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Manual with 1 Reporting Form, 169 pgs.
Everything you need to know from nutrient
requirements with changes in age to the prevention and treatment of
chronic diseases. A must-have manual if you are working with older adults. Great resource to help you pass your Board Certification as a Specialist in Gerontological Nutrition (CSG). This
new comprehensive manual will enable you to:
- counsel elderly clients to improve the quality of their lives
- recommend appropriate biochemical or dietary assessments to determine
the nutritional status of the elderly
- make nutritional modifications important in the prevention and
treatment of major chronic diseases of the elderly
- interpret the role of antioxidants in aging, cancer, cardiovascular
disease and macular degeneration
- counsel older clients about the uses and abuses of supplements
- recognize potential drug-nutrient interactions in the elderly.
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Geriatric
Nutrition: Guidelines for Working with Older Adults, Fourth Edition
Karen M. Chapman-Novakofski, PhD, RD
Copyright 2012 Wolf Rinke Associates. All rights reserved for
this self-directed, accredited learning program. Reproduction in whole
or part without written permission from the publisher is prohibited.
Customer Comments
Retha Watson: "It was easy to read and understand and very informative. I enjoyed it very much."
Joyvelyn V. Hamilton: "Well organized and concepts explained well. Very pleased with this course and I love it."
Philip E. Risley: "Your programs are organized, very interesting
and help me improve my knowledge."
Mary L Owen: "I really liked the wide range of timely health and
wellness topics in this time of increased 'senior population' and the
seniors interest in health and wellness."
Susan Brinkmeier: "I especially appreciated the comprehensive
overview of supplements and the medication guides. The case studies
were realistic and made me re-think some of my approaches to clients."
Carol Darlow: "Informative information. Useful to my job as an
LTC RD. Cost reasonable."
Lisa Maroun: "Besides the knowledge, the case studies, you provided
answers to improve the learning experience."
Donna Christman: "I enjoyed that it was to the point but contained
much information."
Sheila Wooden: "Easy to read, kept your interest, will be a good
reference source."
Overview and Instructions
Nutrition professionals must be aware of the special needs of older
adults-the fastest growing segment of our population. More older adults
than ever are participating in community and outreach health programs
and seeking independent nutritionists for consultation about their health.
To meet the nutritional needs of the older adult, nutrition professionals
must understand the rationale for specific nutrient recommendations
in both preventive health and therapeutic nutrition.
This self-directed, accredited learning program begins with a summary
of nutrition screening options available to those working with older
adults. In chapter 2, you'll find an explanation of the nutrient requirements
that change with age. As additional research is published concerning
older adults, information is provided to care for these individuals
specifically. The chapter includes recommendations for calories, protein,
vitamins A, D, B6, B12, and calcium and sodium.
In chapter 3, the rationales and practical applications of nutrition
in regards to water, iron and zinc are discussed. In chapter 4, the
prevention and treatment of chronic disease is introduced. The conditions
covered include cardiovascular disease, hypertension, cancer, diabetes,
osteoporosis, and macular degeneration.
Chapter 5 focuses on supplements. Potential uses and probable cautions
provide nutrition professionals with useful information for their clients
and patients. These include supplements of those nutrients whose requirements
change with aging, as well as supplements of potential benefit in the
chronic diseases already discussed. Chapter 6 addresses medications
and focuses on the four common diseases of the elderly: cardiovascular
disease, cancer, diabetes, and osteoporosis. Potential interactions,
impacts on nutritional status, and an explanation of various medications
are included. Two case studies provide practice and application.
This is a level 2 Continuing Professional Education (CPE) learning program
approved for 18 Continuing Professional Education Units (CPEUs). That
means that the learner has little or no prior knowledge of the geriatric
nutrition literature. The focus is to increase knowledge and application
by the learner.
We suggest you follow these learning guidelines:
Review the objectives for the learning program.
Read each chapter. Stop and think about how this might apply to situations
you have experienced.
Read the case studies carefully, practicing the application of the information
in each case.
Assess what you have learned by completing the self-assessment instrument
at the end of this learning program.
Compare your answers to the answer key provided. For those that you
answered incorrectly, read the explanations and review the material
in the appropriate chapter. " Calculate your total score. If you
score at least 80% correct, you are ready to transfer your answers to
the CPE REPORTING FORM. If you scored less than 80% correct, re-read
this learning program and re-take the self-assessment until your score
is at least 80% correct.
After you have successfully completed the program, complete the CPE
REPORTING FORM and
Submit on-line at www.easyCPEcredits.com.
