next let's talk about some nutrient related health concerns as well as other types of concerns that come up for this age group so unique to this age group is medication use uh poly Pharmacy or the intake of many medications at once really is an epidemic the average older adult takes about five medications five medications each day the patient who lives in a nursing facility takes 9 to 10 medications per day that's a lot and that really increased is the likelihood of having side effects of medications and multiple side effects right so sometimes when we get a sinus infection we get on antibiotics we can have some dry mouth or difficulty with our GI system imagine being on five or six or seven medications that might have similar side effects often times we see it affect the GI system so dry mouth nausea diarrhea which certainly can affect food intake and choices of this age group there's a lot of interactions with in the drugs as well as with nutrients and herbs many of you going on in nursing will learn quite a bit on these so bottom line certain nutrients and herbs can decrease how well some drugs work and this can overall affect the health status your textbook has some classic examples of drug nutrient interaction so check those out if you're interested mobility issues um about onethird of older adults have disabilities which affect them in terms of their Mobility I listed a few here that I've already alluded to a bit these are some of the more common ones and having these conditions osteoarthritis all the way on down to the vision hearing can really lead to lower quality diets for just the ability of of making Foods or getting to the grocery store uh the other end of the spectrum here is that healthy foods can improve some of these conditions so not all uh hearing loss there's nothing we can do to prevent against that but osteoarthritis there might be uh benefits from consuming omega-3 fatty acids or from certain supplements with osteoporosis there is benefit to consuming more calcium so yes these conditions limit someone and increase the risk of not having a healthy diet however healthy diet can then be be a positive for these conditions on the picture here you see an individual who has very severe arthritis in her hands so this can really limit her food abilities what how she prepares food and um whatnot eye disease uh very common as we get older to lose uh the ability to see as well macular generation so the outcomes of this can lead to decreased nutritional status I do want to make mention though that eating foods that are rich in antioxidants like vitamin C like vitamin E can really slow the progression of eye disease and then finally Alzheimer's Alzheimer's is an irreversible brain disorder it has both genetic links as well as lifestyle risks we know that the condition itself is associated with poor nutrition outcomes uh initially folks might have memory loss or dementia which prevent them from eating when they're supposed to eat or eating healthier foods and then as it progresses they may be completely dependent on others to the Nutritional outcomes are are not great on the other end of that Spectrum though we do know that quality nutrition especially prior to this condition really being exacerbated can help prevent it or delay it there's research now that suggests a certain way of eating you can look it up it's called a mind diet Min n d mind diet certain way of eating can really prevent or delay the condition of Alzheimer's and well worth investigating one of the oh most devastating conditions one can have so those are a few that I wanted to cover that your book also covered but then I want to segue into discussing here briefly some of these other concerns in older adults food insecurity is a huge problem 10 to 15% of older adults experience food insecurity and it's especially higher for women and racial minorities causes money uh certainly finances is a big deal Social Security often is not enough to to be able to purchase all of the the healthy foods one may want to purchase fixed incomes as well aren't always the the most liberal when it comes to how much one gets there's also the inability to get food and meals so maybe there's money there but they don't have transportation or a way to be able to go purchase or then prepare healthy foods uh food security insecurity now especially during this pandemic is really really high across all age groups unfortunately the older adults and the racial minorities are being hit the hardest psychosocial factors I mentioned depression quite assciated with decreased appetite which is that uh perpetuating cycle then of losing self-care abilities and whatnot alcohol abuse is is unfortunately common we see older adults having higher rates of alcoholism than adults and unfortunately for our older adult population they're more sensitive to alcohol they get intoxicated on a smaller amount and alcohol itself can really increase the risk of fall and injuries it's also associated with depression so that can be a perpetuating cycle where they're using alcohol to cope with depression but then the depression is even worse because of alcohol so bottom line all of these concerns and in addition to the ones I mentioned earlier with the physiological changes that are occurring in the body do increase the risk of malnutrition or