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A PROFILE OF DIETARY SUPPLEMENT USE OF ELDERLY IN TWO WISCONSIN COUNTIES
Health centers play varied roles in relation to nursing homes, from following existing patients, to having their physician serve as medical director of nursing homes, to owning and/or operating nursing homes. Community health centers that partner with skilled nursing facilities (SNFs) can enhance the well being of their patients, the community and their organizations. The health center may provide a range of services to help a patient remain in the community, but at times some patients will enter a SNF. In small rural communities without other long term care services, a SNF may be seen as very much a community-based...
8/30/2018 1:57:07 AM +00:00
Population Ageing, Elderly Welfare, and Extending Retirement Cover: The Case Study of Sri Lanka
Community health centers in partnership with skilled nursing facilities build on an existing continuum of care and create caring and competent communities. Partnerships with skilled nursing facilities can be financially rewarding, improve organizational reputations, and enhance the overall capabilities of the health center and its staff. Beyond partnering with SNFs some health centers may also choose to own and operate a SNF in their community. The level of regulation and very different nature of SNF business mean that health centers should approach this level of involvement with caution....
8/30/2018 1:57:07 AM +00:00
Sibship Size and Health Outcomes in Later Life among the Mexican Elderly
Several community health centers operate a PACE program, a home and community based service that allows severely disabled elders who are eligible for nursing home placement to remain in the community. PACE is usually based in adult day health centers and operates as a small Medicare Advantage capitated managed care plan at risk for providing all Medicare and Medicaid covered services including long term care and acute hospital care. Primary care services are also provided by the PACE program in a clinic setting utilizing employed or contracted medical providers. PACE programs typically provide all personal assistance and home health services...
8/30/2018 1:57:07 AM +00:00
SOCIAL EXCLUSION OF THE ELDERLY A COMPARATIVE STUDY OF EU MEMBER STATES
This includes being at risk for all medical and long term care costs. A health center taking on this program must be comfortable assuming significant financial risk as well as be able to assume the significant regulatory requirements for PACE that parallel much larger Medicare Advantage health plans. Despite the risk, PACE is one of the few accepted models for fully integrating health and long term care services for disabled elders and is a very significant resource for communities that have the programs. PACE began as a Medicare waiver program but is now a full Medicare benefit. Since it integrates Medicaid...
8/30/2018 1:57:07 AM +00:00
Addressing the Needs of Elderly, Chronically Ill, and Terminally Ill Inmates
The Medicare Modernization Act of 2003 (MMA) authorized the development of several new types of health plans for the elderly. The new Special Needs Plans (SNPs) are of particular relevance to the disabled elderly population. MMA allowed for three types of Special Need Plans, one aimed at residents of SNFs, a second aimed at dual Medicare and Medicaid eligible individuals, and a third aimed at patients with one or more chronic disease problems. To date, most SNPs have targeted the dually eligible but all three could be relevant to health centers serving the disabled elderly. These new types of plans,...
8/30/2018 1:57:07 AM +00:00
Frameworks of Integrated Care for the Elderly: A Systematic Review
Skilled Nursing Facility SNPs allow specialization in patients who are already institutionalized. Health centers may wish to explore partnering with such plans if their physicians are serving a significant number of nursing home residents or if they contract with or own nursing homes. Typically such plans can provide a more comprehensive and coordinated package of medical care to SNF residents than would be normally provided, thus saving on high cost care and, ideally, providing better quality of life for residents. United Health’s Evercare SNF plan is one of the models for this type of plan. (http://www.cms.hhs.gov/ DemoProjectsEvalRpts/downloads/Evercare_Final_Report.pdf)....
8/30/2018 1:57:07 AM +00:00
Healthy Eating, Active Living: An action plan to improve diet, increase physical activity and tackle obesity (2008-2011)
Dual Eligible SNPs are especially relevant to health centers because health center patients are more likely to be low income and qualify for Medicaid as well as Medicare. These plans receive higher capitation rates than Medicare-only plans because Medicaid recipients have higher levels of disease problems and complicating socio-economic factors and thus are considered by CMS to be of higher risk. Not only do dual eligible patients have more chronic disease problems but they are also more likely to have functional disabilities as well. Because of the higher rates that these plans receive health centers may partner with them to...
