Malnutrition among people older than 65 years - Essay Example

Malnutrition among People Older than 65 years Malnutrition among People Older than 65 years Introduction Malnutrition is regarded as an imbalance of nutrients. That implies that malnutrition can mean excess nutrients of a deficit in nutrients. In the recent years, malnutrition has steadily increased among elderly people. The cause for concern is that malnutrition affects the health of an individual negatively. According to Furman (2006), about 5 to 10% of population in a given community is malnourished. This is a worrying trend considering that the elderly make up a big percentage of the United Kingdom’s population. About 65% of hospitalized people who are over 65 years old suffer from malnutrition (Campbell, 2013). That is a clear indication that malnutrition is not localized to homes. Considering these statistics, it is clear that malnutrition is more common in homes for the elderly and in hospitals which is ironical since these are places where professional care is supposed to be provided to ensure that such cases as malnutrition are avoided. Addressing the complicated needs of the elderly especially the nutritional needs is a complicated issue considering the population of the elderly in the United Kingdom is expected to double by 2030. Therefore, it is imperative that the general public, care givers and hospital staff be trained or advised on how to care for the elderly (Cole, 2012). To many people the word malnutrition conjures up images of children who are starving in Africa. Many people do not realize that the problem of malnutrition is also very real in the United Kingdom. More than 3 million people in the United Kingdom suffer from malnutrition. This paper will focus on the issue of malnutrition on people who are over 65 years old. This is an issue which has been ignored for a long time in the United Kingdom. This paper will consider ways of raising awareness to the general public about malnutrition in people over 65 years of age. This paper will explore ways of evaluating malnutrition among the elderly and health promotion interventions that can be employed to create awareness among the public. The paper will also explore some models and behavior change theories and how they may be applied to solve the issue of malnutrition among the elderly. The paper will also consider psychological effects of malnutrition among the elderly and their caregivers. Despite the recent attention given to malnutrition among elderly people, politicians have been painfully slow in taking the issue seriously. Finding a way to solve this issue will form the basis for this paper. In medical terms, malnutrition is either effect if illness or a cause of illness. Malnutrition can be as a result of another disease like cancer. For instance, people undergoing cancer treatment are usually nauseated and their appetite is usually low. The disinterest in eating can lead to leads to malnourishment if it goes on for a longtime. Malnourishment can lead to exhaustion, confusion, and increases the risk of infections due to a weak immune system as well as increasing the risk of falling due to muscle weakness. Psychological factors such as depression and social isolation can also lead to under-eating (Saletti, et al., 2000). Health Promotion Models and Interventions Health promotion theory usually helps in in capturing the nature of health promotion in a way that provides a frame work for analyzing and describing the processes, activities and contents of health promotion (Kagansky, 2005). Health promotion model studies health promotion framework, practice and design intervention. There are several models of health promotion such as Beattie’s model, Tannahill’s model, Holland and Caplan’s model, Pender’s model and Tone’s model (Russell, 2009). Beattie’s Health Promotion Model This model of health intervention focuses on intervention instead of activity. It is made up of four quadrants. The first one is health persuasion, legislative action, personal persuasion and community development. This model revolves around tacking action after things have already deteriorated. Therefore, this health model is not so much into prevention rather than intervention after the malnutrition process has already started. Tannahill’s Model of Health Promotion This model of health promotion defines plans and carries out health promotions. This model views promotion as made up of three domains. The first domain is health education, prevention and protection. This model emphasizes stress on several actions all of which are geared towards promoting health education, action and reaction. Holland and Caplan Model This model offers several options on dealing with health care. The process involves four step action actions. These are radical humanist, humanist, radical structuralism and traditional approach. Tones Model Tones health care model is based on the relationship between health care policy and health education. This model claims that health promotion is only possible when there is a combination of healthy public policy and availability of health education. Pender’s Health Promotion Model This health model was designed by Nola Pender as a complementary counterpart to behavioral science perspectives and nursing (Holmes, 2008). It gives a framework in which nursing is combined with behavioral science while considering the factors that influence health behaviors. This model views health as not the absence of disease but a proactive state. This model is approach or competence oriented model that and it excludes threat or fear as a motivating reason for health behavior. This model is based on several cognitive and perpetual factors. They include importance of health, definition of health, perceived health control, perceived health status, perceived barriers and perceived benefits. In Pender’s health model, there are also several modifying factors such as demographics, biological factors, situational influences, interpersonal influences and behavioral factors (Pender, 2011). This model promotes the fact that health behavior is the target result and it also represents the end point of this model. This model is concerned with three areas. These areas are individual experiences and characteristics, behavior effects and cognitions and behavioral outcomes. The inferences behind this model are the fact that each and every individual has his or her own unique factors that influence their ensuing activities (Cawood, 2010). As much as nursing procedures can change the set of variables representing behavioral factors remain the same and they affect the motivational impacts. However, this move still instigates that health promotion is supposed