Question

Ruth, 82 years old, was placed in a nursing home due to her family’s inability to meet her increasing health care needs in the late stages of Alzheimer’s disease. This was a very difficult decision for the family, especially for her husband, 85-year-old E. Dale. Ruth had been on a diet for diabetes at home, but now is refusing almost all meals and fluids. Her family has been asked to decide on their plan for provision of tube feeding and IV fluids should this become necessary. In the meantime, the dietary department is doing their best to offer foods to Ruth that she used to like and eat well within the guidelines of a diet for diabetes. Ruth is completely unable to feed herself with utensils and she gets agitated when placed in the dining room with the other residents. She has been losing weight over the past two months since her admission.

Questions:

1. What is the therapeutic benefit of a diet (e.g., for diabetes) when an elderly person is in long-term care?

2. Should Ruth be required to follow a diet for diabetes at this time? Why/Why not?

3. What nutrition interventions might be helpful for Ruth at this time?

Answer 1

1. Diabetes is considered to be a more common disorder in older adults today. The high prevalence in elderly patients are due to age-related physiological changes that leads to increased glucose level in the blood. The therapeutic benefit of a nutritional diet on diabetes improve glycemic control and also accelerate the metabolic outcomes. The patient should get individualized nutritional interventions and guidelines to achieve treatment goals in therapeutic management. Moreover, diabetes education can also provide a comprehensive diabetes self-management and also act as a supportive measure to reduce the disease on patients.

2. Ofcourse yes, she should be instructed or guided to follow a diabetes restricted diet because unrestricted diet may increase her blood glucose level or else leads to anyother fatal conditions. Moreover, it is important to avoid situations like hypoglycemia. Normal intake of a low sugar diet may help her to balance her sugar levels.

3. Eating a well-balanced diet is an important part of staying healthy as you age. For an elderly patients, more amounts of calcium and vitamin D is needed to maintain a bone health. However, to prevent malnutrition in Ruth, these interventions can be tried to increase the intake of diet:

a) Make meals and snacks nutrient- rich b) Add extra calories without extra volume of the food c) Make diabetes restricted diet as per her likes and dislikes d) Encourage her to be more enjoyable and socialat her meal time to reduce agitation e) Allow her family members to share time with her during meal time to increase the intake of the patient. Tube feeding should be restricted In her, because separation from his family is the main reason for refusal of her diet that leading to malnutrition.