8/30/2018 1:57:07 AM +00:00
Health Council of the Netherlands Undernutrition in the elderly
Geriatric case management is a key ingredient of quality health care services for older adults. High rates of chronic conditions, dementia, frailty or disability, and sub-optimal home environment and social supports call for the integration of primary care and case management for elderly patients of community health centers. Case management may support health center disease management efforts but is primarily aimed at supporting the coordination of services that are necessary for living safely in a home environment. Without case management services, patients may have difficulty following home-care instructions, taking medications properly, scheduling appointments, arranging transportation, or accessing the array of...
8/30/2018 1:57:07 AM +00:00
Elderly Victims of Sexual Abuse and Their Offenders
The need for case management is particularly high among elderly patients suffering from isolation, depression, frailty, or chronic or disabling conditions. Patients may lack the social supports or capacity to reach out for help, and family members or other caregivers may lack the resources they need to provide appropriate or adequate care. Given these challenges, the fragmentation of social services in conjunction with medical care can function as an overwhelming barrier to access necessary care to support the “whole patient”. Health center based case management can offer an integrated and holistic approach to patient care that encompasses medical, psycho-social and home...
8/30/2018 1:57:07 AM +00:00
HEALTHY ELDERLY AMERICANS: A FEDERAL, STATE, AND PERSONAL PARTNERSHIP
It will help to connect with local training programs, provide internships, and offer professional development. Some health centers may be able to have trained community health workers perform these functions but the community health worker should be supervised by an MSW level social worker or by a registered nurse. Language access and delivery of culturally appropriate services are also essential components of providing quality care. When health centers are not equipped to provide in-house case management services, or to meet the level of need among the patient population, it is important to develop relationships for effective collaboration with local programs in...
8/30/2018 1:57:07 AM +00:00
DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS HEALTH COMMITTEE
Community health centers face many challenges to providing patients with optimal end- of-life care. Primary care is typically fragmented from specialty, palliative and hospice care. This break in the continuity of care as patients approach death can be alienating, stressful and painful for patients, family members, caregivers and providers. Patients often have difficulty getting their own wishes met as they get swept up in high tech acute care medicine. Given the inevitability of death, and the fact that most people die after the age of 65, End of Life Decisions: Given the unique needs and choices of individual patients, it is important...
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Elderly Americans
End of Life Decisions: Given the unique needs and choices of individual patients, it is important to help identify personal goals for end-of-life care. Ideally, routine assessment of elderly patients on intake, or once trust has been established, includes plans for medical decision-making and life-sustaining treatment choices. These issues should be discussed with patients in a direct way, and documented in advance whenever possible. Social services or case management staff can assist when necessary. These documented wishes should be revisited at critical times such as a new diagnosis or health crisis. These discussions need to be approached with sensitivity and...
8/30/2018 1:57:07 AM +00:00
Where Do Older Americans Live? Geographic Distribution of the Older Population
Palliative Care: The goal of palliative care is to improve the quality of a seriously ill person’s life, and to support the patient and family when faced with terminal illness. This includes managing physical symptoms, assessing psychological and spiritual needs, patient support system and discharge planning issues. Palliative care is part of hospice care, but it can begin any time during a patient’s illness. A team approach to palliative care is optimal, with the primary care provider and social services playing an active role. While it is not currently the norm, palliative care can be provided at community health centers....
8/30/2018 1:57:07 AM +00:00
ELDERLY SERVICES IN HEALTH CENTERS: A Guide to Address Unique Challenges of Caring for Elderly People with Disabilities, Frailty, and Other Special Needs
In February 2007, NACHC produced the document “Elderly Services In Health Centers: A Guide to Position Your Health Center to Serve a Growing Elderly Population.” That document presented issues for health centers to consider to meet elders’ health care needs and to take advantage of opportunities presented by the growing elderly population. This document continues NACHC’s efforts to position health centers to assure elderly people access to quality health care, but with a focus on individuals with medical or mental health conditions that limit their ability to care for themselves. As the number of people over the age of 75 increases,...