to be manifested in good health, improved quality of life and an increase in functional activities. Conceptual Model The public is more aware than ever before about the dangers of malnutrition among the older people. In 2003, the council of Europe published an article on food and nutritional care in hospitals. The paper had data collected from 18 European countries including United Kingdom. The article encouraged consistent assessment of patients’ nutritional needs. While that is a good step towards reducing malnutrition among people over the ages of 65 years, it is still not enough because not everyone above the age of 65 years is in a hospital or nursing home. Therefore, it is imperative to come up with a model that can be used as a guide in creating awareness among the public about the nutritional needs of people over the age of 65 years (Furman, 2006). The model proposed here revolves around two things. The first thing is prevention. That implies that instead of waiting for malnutrition to kick in, measures should be taken to prevent malnutrition in the first place. The second thing to consider is treatment. This step is applicable once the malnutrition has already started. In this step, the public is trained on how to detect malnutrition and the steps to take after that. It is also in this step that the public is trained on the various ways of taking care of people who are suffering from malnutrition. Finally, the people taking care of old people should always make a point of ensuring that the old people understand the reason why they are being put on certain diets even if they do not like the food they are eating (Brotherton and Simmonds, 2010). This model will be popularized by the use of social media. The reason for choosing this method is because nowadays, a lot of communication is happening on the social media platforms. This will ensure that the message gets to as many people as possible in the shortest time possible (Moses, 2014). The poster will include pictures of healthy old people and also pictures of an unhealthy old person. The poster colors are also supposed to be bright and cheerful. The impact of these colors is to convey the happiness of healthy old people. This poster is also meant to create awareness among the old people too. It will be like a message to the old people telling them it is important to take care of their health as well as showing the younger generation the importance of taking care of the older people. This poster will mainly be used in online social media platforms. However, the poster can be adapted to be used in hospital notice boards, nursing homes or in public places like train stations, bus stations and sports stadiums where a lot of people will notice its presence and its message. Health Campaign on Malnutrition among People older than 65 years The number of people above 65 years of age is expected to rise by almost 50% in the next twenty years. This will bring the number to about 16 million people in the United Kingdom. This rise in numbers is significant in the United Kingdom’s demographic structure. Malnutrition is one of the key health issues affecting the elderly in the United Kingdom. Despite the disaster it is, it remains under-treated, under-detected and under-resourced. Malnutrition has over the years been looked over as compared to other ailments affecting people over the age of 65 years. Malnutrition leads to other health problems like weakening the immune system, weight loss and an increase in the rate of hospital admissions and prolonged stays in hospitals (Whitehead, et al., 2010). The challenge facing those who take care of older people whether it is at home or in hospitals is understanding the causes and symptoms of malnutrition. Malnutrition can come as a result of many things including personal reasons, disease, social matters, medical reasons, or poor health among others. It is imperative for the people taking care of old people to understand that malnutrition is treatable and preventable (Wilson, 2009). Therefore, they should ensure that they provide effective preventable measures to avert malnutrition. Malnutrition is not a condition that comes as a result of old age. It costs the United Kingdom a significant amount of money in providing proper health care services as well as proper social care services. Therefore, if the malnutrition problem continues to be ignored it will lead to an increase in health budget at the cost of other projects (Rasheed and Woods, 2013). The malnutrition problem cannot be ignored any longer. This paper will consider the financial impact of malnutrition in the United Kingdom and some of the interventions that can be applied to tackle the causes and consequences of malnutrition. This campaign is meant to create awareness among the public by encouraging prevention as well as early intervention before the problem progresses. The United Kingdom’s population continues to age. Therefore, there is a big risk in the future if the malnutrition issue is not addressed (Brownie, 2006). Understanding the Problem When tackling any problem the first step is to identify the problem and understand it. In the United Kingdom at any given time there are at least three million people who are suffering from malnutrition or run the risk of suffering from malnutrition. About five percent of three million people suffering from malnutrition live in care homes. About 2% of them are in hospitals and 93% live in the community. A study done by ENHA in 2009 showed that one in ten people over the age of 65 years is malnourished or runs the risk of being malnourished. More than 70% of people over the age of 65 years live alone (Elia, 2009). This increases the risk of malnutrition since most people over the age of 65 years cannot take very good care of themselves. Malnutrition in the community can be attributed to life experiences. That might be true, but there are also other causes life like long term illness, anxiety, oral problems and diseases, problems with transport and mobility, poverty, social exclusion or the inability of the body to absorb nutrients. Research has established that malnourished people fall ill much often, greater use of antibiotics, recovery from illness or surgery might take longer and there is a high risk of mortality (Stratton, 2006). Research has also proved that malnourished people living in care home tend to be admitted in hospitals repeatedly or have high probability of being admitted to hospital in the future. Therefore, tackling the problem of malnutrition can help break this cycle. Malnutrition is costly. It affects the old people, their care givers and their families. Malnutrition also presents a bigger problem on social care services