lack of appropriate nutrition in this age group there are govern and Community programs that can assist snap is the food stamp program so providing a set amount of money each month for them to purchase food unfortunately it's often not so there's there's a limit to how much can be purchased food pantries here in the Ozarks we have cross lines or Victory Mission we also have Ozark food Harvest which is our our big food bank so there are organizations like that out there and then governmental programs like Meals on Wheels where they're delivering food we know that the meals that they provide it's one meal per day we know it's going to hit onethird of their rdas for their nutrients so at least they're getting one solid meal in per day what we also find with Meals on Wheels it's a really good uh social program we find that it can help lower anxiety and loneliness because the older adult knows that for a few minutes each day they're going to see somebody somebody is going to deliver them a meal congregate meals uh in the middle of a pandemic we're not seeing this which is unfortunate but obviously we we don't want to have Gatherings of people a congregate meal would be where folks gather at a church or Senior Center and they get a free or reduced cost meal that again hits those rdas uh right now that isn't the the occurrence which is unfortunately leading to uh lower nutritional status and worsening mental health so what can we do there are things we can do to help older adults in our lives increase their nutritional status when we're with them or preparing meals for them or encouraging them to eat encouraging things like spices and Seasonings and marinades and flavors to really enhance the the desirability of that food encouraging foods like soups and gravies and even shakes so that they're getting in fluid eating throughout the day labor saving equipment so can openers or jar openers that are going to open it for them so that they're not having to uh to rely on more convenient style Foods cooking and freezing and delivering those foods to them drinks like boost or insure can certainly be a good option distractions so eating rather than eating and watching TV we find that that folks get in more calories and nutrients when they're eating without distractions and then getting some activity in before their meal that increases appetite couple of other things I'll add in as a dietitian ensuring that folks are getting adequate protein so if they're having difficulty with meat let's say they can't chew as well with uh beef or pork or even chicken then eggs scrambled eggs can be a great option or even whey whey protein powders added into things like oat meat meal or yogurts can really be a nice addition and then my final recommendation would be time uh we know that the older age group struggles with loneliness with depression so the more time we can spend with them uh the better during the midst of a pandemic we're not able to spend as much time with our older adults as we would like so we have to be creative coming up with ways to still connect with them via phone calls via Skype or Zoom sessions send sending letters sending cards sending flowers whatever it might be uh so that they know that they're still loved and appreciated wanted to give activity a slide on its own because it does bear repeating whenever we stop exercising when we start decreasing our activity aging accelerates so it's so so important to keep moving exercise has tons of benefits physical and psychological right we've learned about these and the benefits can be reaped at any age so even if they're 80 and they've never exercised before they can start doing something and it will improve their health status some benefits of exercise Just A Brief Review here can lower heart disease diabetes risk it helps control blood sugars blood pressure also can be controlled it can improve depression and anxiety and enhance Independence which is a big big key for most of our older adults so recommendations are similar to those of adults 150 minutes a week I certainly recommend focusing on both cardio and resistance so functional movements are ideal for this age group there's many programs out there that are designed for seniors uh so you might check them out silver sneakers ageless Grace uh and recommend those to adults that are in your lives so my final thoughts here on this chapter and as well as our semester you could say uh I hope that you've learned some really good nutrition principles this semester ones that you can take with you both personally and professionally into your futures uh as individuals as members of society as well as healthc Care Professionals nutrition plays a really really significant role in our lives and our future health so congratulations we have finished uh goodness it's been a long semester hasn't it uh We've covered a lot of content but I I have enjoyed it I've enjoyed bringing the content to you I hope that you've enjoyed learning the content and again I hope you can take away some key things from the the course so it's now time for you to start preparing for your final exams and don't be strangers in the future I certainly hope to see you in other courses or if you have questions regarding don't hesitate to reach out in the future thank you for listening and good luck on your final exams