8/30/2018 1:57:07 AM +00:00
Canada’s Aging Population: Seizing the Opportunity
This document is based on the recommendations put forward by the 2010 Dietary Guidelines Advisory Committee. The Committee was composed of scientiic experts who reviewed and analyzed the most current information on diet and health and incorporated it into a scientiic, evidence-based report. We want to thank them and the other public and private professionals who assisted in developing this document for their hard work and dedication. Our knowledge about nutrition, the food and physical activity environment, and health continues to grow, relecting an evolving body of evidence. It is clear that healthy eating patterns and regular physical activity are...
8/30/2018 1:57:07 AM +00:00
SOCIAL WELFARE INSTITUTIONS OMR AL MADID INSTITUTION FOR ELDERLY
We are releasing the seventh edition of the Dietary Guidelines at a time of rising concern about the health of the American population. Americans are experiencing an epidemic of overweight and obesity. Poor diet and physical inactivity also are linked to major causes of illness and death. To correct these problems, many Americans must make signiicant changes in their eating habits and lifestyles. This document recognizes that all sectors of society, including individuals and families, educators and health professionals, communities, organizations, businesses, and policymakers, contribute to the food and physical activity environments in which people live. We all have a...
8/30/2018 1:57:07 AM +00:00
Falls and Fall Prevention in the Elderly: Insights from Jamaica
Health inequalities are not only apparent between people of different socio-economic groups—they exist between different genders, different ethnic groups, and the elderly and people suffering from mental health problems or learning disabilities also have worse health than the rest of the population. The causes of health inequalities are complex, and include lifestyle factors—smoking, nutrition, exercise to name only a few—and also wider determinants such as poverty, housing and education. Access to healthcare may play a role, and there are...
8/30/2018 1:57:07 AM +00:00
Health of the Elderly in South-East Asia A profile
We are pleased to present the 2005 Dietary Guidelines for Americans. This document is intended to be a primary source of dietary health information for policymakers, nutrition educators, and health providers. Based on the latest scientific evidence, the 2005 Dietary Guidelines provides information and advice for choosing a nutritious diet, maintaining a healthy weight, achieving adequate exercise, and “keeping foods safe” to avoid foodborne illness. This document is based on the recommendations put forward by the Dietary Guidelines Advisory Committee. The Committee was composed of scientific experts who were responsible for reviewing and analyzing the most current dietary and nutritional...
8/30/2018 1:57:07 AM +00:00
NATIONAL PROGRAMME FOR THE HEALTH CARE OF THE ELDERLY (NPHCE)
The more we learn about nutrition and exercise, the more we recognize their importance in everyday life. Children need a healthy diet for normal growth and development, and Americans of all ages may reduce their risk of chronic disease by adopting a nutritious diet and engaging in regular physical activity. However, putting this knowledge into practice is difficult. More than 90 million Americans are affected by chronic diseases and conditions that compromise their quality of life and well-being. Overweight and obesity, which are risk factors for diabetes and other chronic diseases, are more common than ever before. To correct this...
8/30/2018 1:57:07 AM +00:00
RECOMMENDATIONS FOR BEST PRACTICES in the Management of Elderly Disaster Victims
Thus it is a publication oriented toward policymakers, nutrition educators, nutritionists, and healthcare providers rather than to the general public, as with previous versions of the Dietary Guidelines, and contains more technical information. The intent of the Dietary Guidelines is to summarize and synthesize knowledge regarding individual nutrients and food components into recommendations for a pattern of eating that can be adopted by the public. In this publi cation, Key Recommendations are grouped under nine inter-related focus areas. The recommendations are based on the preponderance of scientific evidence for lowering risk of chronic disease and promoting health. It is impor tant to...