and stretches the resources allocated to the public health sector. To clearly understand the cost of malnutrition one has to consider not only the expense of malnutrition but also the social and personal cost to an individual (Bassey, 2006). Improving Nutrition among the Elderly Considering Pender’s model, preventing and treating malnutrition in people over the age of 65 years in the community or institutional care requires multidisciplinary approach. The multidisciplinary approach refers to dietary approach and disease treatment. Managing diseases and their effects can help in improving appetite and increase food consumption (Guest, et al., 2011). This paper will consider two approaches that can be applied to reduce and eventually eliminate the cases of malnutrition among people over the age of 65 years. These approaches are nutritional supplement and pharmacological solution, nutritional screening and care professional training and reinforcement of policy. Nutritional Supplement and Pharmacological Solution Using appetite stimulant medications and nutritional supplements can be utilized to treat people who have been identified to be malnourished. These methods can be implemented by oral nutritional drugs like ghrelin or individualizing a patient’s diet (Amarel, et al., 2007). This will ensure that the patient will ingest food that has the right nutrients. Oral nutritional supplements are mostly used when treating weight loss and malnutrition. Studies have shown that an oral nutritional supplement have helped in reducing mortality, reduced illnesses and strengthens muscles (Johansson, et al., 2009). This approach has many benefits, but its success is not guaranteed since many patients may opt to go for food taste instead of nutrients. Nutritional Screening and Assessment Identifying malnutrition and its symptoms is very important. That is considered as the first step towards addressing the malnutrition problem (Kaiser, et al., 2011). Nutritional screening can help in in creating awareness about the real dangers associated with malnutrition. This is also a good way of identifying older people who are already suffering from malnutrition or are in danger of being malnourished. Nutritional screening can also help hospital staff become aware of the importance of nutrition among the older people. There are several screening tools. The commonly used tool is Mini Nutritional Assessment (Sutton, et al., 2011). This tool demonstrates sensitivity to a variety of nutritional parameters like dietary intakes. Another common tool is Body Mass Index. This tool is used to observe weight loss (Jones, et al., 2009). Impact of Health Promotion The population of people over the age of 65 years is increasing. Ageing is a natural phenomenon and as people get older and the ageing process sets in some functions become exposed to regular tear and wear. Individual mental, physical and functional capabilities start to decline. During this transition period more health challenges start to appear (Jones, 2011). They may include health problems in digestion, cardiovascular, excretory, urinary systems and nervous system. There are also other health problems that are usually associated with old age such as Alzheimer’s disease, cancer, depression, diabetes and heart disease (Normand, 2012). Despite the fact that ageing is not a disease, the health challenges can make the life of an old person unbearable. These health problems may in turn lead to loss of appetite and considerable weight loss. In the end, an old person having such health challenges will end up suffering from malnutrition (Donini, et al., 2003). Good nutritional care is a basic need for old people (Kondrup, 2002). Therefore, the health campaign mentioned above is supposed to address ways in which old people can have proper nutrition. The impacts of the health intervention campaign include the fact that old people will change their behaviors and create emphasis in eating healthy diets. If the old people are made aware of the dangers of alcohol abuse to their health and their eating habits, most of them will consider stopping alcoholism. The same applies to some types of food that are not healthy especially for people over the age of 65 years. Such kinds of food include foods that contain a lot of fat. These types of food have been proven to be unhealthy even for young people who are always active. Using social platform to create awareness on the dangers of malnutrition among the older people will also have a very big effect especially among the younger generation. Nowadays, social media is the biggest platform across which a message can be delivered across the globe. Studies have shown that youth in the United Kingdom are very ignorant when it come the issue of malnutrition among the elderly. Considering the fact that most of the youths are already registered to at least one social platform, it is easier to post pictures and campaign posters on these social platforms. This method will ensure that the youths are aware what is happening to their grandparents’ health. This method of campaign has been seen to work before in creating awareness on other issues especially concerning humanitarian issues (Carers, 2011). Finally, training care givers on the importance of ensuring that they give the old people proper diet is important especially considering the fact that majority of older people suffering from malnutrition are either in hospitals or in care homes. The impact of this campaign is to show the care givers the benefits of ensuring that old people have proper diets. This campaign can go a long way in reducing the cost of healthcare by reducing the amount of money spent on malnutrition and diseases associated with malnutrition. Further research still needs to be done on the issue of malnutrition among people older than 65 years. The expected increase in the number of old people will definitely increase the financial burden on the patients, care givers and healthcare institutions (Merrell, et al., 2012). Therefore, it is important for adequate research to be done on financial factors that may lead to malnutrition. References Amarel, T., et al., 2007. The economic impact of disease-related malnutrition at hospital admission, Clinical Nutrition, 26, pp. 778-784. Bassey, E., 2006. Demi-span as a measure of skeletal size. Ann Hum Biol, 13(5), pp.499-502. Brotherton, A., and Simmonds, N., 2010. Malnutrition Matters: Meeting quality standards in nutrition care. BAPEN Quality Group, BAPEN. Brownie, S., 2006. Why are elderly individuals at risk of nutritional deficiency? International journal of nursing practice, vol. 12, no. 2, pp. 110-118. Campbell, D., 2013. 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