Nutritional Support for Elder Patients
The modern aging society encourages healthcare workers to provide nutritional support for older people in order to live longer and healthier. The aging process is accompanied by age-related changes that occur at the cellular, molecular, and tissue levels. Aging is a general biological regularity and it is manifested in a significant weakening of the functional capacities of all human body systems. Particularly, geriatric patients experience changes in the digestive system because the secretory and motor functions of the stomach become reduced. To maintain the normal condition and performance of the body, elderly people should receive nutritional support. They need to organize food and always take into account the possibility of their digestive system, the functions of which are reduced over time. Moreover, older people should eat in moderation to keep the biological balance and not gain overweight. With age, the body’s need for calories decreases and, therefore, it is necessary to reduce the calorie intake.
Keywords: nutritional support, older people, geriatric patients, digestive system
Nutritional Support for Elder Patients
Aging is a normal biological process that should be met with understanding and special concern. Older people realize that their main functions experience many age-related changes and require a special care. One of the most important issues in aging is nutritional support. Healthcare providers should educate the geriatric population about their nutritional needs and preferences in accordance with their age. Oftentimes, older people neglect this information but there is an emergency to keep special dieting in order to live longer and healthier. The current paper aims at reviewing, understanding, and evaluating different concepts related to the nutritional support for elder patients, as well as at becoming familiar with the new trends.
The Meaning of Geriatrics
The majority of countries accepts individuals who have reached 65 years of age as elderly or geriatric. Usually, this age is associated with the time when a person begins to receive a pension. However, some countries acquire different standards. For example, in Russia women and men begin to receive pension benefits at 55 and 60, respectively. Despite these differences, the United Nations has established the limit of 60+ to refer to the geriatric population (Siegler, Lama, Knight, Laureano, & Reid, 2015). The study identified that there is a common definition of old age; however, there is no commonly used agreement about the age when a person becomes old (Siegler et al. 2015). Consequently, some countries believe that biological age is equivalent to the old age. Furthermore, the definition of older people depends on the socioeconomic development and living standards. Thus, people in poor countries are aging faster than in most developed countries. As a result, they have a shorter lifespan.
The most popular theoretical perspective of the study of gender and aging is the theory of the life cycle that emphasizes the link between gender differences in early and late stages of life. Gambert (2012) uses this approach to examine how the status and human roles (for instance, marriage, divorce, widowhood, and retirement) may have different impacts on men and women with aging. These roles and statuses, as well as the transition from one state to another, differ in every society. Moreover, they are formed differently in relation to the existing varieties in social structures and cultural practices. However, Cresci (2016) suggests that, sometimes, a non-winning status of females in old age does not leave them a place for healthy nutrition in the geriatric age, especially those in poverty who need to work to the very end of their life, without any retirement. However, in order to avoid this gap, healthcare providers should inculcate proper nutrition habits regardless of older people’s socioeconomic status, race, culture, and so on.
Biological Features of the Aging Body
Aging is commonly understood as a general biological endogenous destructive process, continually increasing with age, which is characterized by the development of age-related changes in health, as well as an increased likelihood of death. It leads to a decrease in adaptive capacity of the body. However, Cresci (2016) believes that aging is manifested in the aging of cells, which eventually leads to their death. Gambert (2012) suggests that older people experience changes in their nervous system, which largely determines changes in other organs and systems. Furthermore, according to Cresci (2016), aging is accompanied by a decrease in brain mass, its volume, and linear dimensions. Age-related changes in the central nervous system are associated with changes in mental, behavioral, and emotional responses, impaired memory, as well as reduced mental and physical performance, motor activity, and fertility, among others.
The first feature of the aging body is the reduction of the intensity of the plastic metabolism with the overall decrease in metabolic rate. However, experiments indicate that aging occurs because the self-renewal of old age proteins slows. Furthermore, the deterioration of protein synthesis results in the reduction of a cell division rate and the violation of their physiological regeneration. As a result, numerous cells undergo atrophy and die. According to Beck, Holst, and Rasmus (2012), the number of nerve cells in the cerebral cortex and the cerebellum also decreases with age. Older people’s slowing bone cell proliferation leads to the bone loss and reduction of their strength.
The second feature is the reduction of the intensity of oxidative processes such as oxygen consumption. On the other hand, the lowering intensity of protein metabolism and the overall reduction in the intensity influence each other. One of the reasons for lowering the metabolic rate is the age enlargement of the colloidal particles of tissue proteins and the general increase of the content of low molecular weight substances (Cresci, 2016). These findings suggest that the changes in the digestive system that affect the geriatric population are a consequence of aging. However, it is important to note that adequate nutrition in combination with physical activity can help older people improve their medical state.
