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Eating problems in older adults) assessing the problem (4)
Eating problems in older adults) assessing the problem: physical difficulties (3)
Eating problems in older adults) assessing the problem: disease (5)
Eating problems in older adults) assessing the problem: environment
- *new place, noise, distractions etc
Eating problems in older adults) assessing the problem: food quality
Home cooked to processed foods found in retirement homes
Oral health depends on (5)
Routine mouth care involves (4)
-rinsing with diluted mild mouthwash
-brushing of teeth
-soaking of dentures overnight
-applying Vaseline to dry lips
Tooth and gum disease) what is the main cause?
- Dental caries
- *especially root caries
Tooth and gum disease) second cause of this
Tooth and gum disease) risk factors for being edentulous (4)
-low income have double risk
- -educational level & being male
- *related to inadequate dental seeking behaviors
Dental caries and diet) most prominent form of tooth decay in the elderly?
Dental caries and diet) how to remedy xerostomia (dry mouth) (3)
-sugar free gum
Fermentable carbs AND dental caries
These types of carbs are more likely to create caries because they crumble and squeeze in between cracks then ferment.
*cakes, soda, etc
Dental caries and diet) consequences of partial dentures
Abrasion or erosion of enamel
Dental caries and diet) how does aging cause lack of pain?
Aging causes less secondary denting, vascularity, and sensitivity of dental pulp
Dental caries and diet) what does lack of pain bc of eroded nerve ends lead to?
No timely dentist visit because they don't feel pain in teeth
What causes xerostomia?
Lack of saliva
Xerostomia) 2 things it may result in
Xerostomia) is it normal part of aging?
Xerostomia) caused by numerous drugs (5)
Xerostomia) how can it be improved? (4)
-drinking more liquids
-use of artificial saliva substitutes
-chewing sugarless gum
Peridontal disease) how does it result?
Bacterial infection of gingiva
Peridontal disease) what does it lead to? (2)
-Destruction of ligaments attaching teeth to jawbone
Peridontal disease) how is it measured?
> 6 mm gingival detachment
Peridontal disease) prevention (3)
-strict oral hygiene to remove plaque
-enhance immune system
Angular cheilitis) what is it?
Chronic inflammation of corners of the mouth usually due to Candida fungus
Angular cheilitis) causes? (5)
-drooping sides of mouth due to dentures not providing muscular support
GERD) how is this caused?
-Lower esophageal sphincter weakens thus allowing stomach contents to flow back into esophagus
GERD) main symptoms (2)
GERD) what is an imporattn risk factor?
- *as one grows older, LES gets weaker
GERD) nutritional remedies (4)
-avoid large meals
-sit upright after eating
-reduce intake of foods that stimulate gastric acid
Constipation ) self defined
Abdominal discomfort, straining, passage of hard stools, inability to defecate when desired, and a feeling of incomplete evacuation
Constipation ) Rome III Def. : 2 of the following symptoms are present at least 12 weeks in last year (3)
-straining, lumpy, or hard stools
-sensation of incomplete evacuation or blockage
-manual manipulation to facilitate
Constipation ) what is considered as constipation?
Less than 3 bowel movements per week
Causes of constipation) aging intestinal muscles become...
- Less responsive leading to increased storage time
- *peristalsis not as efficient
Causes of constipation) stomach secretions AND Muscle strength & peristalsis
Lower levels of stomach secretions and potentially less muscle strength may affect peristalsis
Causes of constipation) diseases (5)
Causes of constipation) obstruction or diverticulosis : how can it cause constipation?
It can slow down the transit time
Causes of constipation) risk factors (3)
- *most claim constipation as side effect
-high iron or other mineral supplements
Causes of constipation) evidence that exercise relieves constipation in elders?
It is lacking
Nutritional interventions for constipation ) increase overall fiber intake
-insoluble fiber add to fecal bulk and stimulates peristalsis
Nutritional interventions for constipation ) what should patients be counseled?
Target should be at least 3 bowel movements per week
Nutritional interventions for constipation ) use of bulk laxatives (2)
- -special bran recipe
- *unprocessed bran, applesauce, prune juice
Nutritional interventions for constipation ) if no bowel movement by 2nd day use (2)
Nutritional interventions for constipation ) if no response? (2)
Dysphagia) what is it?
Dysphagia) Not a disease but...
It is a condition that results bc of a disease
Dysphagia) condition associated with this (10)
-spinal cord injury
-traumatic brain injury
Swallowing process) oral phase
-sucking, chewing, and moving food or liquid into the throat
Swallowing process) pharyngeal phase
-starting the swallow, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway or to prevent choking
Swallowing process) esophageal phase (2)
-relaxing and tightening the openings at the top and bottom of the esophagus
-squeezing food through the esophagus into the stomach
Barium swallow test for dysphagia ) what is it used for?
Barium swallow test for dysphagia ) what is it made from?
Barium swallow test for dysphagia ) how is it afdmintieterd ?
Added to foods/beverages of different viscosities
Barium swallow test for dysphagia ) what is taken to track down the barium?
Signs and symptoms of dysphagia ) (8)
-difficulty controlling food or saliva in the mouth
-difficulty initiating a swallow
-coughing during or immediately after eating or drinking
-recurring pneumonia or chest congestion
-throat clearing while eating
-sensation of food getting stuck
-coughing or choking
-wet or girly voice after swallowing
Dysphagia) consistency of liquids: nectar thick liquids (2)
-slightly thicker than water that coat and drip off a spoon
-similar to unset gelatin
Dysphagia) consistency of liquids: honey thick liquids
Thick as honey and flow off a spoon in a ribbon
Dysphagia) consistency of liquids: spoon thick liquids (2)
-remain on spoon in a soft mass
Dysphagia) consistency of liquids: standards for any of these?
No, they all vary by the insititution that it is being served
Dysphagia) consistency of liquids: 4 natural thickeners used?
-instant potatoes flakes
-puréed fruits in juice
Dysphagia) minimize eating and nutrition problems (5)
-avoid foods that are hard to chew or swallow
-serve soft foods
-encourage person to sit up straight
-after meal is over, ensure that there isn't any of it remaining on mouth
-be alert for choking and aspiration
Dysphagia) food consistency modification: level 4
- Regular foods
- *nothing changes
Dysphagia) food consistency modification: level 3 advanced-mild dysphagia
-near-regular with the exception of very hard, sticky, or crunchy foods
Dysphagia) food consistency modification: level 3 advanced-mild dysphagia how should foods be served?
bite size cubes
Dysphagia) food consistency modification: level 3 advanced-mild dysphagia, avoid...
-crusty or dry bread, nuts, apples, dry fruit, coconut, raw veggies and corn
Dysphagia) food consistency modification: level 2; mechanically altered (2)
-foods are moist, soft, and cohesive
-meats are ground or minced
Dysphagia) food consistency modification: level 2; mechanically altered , avoid...
Rice, corn, bread, soups, and casseroles with large chunks, nuts, and chewy, stringy or dry foods
Dysphagia) food consistency modification: level 1; puréed foods with added protein (4)
- -pureed and cohesive foods
- *no mixed textures
-everything is pudding like
-nothing that requires chewing is allowed
-close supervision during feeding
Look at slides for tips for feeding older patients
Look for hints for caregiver for older patients
Head & neck exercises) how is it? And what does it do (2)
-patient lying supine and lifting head up for 20x.
Reinforces the action of suprahyoid muscles that are cortical to upper esophageal sphincter opening