Question

John, 78 years old, is a sometimes homeless veteran. He is missing many teeth from years of no dental care. John receives a monthly retirement check but he has great difficulty meeting his monthly bills, let alone buying enough food, and this has caused many evictions. When he can afford them, John has his prescriptions filled for a diuretic (for high blood pressure) and a statin (for high cholesterol). John isn’t sure what his current weight is, but he has had to tighten his belt to the last notch over the past eight months. He has no family with whom he is still in contact, and he eats all of his meals alone. At a neighbor’s insistence, John is visiting the local senior center to eat lunch for the first time. The day he visits, each person is having a free nutrition screen completed by a program staff member.

Questions:

1. Using the “Determine Your Nutritional Health” checklist (p. 459), assess John’s nutritional status. What is his score?

2. Review the “DETERMINE: Warning signs of poor nutritional health” checklist shown in Table 18.5 (p. 458). Prioritize John’s nutrition problems based on this screening tool.

3. What parts of the nutrition education handout created by the University of Florida IFAS Extension (access at http://edis.ifas.ufl.edu/he944) should be used to provide nutrition education to John?

4. What should the local senior center registered dietitian do for John to help address the nutrition problems you identified in #2?

Answer 1

​​​​​(1) Before answering this question we must know about "determine your nutrional health checklist"

NUTRITIONAL HEALTH CHECKLIST

1)I have an illness or condition that made me change the kind and/or amount of food I eat. {2}
2) I eat fewer that 2 meals per day. {3}
3) I eat few fruits and vegetables, or milk products. {2}
4) I have 3 or more drinks of beer, liquor or wine almost every day. {2}
5) I have tooth or mouth problems that make it hard for me to eat. {2}
6) I don’t always have enough money to buy the food I need. {4}
7) I eat alone most of the time. {1}
8) I take 3 or more different prescribed or over-the-counter drugs a day. {1}
9) Without wanting to, I have lost or gained 10 pounds in the last 6 months. {2}
10) I am not always physically able to shop, cook and/or feed myself. {2}

This scale has 10 question of 21 points ,ask himself each question and rate that answer if

Scoring: 0-2 = LITTLE TO NO RISK, recheck in 6 months
3-5 = MODERATE RISK, consider nutritional supplements, meals on
wheels, etc. recheck in 3 months.
6 or greater = HIGH NUTRITIONAL RISK, see physician, dietician, etc.
Here johns score is. 13 out of 21 it indicate high nutritional risk.

2) johns nutrional problems based on warning sighns of poor nutrional health checklist are following-

1)disease-he is suffering from high blood pressure and high cholesterol level this alter his nutrtion.

2) eating poorly-most of he eats alome and most of time he didnt made food for himself.

3) tooth loss- he has no dental caries but still he is loosing teeth.

4)economic hardship

5) reduced social contact;he lives qlone he has no one tolive with him

6) multiple medicine-he has taking anti diuretics as well as statins

7) unvoluntry weight gain

4)

Disease
Any disease, illness, or chronic condition that causes you to change the way you eat, or makes it hard for you to eat, puts your nutritional health at risk. People with confusion or memory loss may not remember what, when, or if they have eaten.

What you can do:

Choose foods you are able to eat.
Use herbs or spices to improve taste.
Eat small meals and snacks.
Use reminders to eat; for example, put a note on your refrigerator or bathroom mirror.
Eating Poorly
Eating too little or eating too much can lead to poor health. Eating the same foods day after day, or not eating fruits, vegetables, and milk products daily also can cause poor nutritional health. Also, drinking alcohol can make many health problems worse.

What you can do:

Choose a variety of foods you like.
Have fruit with breakfast and snacks.
Limit alcohol use.
Boost up your meals; for example, add grated carrots to sandwiches or make soups with low-fat milk instead of water.
Tooth Loss/Mouth Pain
We need a healthy mouth, teeth, and gums to be able to eat a variety of foods. Missing, loose, or rotten teeth make it hard to eat; so do dentures that don't fit well or cause mouth sores.

What you can do:

Take care of your teeth and gums!
Be sure your dentures fit right.
Visit the dentist regularly.
Choose foods you are able to eat.
Economic Hardship
About one in ten Americans over age 65 (over 4 million people) live in poverty. Spending less than about $40 per week for food makes it very hard to get the foods you need to stay healthy.

What you can do:

Use available resources such as food stamps (SNAP).
Share meals with a friend.
Use coupons and buy store brand foods.
Eat less expensive protein foods, such as lentils, eggs, and pinto, lima, and kidney beans.
Reduced Social Contact
Just over one-fourth of all people over 65 years old live alone. Being with people daily has a positive effect on morale, well-being, and eating habits.

What you can do:

Share meals with a friend.
Eat at congregate meal sites or senior centers.
Stay in touch with family and friends.
Multiple Medications
Many Americans over 65 years old take multiple medications daily. Getting older may change the way the body responds to certain drugs. The more medicines you take, the greater the chance for side effects. This may include increased or decreased appetite, change in taste, constipation, drowsiness, diarrhea, or nausea. Large doses of vitamins or minerals act like drugs and also can cause harm.

What you can do:

Buy all medicines at one pharmacy.
Talk to your pharmacist about the medicines you take.
Learn about possible interactions between foods and medicines you take.
Make a list of all your medicines, including vitamin/mineral supplements and over-the-counter medicines. Take this list to all your doctor visits.
Involuntary Weight Loss/Gain
Losing or gaining weight when you are not trying to do so is an important warning sign that must not be ignored. Also, being either overweight or underweight increases your chance of poor health.

What you can do:

Eat healthy foods every day.
Stay as active as you can.
Tell your doctor about any change in your appetite and/or weight.
Needs Assistance in Self Care
The majority of older people are able to eat and take care of themselves. However, almost one half of people age 65 or older have trouble walking, shopping, buying and cooking food, and/or eating.

What you can do:

Stay in contact with family and friends.
Take advantage of available services such Meals on Wheels and food delivery programs from grocery stores or online food companies.
Elder Years Above Age 80
Most older people lead full and productive lives. But as age increases, risk of frailty and health problems increase.

What you can do:

Check your nutritional health often.
Stay as active as possible.
Treat yourself well with good meals.