当前课程知识点:Gerontological Nursing > CHAPTER4: Elderly Daily Care > 4.4 Dietary Care for the Elderly > 4.4.1 Nutritional Needs of the Elderly and Influencing Factors of these Needs
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同学们好
俗话说民以食为天
饮食与营养对老年人来说
同样是非常重要的
合理的饮食与营养
是维持老年人健康的基本要素
饮食的制作和享受美食的过程
也可以给老年人带来
精神上的满足和享受
对于老年人群
他们的营养情况到底如何呢
中国科学院联合北京协和医院
开展了一项
有关社区老人营养风险的研究
调查评估3885名社区老人的营养风险
结果表明
接近半数的老年人存在高度营养风险
且营养风险的程度
随着年龄的增加不断提高
其中80岁及以上年龄段老人
高度营养风险比例高达53%
显著高于其他年龄段
这些数据表明
中国老年人的营养问题十分突出
急需改善
了解老年人的营养需求
识别影响因素
对改善老年人的营养状况
具有重要意义
那么
对于老年人群来说
随着身体的老化
在营养需求上会产生哪些变化呢
哪些因素又将影响
老年人的营养摄入呢
接下来
让我们共同分享
老年人的营养需求特点和影响因素
首先让我们先来认识下
当步入老年后
到底需要怎样的营养摄入呢
下面就让我们通过
这个金字塔
来了解老年人的营养需求
在这个金字塔当中我们看到
碳水化合物
仍然是占比最多的营养素
其供给能量
应占到总热能的55%-65%
但需要注意的是
老年人热能的摄入
应较年轻时减少20%-30%
以免过剩的热能
导致老年人肥胖的问题
还要注意
选择低血糖生成指数的食物
避免血糖水平波动过大
其次脂肪和蛋白质的摄入
仍十分重要
老年人需要摄入较为丰富的
蛋白质来补充组织蛋白的消耗
蛋白质的摄入的原则是优质少量
应尽量保持
优质蛋白占蛋白质总量的一半以上
豆类和鱼类对老年人来说
都是不错的选择
在脂肪摄入方面
老年人应该减少
饱和脂肪酸和胆固醇的摄入
避免猪油 肥肉等动物性脂肪
可以交替吃些
花生油 豆油 橄榄油等植物油
第三
无机盐和维生素的摄入不可或缺
老年人容易发生钙质代谢负平衡
特别是绝经后的女性易发生骨质疏松
在饮食中注意补充富含钙质的食物
比如说奶类和奶制品 豆类和坚果等
还可以增加户外日光照射
以帮助钙的吸收
此外老年人易发贫血
也要注意选择含铁丰富的食物
比如说瘦肉 动物的肝脏等
在维生素补充方面
老年人可多进食蔬菜和水果
特别是富含维生素A B1 B2 C的食物
可增强机体的抵抗力
延缓衰老的过程
最后
老年人还应保证
食物中的膳食纤维和水的摄取
改善肠道功能
降低血糖和胆固醇
控制体重和减肥
预防结肠癌等恶性肿瘤
通过前面的介绍
大家已经对老年人的营养需求有所了解
那么
对于老年人来说
哪些因素将会影响营养的摄入呢
第一个重要的影响因素
就是老化带来的生理上的改变
随着系统老化
老年人味觉功能下降
特别是苦味和咸味
感觉功能显著丧失
加上多伴有嗅觉功能的减退
对食物的香味的感受力明显下降了
老年人往往呢喜欢味道浓重的菜肴
此外
老年人由于握力下降
加上关节病变和其他疾病
导致的肢体麻痹或震颤
导致老年人自行进食能力
也出现了困难
最重要的因素则是
老年人消化系统的改变
首先
是老年人牙齿缺失
及咀嚼肌群肌力下降
导致老年人的咀嚼功能减退
不同程度的限制了他的进食
其次
老年人吞咽反射能力也不断下降
食物呢容易误咽而引起肺炎
甚至发生窒息
第三
老年人对食物的消化吸收功能下降
导致所摄取的食物
不能有效地被机体所利用
容易引起腹泻
第四
老年人胃肠蠕动减慢
易发生便秘
而便秘又可引起
腹部的饱胀感 食欲不振等等
对老年人造成不良的影响
另外
老人的基础疾病也比较多
比如说糖尿病
肾脏疾病等也是影响
食物消化和吸收的重要因素
除了这些生理因素之外
心理因素也是影响
老年人营养摄入的原因之一
丧偶 独居 入住养老院或医院
而感到不适应的老年人
往往会因为负性情绪
而导致饮食摄入的异常
对于排泄功能异常
而又不能自理的老年人
有时他们会考虑到照顾者的需求
往往呢会自己控制饮食的摄入量
而对于痴呆老年人
如果照顾者不加控制则
会导致老人饮食过量 过少
或出现异食行为
从而影响他的营养摄入
此外老年人的经济实力
生活环境及价值观等社会因素
对其饮食习惯的影响
也是不容忽视的
经济状况不佳可使老人
选择食物的种类和数量减少
导致营养不良
营养学知识缺乏可引起
偏食或摄入食物种类单一
导致营养失衡
有的老人在饮食观念上认为
不劳动者不得食
由于他们认为自己丧失了劳动能力
因此就在饮食上
极度限制自己的需求
而导致了影响健康
因此
老年人在饮食上要做到平衡膳食
适当限制热量的摄入
保证足够的优质蛋白 低脂肪
低糖 低盐 高维生素和适量的
含钙和铁的食物
同时
注意良好的饮食习惯的养成
在饮食习惯上要注意少食多餐
正餐7分饱
特别是晚餐不宜过饱
还要做到膳食口味清淡
食物呢应该细 软 松
饭菜温度适宜
两餐之间
或入睡前可加用温热饮料
以解除疲劳 温暖身体
总之
老年人的营养问题
应该引起充分的重视
在了解老年人营养需求的基础上
分析和明确
影响老年人营养的主要因素
并给予适当的干预
来改善老年人的营养状况
这节课就讲到这里
谢谢大家
-1.1 Human Life Expectancy and Age Classification of the Elderly
--Human Life Expectancy and Age Classification of the Elderly
--【Vedio Recommendation】 How do we measure life expectancy ?
