Nutrition and hydration in the elderly

The elderly often show less interest in eating and weight loss can be quiet remarkable. You can also stop drinking so much - especially if you have incontinence problems. In the face of advanced dementia and / or a terminal illness, this lack of interest in food and drink can become even more pronounced. Family dinners are less of a social event and more a battle of wills, as children focus their energy on what you eat and how much you eat to be. If there is an extreme weight loss, nutrition and artificial hydration may be considered.

Before considering alternative methods of nutrition and hydration there are certain questions that need to be made:

* Has there been a study of swallowing (barium swallow) to rule out a physical problem that makes swallowing difficult? Muscle strength tends to decrease as we age. This decrease in muscle strength can affect the muscles involved in swallowing. Stroke or TIA ("mini"-movements) can affect the control of the muscles needed for swallowing effectively.
* Are ill-fitting dentures or poor dentition due to a decrease in food? If dentures do not fit, eating can become a problem and even painful. Chewing and eating can also be difficult if the natural teeth are missing or broken.
* Is there a fear of eating or drinking due to problems with incontinence? The elderly are incontinent and can not eat or drink if they are afraid it may have an "accident" or not have easy access to a bathroom when needed.
* Depression is a factor? Clinical depression can cause a lack of appetite can result in weight loss. Depression can also cause a lack of interest in activities such as family dinners, restaurants, etc.
* Are the drugs to blame? Many medications can cause a lack of appetite or make food "taste funny".
* Is the dementia is a factor? The elderly with dementia may forget how to prepare food, how to feed themselves, or how to chew and swallow.
* Is a decrease in appetite for the result of a terminal illness? One of the problems encountered with terminal illness is a natural decrease in hunger and thirst as the body prepares for death. Medical professionals should be involved in helping patients and their families understand the disease process and its impact on nutrition and swallowing.

If the alternative supply and / or hydration are considering some issues should be considered:

* The alternative nutrition / hydration to improve nutritional status?
* The alternative nutrition / hydration reduces the risk of the disease or prevent the disease?
* The alternative nutrition / hydration helps to increase life expectancy?
* The alternative nutrition / hydration to improve the quality of life?
* You alternative nutrition / hydration intervention in the short term or long term?
* What are the risks associated with alternative nutrition / hydration?
* Is there any consideration whether the alternative nutrition / hydration is always, but there is a "change of heart"?

All these questions need to be carefully considered before taking steps to pursue alternative means of supply. Professionals need to educate families about the benefits and contra-supply pipe, nutritional supplements, appetite stimulants, etc., before making a decision. This education must be specific to the patient in question and take into account the overall health of the patient.

Susan Ross has been a speech pathologist for 33 years and has worked in a variety of environments. She is a lifelong learner, who recently received two ACE Awards for the American Speech Hearing Association and for his efforts in seeking opportunities for continuing education. In addition to his clinical experience, with more than 20 years of management experience in the continuum of geriatric care (SNF, ALF, ILF, home health and welfare). He has received awards for their service and customer retention, scheduling clinical training, and consulting, and employee retention.