Or Fax to: (410) 531-9282,
Or Mail to: Wolf Rinke Associates, 721 Valley Forge Road #486, Valley Forge, PA 19481,
Upon receipt of your CPE Reporting Form, we will e-mail you a Certificate
of Completion within 3-5 days.
When you submit your CPE Reporting Form to us via mail, fax or www.easyCPEcredits.com,
be sure to write your correct email address in the space provided on
the CPE Reporting Form. If writing by hand, be sure to print your e-mail
address clearly.
To ensure that our e-mails are delivered to your inbox (instead of
your junk/spam folders), please add cpesupport@wolfrinke.com to your
Address Book or Safe List of allowed email senders. Also, be sure to
allow attachments from this email address.
Goals and Objectives
Goals
To provide you with comprehensive nutrition information that will enable
you to counsel elderly clients and improve the quality of their life.
Objectives
As a result of studying and applying the information presented in this
accredited, self-directed learning program, you will be better able
to:
- Counsel clients about diets that reflect nutrient requirements of
older people;
- Recognize why requirements change with age and be able to integrate
that knowledge into case management;
- Recommend appropriate biochemical or dietary assessments to determine
the nutrition status of older people;
- Counsel clients regarding nutritional modifications that are important
in the prevention and treatment of osteoporosis, cardiovascular disease,
cancer, diabetes, and macular degeneration;
- Provide comprehensive nutrition information that will promote health
and improve the quality of life of elderly clients;
- Counsel older clients about the possible uses and abuses of supplements;
- Evaluate the potential effects on nutritional status caused by drugs
prescribed for cardiovascular disease, cancer, and diabetes.
Table of Contents
Introduction 1
Chapter 1 Nutritional Screening and Assessment 5
Screening Tools 5
Subjective Global Assessment (SGA) 5
DETERMINE checklist and the Nutrition Screening Initiative 6
Mini Nutrition Assessment (MNA) 6
Tools used less often 7
Anthropometric Measures 7
Height 7
Weight 8
Body Mass Index (BMI) calculation and interpretation 9
Usual and ideal body weight 10
Waist circumference 10
Calf circumference 10
Other measures 10
Dietary Assessments 11
Biochemical Measures 12
Clinical Exam 12
Nutrition and Health Literacy 12
Clinical Implications 13
Chapter 2 Nutrient Requirements Important to Aging 14
Calories 14
Energy expenditure and balance 14
Energy expenditure in aging 15
Energy requirements 16
Caloric restriction and longevity 18
Protein 20
Protein digestion and metabolism 21
Dietary protein requirements 21
Assessing adequacy of dietary protein 23
Effects of inadequate protein intake or protein supplements 24
Vitamin A 25
Vitamin A digestion and metabolism 25
Function of vitamin A 25
Vitamin A requirements 26
Food and supplemental sources of vitamin A 27
Assessing adequacy of vitamin A status 27
Effects of inadequate vitamin A intake 28
Effects of high or supplemental vitamin A intake 28
Vitamin D 29
Vitamin D digestion, activation and metabolism 29
Functions of vitamin D 29
Vitamin D requirements 29
Food and supplemental sources of vitamin D 30
Assessing adequacy of vitamin D status 31
Effects of inadequate vitamin D intake 32
Effects of high or supplemental vitamin D intake 32
Vitamin B6 (pyridoxine) 33
Vitamin B6 digestion and metabolism 33
Functions of vitamin B6 33
Vitamin B6 requirements 33
Vitamin B6 in foods and supplements 34
Assessing the adequacy of vitamin B6 status 34
Effects of inadequate vitamin B6 intake 34
Effects of high or supplemental vitamin B6 intake 35
Vitamin B12 35
Vitamin B12 digestion and metabolism 35
Functions of vitamin B12 36
Vitamin B12 requirements 36
Additional factors effecting vitamin B12 requirements 37
Vitamin B12 in foods and supplements 37
Assessing the adequacy of vitamin B12 status 38
Effects of inadequate vitamin B12 intake 40
Effects of high or supplemental vitamin B12 intake 40
Calcium 41
Calcium absorption and metabolism 41
Functions of calcium 43
Calcium requirements 43
Calcium in foods and supplements 43
Assessing the adequacy of calcium status 44
Effects of inadequate calcium intake 44
Effects of high or supplemental calcium intake 44
Sodium 45
Sodium absorption and metabolism 45
Functions of sodium 45
Sodium requirements 45
Sodium in foods 46
Assessing the adequacy of sodium status 46
Effects of inadequate sodium intake 47
Effects of high sodium intake 47
Clinical Implications 48