-1.2 Population Aging
--【Literature Recommendation】World Report on Ageing and Health: 2015
-1.3 Influence and Countermeasures of Population Aging
--Influence and Countermeasures of Population Aging
--【Literature Recommendation】World Population Ageing Highlights:2019
-1.4 Goals and Principles of Elderly Care
--Goals and Principles of Elderly Care
--【Book Recommendation】Evidence-Based Geriatric Nursing Protocols for Best Practice
-1.5 Theories Related to Elderly Care
--1.5.1 Personality Development Theory and Life Review
--1.5.2 Disengagement Theory and Activity Theory
--1.5.3 Self-efficacy and Chronic Disease Management
--【Vedio Recommendation】8 Stages of Development by Erik Erikson
--【Literature Recommendation】Activity Theory, Disengagement Theory, and Successful Aging
--【Book Recommendation】Self-Efficacy in Changing Societies
-1.6 Elderly Support and Elderly Care
--1.6.1 Concepts of Elderly Healthcare, Elderly Support and Elderly Care
--1.6.2 Home-based Elderly Care Model
--1.6.3 Institutional Elderly Care Model
--1.6.4 Integrated Medical and Nursing Care Model
--【Vedio Recommendation】Day in the Life of Home Care
--【Website Recommendation】Official Website of the National Institutes of Health
-Concept Map
--【Concept Map】General Introduction to Geronological Nursing
-【Test】CHAPTER 1
-2.1 Aging Changes in the Elderly
--2.1.1 Aging of the Respiratory System
--2.1.2 Aging of the Cardiovascular System
--2.1.3 Aging of the Digestive System
--2.1.4 Aging of the Urinary System
--2.1.5 Aging of the Endocrine System
--2.1.6 Aging of the Motor System
--2.1.7 Aging of the Nervous System
--2.1.8 Aging of the Sensory System
--【Literature Recommendation】Exercise Attenuates the Major Hallmarks of Aging
--【Book Recommendation】Hazzard's Geriatric Medicine and Gerontology
-2.2 Comprehensive Health Assessment of the Elderly
--Comprehensive Health Assessment of the Elderly
--【Literature Recommendation】Instruments to evaluate mental well-being in old age: a systematic review
-2.3 Principles of Elderly Health Assessment
--Principles of Elderly Health Assessment
-2.4 Assessment of the Functional Status of the Elderly
--Assessment of the Functional Status of the Elderly
--【Literature Recommendation】The Lawton Instrumental Activities of Daily Living (IADL) Scale
-2.5 Assessment of Cognitive Function in the Elderly
--Assessment of Cognitive Function in the Elderly
-2.6 Assessment and Adjustment of the Living Environment for the Elderly
--Assessment and Adjustment of the Living Environment for the Elderly
-Concept Map
--【Concept Map】Elderly Health Assessment(1)
--【Concept Map】Elderly Health Assessment(2)
-【Test】CHAPTER 2
-3.1 Overview of the Psychological Characteristics of the Elderly
--Overview of the Psychological Characteristics of the Elderly
-3.2 Influencing Factors of Psychological Changes in the Elderly
--Influencing Factors of Psychological Changes in the Elderly
-3.3 Common Psychological Issues and Their Management in the Elderly
--3.3.1 Common Psychological Issues and Their Management in the Elderly (1)
--3.3.2 Common Psychological Issues and Their Management in the Elderly (2)
--【Book Recommendation】Development Through the Lifespan
-3.4 Depression in the Elderly
--3.4.1 Overview of Depression in the Elderly
--3.4.2 Clinical Symptoms of Depression in the Elderly
--3.4.3 Caring for Elderly Patients with Depression
--【Documentary Recommendation】Depression:Out of the Shadows
-3.5 Elderly Patients with Dementia
--3.5.1 Identification of Dementia Symptoms in the Elderly
--3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia
--3.5.3 Safety Care of Elderly Patients with Dementia
--【Website Recommendation】The Global Voice on Demaentia
-Concept Map
--【Concept Map】Elderly Mental Health and Mental Health Care
-【Test】CHAPTER 3
-4.1 Precautions for Daily Care of the Elderly
--Precautions for Daily Care of the Elderly
-4.2 General Care of Elderly Skin
--4.2.1 Characteristics and General Care of Elderly Skin
--4.2.2 Skin Itching and Its Management in the Elderly
--【Website Recommendation】American Academy of Dermatology