8/30/2018 1:57:07 AM +00:00
ACCESS TO HEALTH SERVICES FOR ELDERLY MÉTIS WOMEN IN BUFFALO NARROWS, SASKATCHEWAN
A basic premise of the Dietary Guidelines is that nutrient needs should be met primarily through consuming foods. Foods provide an array of nutrients and other compounds that may have beneficial effects on health. In certain cases, fortified foods and dietary supplements may be useful sources of one or more nutrients that otherwise might be consumed in less than recommended amounts. However, dietary supplements, while recommended in some cases, cannot replace a healthful diet. Two examples of eating patterns that exemplify the Dietary Guidelines are the USDA Food Guide (http:// www.usda.gov/cnpp/pyramid.html) and the DASH (Dietary Approaches to Stop Hypertension) Eating...
8/30/2018 1:57:07 AM +00:00
Topics in the Economics of Aging
The Dietary Guidelines is intended primarily for use by policymakers, healthcare providers, nutritionists, and nutrition educators. The information in the Dietary Guidelines is useful for the development of educational materials and aids policymakers in designing and imple menting nutrition-related programs, including federal food, nutrition education, and information programs. In addition, this publication has the potential to provide authoritative statements as provided for in the Food and Drug Administration Modernization Act (FDAMA). Because the Dietary Guidelines contains discussions where the science is emerging, only statements included in the Executive Summary and the sections titled “Key Recommendations,” which reflect the preponderance of scientific...
8/30/2018 1:57:07 AM +00:00
Care and compassion? Report of the Health Service Ombudsman on ten investigations into NHS care of older people
Because of the threepart process used to develop and communicate the 2005 Dietary Guidelines, this publication and the report of the DGAC differ in scope and purpose compared to reports for previous versions of the Guidelines. The 2005 DGAC report is a detailed scientific analysis that identifies key issues such as energy balance, the conse quences of a sedentary lifestyle, and the need to emphasize certain food choices to address nutrition issues for the American public. The scientific report was used to develop the Dietary Guidelines jointly between the two Departments, and this publication forms the basis of recommendations that will be used by USDA and HHS for program and policy development. Thus it is a publication oriented toward policymakers, nutrition educators, nutritionists and healthcare providers rather than to the general public, as with previous versions of the Dietary Guidelines, and contains more technical information. New sections in the Dietary Guidelines, consistent with its use for program development, are a glossary of terms and appendixes with detailed information about the USDA Food Guide and the Dietary Approaches to Stop Hypertension (DASH) Eating Plan as well as tables listing sources of some nutrients. Consumer messages have been developed to educate the public about the Key Recommendations in the Dietary Guidelines and will be used in materials targeted for consumers separate from this publication. In organizing the Dietary Guidelines for the Departments, chapters 2 to 10 were given titles that characterize the topic of each section, and the Dietary Guidelines itself is presented as an integrated set of Key Recommendations in each topic area. ...
8/30/2018 1:57:07 AM +00:00
Influenza vaccination for healthcare workers who work with the elderly (Review)
Good nutrition is vital to good health and is absolutely essential for the healthy growth and development of children and adolescents. Major causes of morbidity and mortality in the United States are related to poor diet and a sedentary lifestyle. Specific diseases and conditions linked to poor diet include cardiovascular disease, hyper tension, dyslipidemia, type 2 diabetes, overweight and obesity, osteoporosis, constipation, diverticular disease, iron deficiency anemia, oral disease, malnutrition, and some cancers. Lack of physical activity has been associ ated with cardiovascular disease, hypertension, overweight and obesity, osteoporosis, diabetes, and certain cancers. Furthermore, muscle strengthening and improving balance can reduce falls and increase functional status among older adults. Together with physical activity, a highquality diet that does not provide excess calories should enhance the health of most individuals. Poor diet and physical inactivity, resulting in an energy imbalance (more calories consumed than expended), are the most important factors contributing to the increase in overweight and obesity in this country. Moreover, over weight and obesity are major risk factors for certain chronic diseases such as diabetes. In 1999–2002, 65 percent of U.S. adults were overweight, an increase from 56 percent in 1988–1994. Data from 1999–2002 also showed that 30 percent of adults were obese, an increase from 23 percent in an earlier survey. Dramatic increases in the prevalence of overweight have occurred in children and adolescents of both sexes, with approximately 16 percent of children and adolescents aged 6 to 19 years considered to be over weight (1999–2002).3 In order to reverse this trend, many Americans need to consume fewer calories, be more active, and make wiser choices within and among food groups. The Dietary Guidelines provides a framework to promote healthier lifestyles (see ch. 3). ...
