The purpose of this assignment is to review literature based on the chosen subject “Nutrition in the Elderly”. It will look at different aspects of best nursing practice in this area. Firstly it will discuss briefly what a literature review is and then how the literature search was carried out, and outline any limitations in the findings. It will also provide a brief outlook on elderly nutrition to give a reader a basic knowledge of the issues in the area of care.Following on from this the assignment, will then discuss and criticise the best nursing practice in the main themes that arose in the literature search.
The main themes that will be discussed are Malnutrition, how malnutrition has an effect on dementia, Assessment Screening tools and Communication. The reasons for choosing this subject is that while participating in an online blog in university I developed an interest in this area of practice.With an increasingly elderly population knowledge of this subject will be a fundamental requirement of future nursing practice. A literature review is carried out when researching a particular topic.
In order to do this the researcher has to conduct a literature search on their chosen subject. This should be up to date and reliable, Cronin,P, Ryan,F and Coughlan,M (2007). The point of a literature review is to bring the reader up to date with the most recently published information on the chosen topic.The review will also is to increase the writers understanding of the chosen topic. A systematic review of the literature was carried out.
According to parahoo (2006) a systematic review is a way of searching for literature, appraise, link together and give a summary of the information the writer had gathered. The chosen topic was “nutrition in the elderly”. As the literature search was being carried out certain recurring themes emerged. For example, when nutrition in the elderly was being searched malnutrition would frequently show up.This will enable the researcher to identify reoccurring themes which will be discussed in greater detail later.
This then narrowed down the search further to uncover more of a detailed search. While carrying out this literature search and analyzing different articles, a note was made of the key words used to search for the article that the writer would have used. These are found usually on the front page of an article Fowler, J (2011). These key words were also used to identify more articles on that certain theme.As a wide search was carried out there were a large number of key words and they will be found in appendix one. The literature search results are as follows.
The databases used were from the university website which had a link into EBSCO HOST. This is a database which allows a person to cross search many databases at the same time. This was the avenue this search took. The databases that were searched were as follows. British Nursing Index, Cinahl, Health Source: Nursing/Academic edition and Medline.As a literature search is to bring the reader up to date with current literature a limit was set on the years in which the articles were published.
This search was based on information published between 2004 to 2011. Using EBSCO HOST allowed the cross search to be narrowed down to, research article, evidence based practice, language, age group and peer reviewed. This allowed the search to bring back the results required. Searching using the key word nutrition with these limitations identified 21018 results.Elderly nutrition however identified 5085 results.
Since there were a large number of results the search was further narrowed. To achieve this different key words were used for example malnutrition, nutrition disorders, hospital catering, under nutrition. As the search was being carried out, there were a few problems. For example searching nutrition while using a crossed database would identify articles that no relevance to the searched key word. *GIVE EXAMPLE*? This meant spending time going through all results carefully.
This paper will briefly discuss nutrition to give baseline knowledge to the reader. A healthy diet will maintain adequate nutrition. According to Nazarko (2009) a healthy diet will supply a person will the correct amount of calories and nutrients to maintain good health. A healthy diet contains five main food groups Food Standard Agency (FSA) (2008) have identified that it should include “bread, cereal (including breakfast cereals) and potatoes(starchy food). Fruit (including fresh fruit juice) and vegetables.
Meat and fish. Milk and dairy foods. Fat and sugar”. These different types of food should be included in to a daily diet to ensure the person is receiving the adequate amount of nutrients to maintain health. If an inappropriate balance of the various foods groups is consumed or if the food is inappropriately prepared the nutritional benefit derived will be affected FSA (2008). Nazarko (2009) describes that the use of little fat and butter and they way food is cooked for example frying food.
If there is an over emphisis on, for example fats and sugars at the expense of fruit and vegetables then a nutritional imbalance will result. If this happens to an older person they are more at risk to being malnourished. World Health Organization (WHO) (2011) defines a person of 65 years and over to be classed as being elderly. WHO (2003) also states that malnourishment is hard to characterize as it is not just one condition. WHO narrows the condition down into two categories.
Firstly, under-nutrition. This is classed as a low intake of food.Secondly malnutrition is defined as a lack of nutrients, and would result in health issues. The National Institute for Clinical Excellence (NICE) (2006) also state that malnutrition is a insufficiency of nutrients such as protein, energy, vitamins and minerals and this would have an adverse effect on the body’s health. NICE have identified malnutrition as a Body Mass Index (BMI) of less than 18.
5kg/m2. An unintentional weight loss greater than 10% within 3 to 6 months . A BMI of less than 20kg/m2, with an unintentional weight loss greater than 5%.In order to identify best nursing practice for the elderly, this essay will look at examples of good practice. According to Ashurst,A Arrowsmith, J 2010 the patient must be assessed for malnourishment in the first instance, also gaining the patients eating habits and exploring the patients external factors to the reasons for the malnourishment. The Nurse would have to think about a plan of treatment, this would contain a care plan on how to improve the malnourishment and put any treatments in place for example high calorie diet or even supplements.
Dunne,A (2008) also agrees that a care plan should be put in place to record and review the patient’s weight and treatment on regular bases. This should be looked at in short and long term bases Dunne, A (2008). Dunne, A (2008) recommends that if an elderly person is malnourished then by raising dietary intake then the weight of the person should increase. As it is important to assess the patient the assignment will then look at screening and assessment tools. Assessment toolsAs prior to looking at malnourishment it was proved that it is important to assess the patient when first in contact with a health professional. This will indicate if the patient is malnourished or not.
There are many assessment tools that are used on a daily bases, theses can be used in settings of, hospitals, in the community or used in nursing homes. This paper will discuss a selected number of tools as there are too many to The first assessment tool to be discussed is the malnutrition universal screen tool (MUST) *expanding on* MALNUTRITION Reasons for malnutrition- dementia , social, Dysphagia, nurse workload (protected meal times),etc
