Caring for an Older Relative in My Home

1
Caring for an Older Relative in My Home
Consumer and Family Sciences Department of Foods
Nutrition Dorothy Morré, PhD Laura Palmer, MS,
RD
Purdue University is an Equal Opportunity/Equal
Access institution.
2
Objectives

• Explore the demographicsof aging.
• Learn how to identify signs ofinability to live
  independently.
• Consider benefits andchallenges of living with
  family.
• Explore challenges presented to caregiver.
• Understand the nutritional needs of an older
  adult in your home.
• Identify changes in the body that affect
  nutrition in older adults.

3
People Are Living Longer

• 1900, 4 older than 65
• 1990, 12.6 older than 65
• 2010, first of baby boomer generation turns 65
• 2030, 20 of all U.S. residents will be over
  65 their care will require about half of all
  health-care expenditures
• Greatest increase is those 85 and older, a 200
  increase since 1960

Perron Robinson., 1998. Archives of Am. Acad.
Orthop. Surg., 21-8
4
Dependency Generally Increases with Age
Dependency is defined as a lack of
independence or self-sufficiency.

• Among those older than 70, two of five (8.5
  million) need help with one or more daily
  activities.
• By 2030, about 21 million older individuals with
  activity limitations may need help.

5
Signs of Inability to Live Independently

• Requires assistance in performing basic
  activities of daily living.
• Fails to eat regularly or adequately.
• Needs assistance in eating.
• Weight loss greater than 10 pounds during past 6
  months.
• Restricted to wheelchair or bed.
• Home shows signs of neglect.

6
Mobility Is the Key for Independence
Mobility (how well the person can move about) is
an important factor for someone who lives alone.

• Problems result from lower body disabilities.
• If a person is immobile, it is nearly impossible
  to remainindependent.

7
Assessing Dependency Activities of Daily Living

• Bathing
• Dressing
• Toileting
• Transferring
• Continence
• Feeding

8
(No Transcript)
9
Assessing Dependency Instrumental
Activities of Daily Living

• Telephone
• Grocery shopping
• Preparing meals
• Housework
• Laundry
• Medications
• Finances

10
Additional signs of inability to live
independently Instrumental Activities of Daily
Living
Scoring Total the number of points. The lower
the score, the more dependent the older adult is.
Scores are only for individuals. It is useful to
see the score comparison over time.
Modified from Lawton, M.P. Brody, E.M. (1969).
The Gerontologist, 9, 179-186 
11
What May an Older Relative Give Up to Live in
Your Home?

• Independence
• Leaving a familiar neighborhood of friends and
  peers, leading to a feeling of isolation
• Self-reliance their attempts to contributemay
  be rejected
• Role reversal parents become childlike as their
  child becomes parentlike

12
Why Might It Be Important to Live in Your Home?

• Familiar surroundings
• Feeling of security
• Eases the season of loss

13
Why Might It Be Important to Live in Your Home?

• Contributes to socialization
• Aids in meeting nutritional needs
• Active families may motivate them toremain or
  become physically active

14
Who Provides the Help?
Majority rely on family
Family members provide about 80 of necessary
care for older adults.
Source U.S. Agency for Healthcare Research and
Quality. Long-term Care Users Range in Age and
Most Do Not Live in Nursing Homes. http//www.nfca
cares.org/who_are_family_caregivers/care_giving_st
atstics.cfm
15
Who Provides the Help?
Twenty percent of middle-aged households
include at least one elderly relative who
cannot be left alone. Many of these households
also include children and even grandchildren.
Source Federal Agency for Healthcare Research
and Quality. Elderly/Long-term care.
http//www.ahrq.gov/research/feb00/0200ra18.htm
16
Family Can Be a Good Support System
However, the picture is not always a bunch of
roses
17
How many of you are caring for an older relative
in your home?
More than one older relative?
If you are not currently caring for an older
relative, chances are that you will at some time
during your lifetime.
How many are caring for an older relative and
children at the same time in your home?
18
The Sandwich Generation
This term refers to people who are caring for
their aging parents while supporting their own
children.
G E N E R A T I O N
S A N D W I C H
19
What Challenges May the Family Face?