8/30/2018 1:57:07 AM +00:00
HEALTH AND LABOR FORCE PARTICIPATION OF THE ELDERLY IN TAIWAN
There is a growing body of evidence which demonstrates that following a diet that complies with the Dietary Guidelines may reduce the risk of chronic disease. Recently, it was reported that dietary patterns consistent with recommended dietary guidance were associated with a lower risk of mortality among individuals age 45 years and older in the United States.4 The authors of the study estimated that about 16 percent and 9 percent of mortality from any cause in men and women, respectively, could be eliminated by the adoption of desirable dietary behaviors. Currently, adherence to the Dietary Guidelines is low among the U.S. population. Data from USDA illustrate the degree of change in the overall dietary pattern of Americans needed to be consistent with a food pattern encouraged by the Dietary Guidelines (fig. 1). A basic premise of the Dietary Guidelines is that nutrient needs should be met primarily through consuming foods. Foods provide an array of nutrients (as well as phyto chemicals, antioxidants, etc.) and other compounds that may have beneficial effects on health. In some cases, forti fied foods may be useful sources of one or more nutrients that otherwise might be consumed in less than recom mended amounts. Supplements may be useful when they fill a specific identified nutrient gap that cannot or is not otherwise being met by the individual’s intake of food. Nutrient supplements cannot replace a healthful diet. Individuals who are already consuming the recommended amount of a nutrient in food will not achieve any addi tional health benefit if they also take the nutrient as a supplement. In fact, in some cases, supplements and fortified foods may cause intakes to exceed the safe levels of nutrients. Another important premise of the Dietary Guidelines is that foods should be prepared and handled in such a way that reduces risk of foodborne illness. ...
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Clinical practice guideline for the assessment and prevention of falls in older people
A basic premise of the Dietary Guidelines is that food guidance should recommend diets that will provide all the nutrients needed for growth and health. To this end, food guidance should encourage individuals to achieve the most recent nutrient intake recommendations of the Institute of Medicine, referred to collectively as the Dietary Reference Intakes (DRIs). Tables of the DRIs are provided at http://www.iom.edu/Object.File/Master/21/372/0.pdf. An additional premise of the Dietary Guidelines is that the nutrients consumed should come primarily from foods. Foods contain not only the vitamins and minerals that are often found in supplements, but also hundreds of naturally occurring substances, including carotenoids, flavonoids and isoflavones, and protease inhibitors that may protect against chronic health conditions. There are instances when fortified foods may be advantageous, as identified in this chapter. These include providing additional sources of certain nutrients that might otherwise be present only in low amounts in some food sources, providing nutrients in highly bioavailable forms, and where the fortification addresses a documented public health need. ...