-4.3 Clothing Hygiene for the Elderly
--Clothing Hygiene for the Elderly
--【Literature Recommendation】The Design Methods of Functional Clothing for the Elderly
-4.4 Dietary Care for the Elderly
--4.4.1 Nutritional Needs of the Elderly and Influencing Factors of these Needs
--4.4.2 Dietary Care for the Elderly
--【Book Recommendation】Nutrition Care of the Older Adult: a Handbook for Dietetics
--【Website Recommendation】Nutrition for older persons
-4.5 Sleep Guidance for the Elderly
--4.5.1 Sleep Characteristics of the Elderly
--4.5.2 Sleep Guidance for the Elderly
--【Book Recommendation】An Occupational Therapist's Guide to Sleep and Sleep Problems
--【Website Recommendation】American Academy of Sleep Medicine
-4.6 Exercises Guidance for the Elderly
--4.6.1 Evaluation of Exercise Intensity in the Elderly
--4.6.2 Precautions Elderly Undertaking Exercises
--【Website Recommendation】American College of Sport Medicine
--【Book Recommendation】Handbook of Activities for the Elderly
-Concept Map
--【Concept Map】Elderly Daily Care
-【Test】CHAPTER 4
-5.1 Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly
--Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly
--【Website Recommendation】How Drugs Work In the Elderly
-5.2 Common Adverse Drug Reactions and Their Causes in the Elderly
--Common Adverse Drug Reactions and Their Causes in the Elderly
-5.3 The Principles of the Use of Medications in the Elderly
--The Principles of the Use of Medications in the Elderly
-5.4 Prevention of Adverse Drug Reactions in the Elderly
--Prevention of Adverse Drug Reactions in the Elderly
-5.5 Medication Compliance in the Elderly
--Medication Compliance in the Elderly
-Concept Map
--【Concept Map】Medication Safety and Care for the Elderly
-【Test】CHAPTER 5
-6.1 Falls in the Elderly
--6.1.1 Epidemiological Characteristics of Elderly Falls
--6.1.2 Risk Factors for Falls in the Elderly
--6.1.3 Prevention of Falls in the Elderly
--【Website Recommendation】CDC STEADI(Stopping Elderly Accidents, Deaths & Injuries Tool Kit)
-6.2 Dysphagia in the Elderly
-6.3 Urinary Incontinence in the Elderly
--Urinary Incontinence in the Elderly
-6.4 Constipation in the Elderly
-6.5 Dry Mouth in the Elderly
--【Website Recommendation】Academy of Nutrition and Dietetics
-6.6 Elderly Nutritional Deficiencies
--Elderly Nutritional Deficiencies - emaciation
-6.7 Visual Impairment in the Elderly
--Visual Impairment in the Elderly
--【Website Recommendation】Senior Eye Exams
-6.8 Senile Deafness
-6.9 Elderly Delirium
-6.10 Elderly Frailty
--【Literature Recommendation】Frailty in elderly people/Frailty in older people
-6.11 Pneumonia in the Elderly
-6.12 Hypertension in the Elderly
--【Literature Recommendation】2018 Chinese Guidelines for Prevention and Treatment of Hypertension
-6.13 Stroke in the Elderly
-6.14 Stable Angina in the Elderly
--Stable Angina in the Elderly
-Concept Map
--【Concept Map】Nursing Care for the Elderly with Common Health Problems and Diseases
-【Test】CHAPTER 6
-7.1 Concept of Hospice Care
--【Website Recommendation】 Definition of Palliative Care,WHO
-7.2 Death Education
--【Book Recommendation】The Meaning of Death by Herman Feife
-7.3 Nursing for Pain in the Dying Elderly
--Nursing for Pain in the Dying Elderly
-7.4 Nursing for Major Bleeding in the Dying Elderly
--Nursing for Major Bleeding in the Dying Elderly
-7.5 Nursing for Delirium in the Dying Elderly
--Nursing for Delirium in the Dying Elderly
-7.6 Nursing for Dyspnea in the Dying Elderly
--Nursing for Dyspnea in the Dying Elderly
--【Website Recommendation】The Hospice and Palliative Nurses Association,HPNA
-7.7 Psychological Problems and Nursing in the Dying Elderly
--Psychological Problems and Nursing in the Dying Elderly
--【Book Recommendation】On Death and Dying ,by Elisabeth Kübler-Ross
-7.8 Grief Counseling for the Widowed Elderly
--Grief Counseling for the Widowed Elderly
--【Book Recommendation】I Wasn't Ready to Say Goodbye,by Noel·Brook,Blair·Pamela
-Concept Map
--【Concept Map】Hospice Care for the Elderly
-【Test】CHAPTER 7
-Final Exam