• Decision during time of active career
• Loss of job
• Resentful children
• Additional expenses

20
What Challenges May the Caregiver Face?

• Caregiving can be stressful
• Responsibilities can be overwhelming
• Caregivers must be sure to take care of their own
  health
• Preparing meals may become more difficult.

21
Nutrition for Older Adults

• Changes that affect nutrition as we age
• Senses
• Body structure
• Specific nutrient needs

22
Sensory Changes

• Loss of smell
• Experiment with fresh herbs and unusual spices
• Focus on eye appeal

23
More Sensory Changes

• Loss of taste
• Altered by medications
• Can lead to loss of appetite

24
Structural Changes

• Reduced muscle mass
• and strength
• Reduced organ function
• Decrease in weight

25
More Structural Changes

• Loss of bone density
• Loss of teeth

Dense bone vs. porous bone
26
Nutritional Needs Change with Age
Total energy requirements decline Older
adults need to eat less to maintain the same
body weight because of reduced muscle mass and
less daily activity.
27
Nutritional Needs Change with Age

• Daily requirements for most vitamins and
  minerals do not decrease with age
• Older adults need a
• nutrient-dense diet, which
• may be supplemented
• with a daily multivitamin.

28
The Energy Nutrients

• Carbohydrates
• Protein
• Fat

29
The Energy Nutrients

• Carbohydrates
• Grains are especially good for older adults
• Full of fiber (bulk)
• Provide energy, vitamins, and minerals
• When buying carbohydrates,
• look for whole-grain as the
  
  
• first ingredient

30
The Energy Nutrients
Protein How can older adults get enough protein?

• Include a protein food source at each meal
• If chewing is difficult, chop meat well
• If tolerated, include dairy products

31
The Energy Nutrients

• Fat
• Solid fats vs. oils
• Eating less fat is often beneficial because it
  lowers the risk of chronic heart disease, cancer,
  and obesity

32
The Daily Diet
Increase

• Fluids
• Calcium
• Fiber

33
The Daily Diet

• Fluids
• Function
• Reduce stress on kidneys
• Reduce constipation
• Ensure adequate blood volume
• Help carry medicine to proper places in the body

34
The Daily Diet

• Water
• Take regular breaks throughout the day to drink
  a glass of water
• Have fluids with your meal try soups and juices
• Keep a water container available at all times

35
The Daily Diet

• Calcium
• Calcium is the most abundant mineral
• in the body
• Strengthens bones and teeth
• Reduces risk of fractures from falls

36
Specific Nutrient Needs

• Show me the calcium
• Make dairy choices at every meal

• Sources
• Yogurt
• Milk
• Cheese
• Fortified whole grains
• Calcium-fortified orange juice

37
Specific Nutrient Needs

• Fiber
• The part of the plant that
• cannot be digested
• Lowers blood cholesterol
• Reduces constipation

38
Specific Nutrient Needs

• Fiber boosters
• Whole grain bread and flour
• Brown rice
• Fruits and vegetables
• Legumes and peanut butter
• High-fiber cereal
• Add additional fiber to food by sprinkling
  on some bran

39
Variety Spice Up Life

• More than 40 nutrients required daily

• Increased importance of nutrient density and
  variety

40
Opportunities to Include a Variety of Foods

• Provide breakfast foods for lunch or dinner
• Include a snack between meals
• Encourage small, frequent meals

41
Additional Tips for Increasing Food Consumption

• Taste and smell
• Texture and consistency
• Social dining

42
Factors to Consider when Preparing Meals for
Older Adults

• Does your family member have difficultywith
  chewing?
• Is your family member on a restricted diet?
• What is the activity level of your adult
  relative?
• Do they take medications?

43
Summary

• Dependency increases
• with age

• Two ways to assess
• dependency are
• ? Activities of Daily Living
• ? Instrumental Activities of Daily Living

• Older relatives experience benefits and
• challenges when living in home of family.

• Changes in the body affect nutrition in older
• adults.

• Nutritional needs change because of
• declining total energy requirements.

44
Assessing the Daily Diet of an Older Adult

• Was Today a Good Nutrition Day?