Nutritional Requirements of the Elderly
Most researchers admit that in old age, in order to maintain the normal condition and performance of the body, people should eat the right food. If individuals do not balance their nutrition, it significantly affects the development of the aging process. Therefore, it is necessary to organize a proper dieting and always take into account the possibility of the digestive system, the functions of which are reduced over time. The first rule is to eat in moderation. The second rule refers to the opinion that dieting should be biologically balanced. Finally, the third rule suggests adding to the diet products that contain the anti-sclerotic agent. However, some scholars believe that for older people, the diet with a relatively low amount of calories provides the best solution to their health regardless of their vital substances (Beck et al. 2012). On the contrary, Siegler et al. (2015) report that only well-balanced food matters to elderly dieting.
While studies by Cresci (2016) and Gambert (2012) generally claim that unconditional sugar and other sweet foods, as well as fats and fatty foods, are subject to the limitation, Beck et al. (2012) has found that in the diet of older people one should take into consideration individual characteristics and long-term habits. In old age, the processes of growth and formation of body tissues are not in progress anymore, and, therefore, the need for a plastic material, including protein, is less than in young people with incomplete growth processes. However, there are different views on determining the elderly needs for the protein, and this question cannot be considered because it is not fully investigated and resolved. However, the majority of researchers still believes that in the diet of elderly, proteins must be present in sufficient quantities, but slightly lower than in the young and middle ages (Siegler et al. 2015).
Remarkably, the Nutrition Institute has designed and recommended the following norms of daily protein requirements for older people. Thus, old men are supposed to take 80g of protein per day, including 48g of animal protein, while old women should take 71g per day, including 43g of animal protein (Gambert, 2012). Furthermore, sugar and sugary foods require special restrictions. Many nutritionists suggest, however, avoiding confectionery products and jam that are rather popular among elderly (Beck et al. 2012). Moreover, many of them believe that these products improve their mood and entire well-being. It seems that all researchers have concluded that products from whole grains (for instance, rye and wheat bread), as well as potatoes and other vegetables, are among the most desirable products because they contain fiber carbohydrates and pectin.
Most nutritionists respond positively to fruits and vegetables due to their fiber that stimulates gastric digestion. Cresci (2016) notes that raw vegetables and fruits are of the greatest value because they include tartaric acid that suppresses putrefactive intestinal flora. Gambert (2012) believes that pectin is an important means of normalizing bowel movements. Boiled vegetables, especially beets and carrots, contain pectin. The amount of pectin is much higher in baked apples than in raw ones.
New Trends Related to Nutritional Support for Elder Patients
A great variety of scholars admit that food for the elderly should be varied, digestible, and biologically valuable, but, compared with young people, food should be energetically less valuable (Siegler et al. 2015). The diet should contain a sufficient amount of protein, vitamins, and salts, especially calcium, potassium, and iron. Beck et al. (2012) advise older patients to monitor weight and take steps to normalize it, considering that full fat intake should be reduced to 60-70g. Moreover, they should not forget that there is the hidden fat in pork, should not eat fried foods, and should limit the intake of egg yolk. Gambert (2012) believes that the yolks should be eaten no more than two times a week. Furthermore, older people should eat 4-5 times a day, chewing food more slowly than previously. They should also be aware of the condition of the teeth and the digestive system. Despite nutrition preferences, they should never overeat. Cresci (2016) admits that the daily rate of caloric intake should be 2000-2400 calories depending on physical activity. In the case of overweight, this rate should be even lower.
Many studies assert that nutritionists should develop diets that contain a sufficient amount of protein that prevents the reducing of muscle tissue, and thus, prevents premature aging (Beck et al. 2012). The menu should mostly include such food as lean meat, cottage cheese, cheese, milk, and milk products, and others. According to Siegler et al. (2015), 300g of milk per day provide sufficient calcium for the prevention of bone fractures. Others suggest that it is better to eat high-quality vegetable oils such as sunflower, corn, and soybean, which help reduce cholesterol in the blood (Gambert, 2012). Simultaneously, older people should not prepare food for a few days in advance, taking into consideration that fresh food is the foundation of good nutrition.
As for the recommendations, it would be advisable not only to keep dieting in the old age but also to remain active. Even small physical exercises can improve older people’s mood that can positively impact their health. Moreover, it is necessary to communicate with their family members and friends. Communication is a great tool in improving psychological state that influences the physical well-being.
Nutritional support for elder patients is the core of their well-being. The geriatric population should understand that aging is a normal biological process that requires special concern. Although their main biological functions experience many age-related changes, proper nutrition can solve many health problems. Healthcare providers should educate the geriatric population about their nutritional needs and preferences in accordance with their age. Nowadays, experts have developed numerous recommendations and diets that can help older people feel the fullness of life. Older people should organize their nutrition in relation to the possibility of their digestive system, the functions of which are reduced over time. Moreover, older patients should keep biological balance and not gain overweight. Therefore, healthcare providers should inculcate proper nutrition habits regardless of their socioeconomic status, race, culture, and so on.