8/30/2018 1:57:07 AM +00:00
Care Homes for Older People: FACILITIES, RESIDENTS AND COSTS
Each basic food group5 is the major contributor of at least one nutrient while making substantial contributions of many other nutrients. Because each food group provides a wide array of nutrients in substantial amounts, it is important to include all food groups in the daily diet. Both illustrative eating patterns include a variety of nutrien dense foods within the major food groups. Selecting a variety of foods within the grain, vegetable, fruit, and meat groups may help to ensure that an adequate amount of nutrients and other potentially beneficial substances are consumed. For example, fish contains varying amounts of fatty acids that may be beneficial in reducing cardiovas cular disease risk (see ch. 6). NutrientDense Foods Nutrientdense foods are those foods that provide substan tial amounts of vitamins and minerals (micronutrients) and relatively few calories. Foods that are low in nutrient density are foods that supply calories but relatively small amounts of micronutrients, sometimes none at all. The greater the consumption of foods or beverages that are low in nutrient density, the more difficult it is to consume enough nutrients without gaining weight, especially for sedentary individuals. The consumption of added sugars, saturated and trans fats, and alcohol provides calories while providing little, if any, of the essential nutrients. (See ch. 7 for additional information on added sugars, ch. 6 for information on fats, and ch. 9 for information on alcohol.) ...
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How to Write an Exercise Prescription
Efforts may be warranted to promote increased dietary intakes of potassium, fiber, and possibly vitamin E, regard less of age; increased intakes of calcium and possibly vitamins A (as carotenoids) and C and magnesium by adults; efforts are warranted to increase intakes of calcium and possibly magnesium by children age 9 years or older. Efforts may be especially warranted to improve the dietary intakes of adolescent females in general. Food sources of these nutrients are shown in appendix B. Low intakes of fiber tend to reflect low intakes of whole grains, fruits, and vegetables. Low intakes of calcium tend to reflect low intakes of milk and milk products. Low intakes of vitamins A (as carotenoids) and C and magne sium tend to reflect low intakes of fruits and vegetables. Selecting fruits, vegetables, whole grains, and lowfat and fatfree milk and milk products in the amounts suggested by the USDA Food Guide and the DASH Eating Plan will provide adequate amounts of these nutrients. ...
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Vaccines for preventing influenza in the elderly (Review)
Low intakes of fiber tend to reflect low intakes of whole grains, fruits, and vegetables. Low intakes of calcium tend to reflect low intakes of milk and milk products. Low intakes of vitamins A (as carotenoids) and C and magne sium tend to reflect low intakes of fruits and vegetables. Selecting fruits, vegetables, whole grains, and lowfat and fatfree milk and milk products in the amounts suggested by the USDA Food Guide and the DASH Eating Plan will provide adequate amounts of these nutrients. Most Americans of all ages also need to increase their potassium intake. To meet the recommended potassium intake levels, potassiumrich foods from the fruit, vegetable, and dairy groups must be selected in both the USDA Food Guide and the DASH Eating Plan. Foods that can help increase potassium intake are listed in table 5 (ch. 5) and appendix B1. Most Americans may need to increase their consumption of foods rich in vitamin E (αtocopherol) while decreasing their intake of foods high in energy but low in nutrients. The vitamin E content in both the USDA Food Guide and the DASH Eating Plan is greater than current consump tion, and specific vitamin Erich foods need to be included in the eating patterns to meet the recommended intake of vitamin E. Foods that can help increase vitamin E intake are listed in appendix B2, along with their calorie content. Breakfast cereal that is fortified with vitamin E is an option for individuals seeking to increase their vitamin E intake while consuming a lowfat diet. ...
8/30/2018 1:57:07 AM +00:00
Cognitive Impairment in the Elderly – Recognition, Diagnosis and Management
Although a substantial proportion of individuals over age 50 have reduced ability to absorb naturally occurring vitamin B12, they are able to absorb the crystalline form. Thus, all individuals over the age of 50 should be encour aged to meet their Recommended Dietary Allowance (RDA) (2.4 µg/day) for vitamin B12 by eating foods fortified with vitamin B12 such as fortified cereals, or by taking the crystalline form of vitamin B12 supplements. Women and Iron Based on blood values, substantial numbers of adolescent females and women of childbearing age are iron deficient. Thus, these groups should eat foods high in hemeiron (e.g., meats) and/or consume ironrich plant foods (e.g., spinach) or ironfortified foods with an enhancer of iron absorption, such as foods rich in vitamin C (e.g., orange juice). Appendix B3 lists foods that can help increase iron intake and gives their iron and calorie content. ...
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