play bingo in the dining room after meals. She is 87 years old. Her weight has been stable for at least the last 6 months.   She has had no illness of any kind for the last year, but her family put her in the assisted living facility because of her continuing loss of mobility. She can walk with a walker and gets to the dining room in the facility without assistance. She eats 3 meals a day in the dining room with some ladies she has met in the facility and has two snacks a day in her apartment that are provided by her family. She does not need help eating and has no difficulties eating.  She has regular visits from her family. Martha's family visits her every Sunday to eat dinner with her in the facility. Her niece also comes by once a week to visit and bring her snacks and anything else that she needs. Martha does not drink alcohol, has all of her own teeth which are still in pretty good condition, and takes only one pill daily for high blood pressure. Her food intake has been pretty consistent and if anything it has improved since she moved into the assisted living facility. She is not depressed and has suffered no trauma (psychological or physiological in the last year) except for moving out of her life-long house to move into the assisted living facility.

A typical day of food intake since living in the assisted living facility:

Breakfast:

1 cup of tea with sugar

2 slices of toast with butter and jelly

½ cup juice

Lunch:

             Chicken breast or other meat

             Mashed potatoes or rice

             Vegetables

             (she usually eats half of the portions served)           

             Cookie

             Iced tea

             

Snack:

½ Banana

Small sweet roll

Coffee

Dinner:

             Entrée

             Mashed potatoes or rice (unless entrée contains noodles)

             Vegetables

             Iced tea

             Cake

             (she eats about ½ of the portions served)

HS snack:

             Tea with sugar

             One piece of chocolate candy

1.     Complete the DETERMINE and Mini-Nutritional Assessment for Martha

2.     Is Martha at risk for any vitamin or mineral deficiencies based on her age, gender and diet recall. Explain the physiology of these deficiencies if they are age or gender related.

3.     Is Martha at risk for any macro nutrient deficiencies based on her age, gender and diet recall. Explain the physiology of these deficiencies if they are age or gender related.

4.     What is Martha's Ideal body weight? Percent ideal body weight? BMI?

5.     Calculate Martha's calorie, protein and fluid needs.

6.     Write ADIME for Martha