Document Type

Critically Appraised Topic

Publication Date

2011

Clinical Scenario

Adequate nutrition has been shown to be a cornerstone of health and wellness. As people grow older, disease, injury, cognition, pain, fatigue and environment act together to limit their ability to access, prepare and ingest adequate nutrition. As the percentage of older adults in society continues to increase this is becoming an issue that impacts all levels of society. This study looks at how environment and organizational processes in a variety of long-term-care mealtime settings affects the resident’s nutritional status and quality of life. Occupational therapists (OT) have expertise in observation and analysis of environments, activities, biomechanics and psychosocial issues. It is important for OTs to be educated about the importance of nutrition in the health of older adults, and to use their skills to help older clients engage in healthful eating habits and improve access to adequate nutrition.

Clinical Question

What is the impact of nutritional status on the health and quality of life of older adults?

Clinical Bottom Line

Many factors are correlated with the older adults’ ability to remain nutritionally sound: environmental factors, socio-economic status, underlying health conditions, medications, cognitive abilities, age, race and sex (Dong, Simon, & Evans, 2009). The interrelationship between nutritional status and health is a complicated one. Malnutrition and vitamin deficiencies play a part in cognitive losses and chronic health conditions (Scott et al., 2006). Hindered by these impairments older people find themselves with less autonomy and personal control over food selection, preparation, time allowed to eat, and preferred eating environments.

In this article, the authors presented evidence of how the mealtime organizational processes and environment impacted residents in long-term care facilities in three different dining settings. From the data it is obvious that based on setting and health, older residents have very different opportunities to eat healthy foods and supplements. They stressed that governments and facilities have a responsibility to ensure that all citizens have adequate nutrition. Services must be offered in a manner which allows individual autonomy and meets cultural and social needs. Addressing these factors will improve the older resident’s quality of life, and thereby improve social participation and overall health.

Comments

Revised document posted 7.17.2012.

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