Chapter 3 Nutrients with Special Implications for the Older Adult 49
Water 49
Water requirements 49
Dehydration 49
Iron 51
Function of iron 51
Iron absorption 51
Iron requirements 51
Food sources of iron 51
Issues with iron and aging 52
Evaluation of iron status 52
Zinc 53
Function of zinc 53
Zinc absorption 53
Zinc requirement and food sources 53
Issues with zinc in aging 54
Evaluation of zinc status 54
Clinical Implications 55
Chapter 4 Nutrition in the Prevention and Treatment of Chronic Disease
56
Cardiovascular Disease 56
Atherosclerosis development 56
Lipoproteins 56
Fatty streaks and fibrous plaques 57
Risk factors 58
A risk equivalent is: 59
Therapeutic lifestyle changes for treating elevated blood lipids 59
Dietary fat 59
Saturated fat 60
Medications for treating elevated blood lipids 63
Risk reduction in older adults 63
Hypertension 63
Cancer 65
Diet and cancer 65
Dietary fat, alcohol, overweight and breast cancer 65
Dietary fat and colon cancer 66
Fiber and cancer 66
Therapeutic nutrition in cancer 67
Diabetes Mellitus 68
Symptoms and diagnosis of diabetes 69
Treatment and monitoring 70
Osteoporosis 75
Symptoms of osteoporosis 77
Diagnosis of osteoporosis 77
Risk factors 77
Universal prevention recommendations 79
Specific dietary recommendations for treatment 79
Physical activity 80
Treating osteoporosis with medication 81
Macular Degeneration 82
Risk factors 83
Medical treatment 83
Nutrition and macular degeneration 83
Clinical Implications 85
Chapter 5 Supplements 86
Potential Uses of Dietary Supplements 86
Supplements of Nutrients whose Requirements Increase with Age 87
Calcium supplementation 87
Vitamin D supplementation 89
Vitamin B6 supplementation 90
Vitamin B12 supplementation 91
Protein supplementation 92
Supplements for Fortifying a Generally Poor Diet 92
Nutritional health depends upon a good diet 93
Supplements may be inappropriately used to treat a disease 94
Some supplements may not be effective 95
Some supplements may be unsafe 95
Supplements may stress a limited budget 96
Supplementation to Reduce the Risk of Certain Diseases 96
Vitamin C, Cancer, and Cardiovascular Disease 97
Vitamin C and cancer 97
Vitamin C and cardiovascular disease 98
Assessing adequacy of vitamin C status 98
Health risks with excess intake 98
-carotene, Cancer, and Cardiovascular Disease 98
Vitamin E, Cancer, and Cardiovascular Disease 99
Vitamin E and chronic disease 99
Health risks with excess intake 100
Zinc Supplementation 100
Clinical Implications 101
Chapter 6 Medications and the Elderly 102
Nutritional Considerations in the Drug Management of Cardiovascular
Disease 102
Hypertension 102
Angina pectoris 104
Atherosclerosis 105
Congestive heart failure 105
Nutritional Considerations in the Drug Management of Cancer 106
Nutritional Considerations in the Drug Management of Diabetes 109
Nutritional Considerations in the Drug Management of Osteoporosis 112
Clinical Implications 114
Case Study Osteoporosis 115
Case Study Diabetes and Cardiovascular Disease 119
References 123
List of Abbreviations 143
Self-Assessment Questions 145
Answer Key 157
Explanations to Self-Assessment Questions 158
About the Author 168
About Wolf Rinke Associates, Inc. 169
About the Author
Karen Chapman-Novakofski, PhD, RD, LD, is a registered and licensed
dietitian with more than 30 years of experience working with the elderly.
For 11 years she was a nutrition support team dietitian at a Veterans
medical center where she worked with severely malnourished as well as
outpatient aging veterans.
Today, Dr. Chapman-Novakofski is a Professor of Nutrition in the Department
of Food Science and Human Nutrition, the Division of Nutritional Sciences,
and the Department of Internal Medicine at the University of Illinois.
Her research, teaching, and outreach efforts focus on geriatric nutrition.
Dr. Chapman-Novakofski has published more than 200 journal articles
and abstracts, and teaches geriatric nutrition to both undergraduate
and graduate students. Her outreach efforts in geriatric nutrition education
include state and national conference presentations, and distribution
of educational materials. In 2006, she received the Distinguished Service
Award from the American Dietetic Association Gerontological Nutritionist
Practice Group. In her role as an extension specialist at the university,
Dr. Chapman-Novakofski collaborates with many public and private agencies
in the delivery of nutrition education and nutrition services to the
older adult in Illinois.
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