Is nutrition intervention an essential component to the management of Essay

Is nutrition intervention an essential component to the management of diabetes in the ELDERLY - Essay Example The prevalence of type 2 DM has nearly doubled over the past 25 years, with certain groups - native Americans, Hispanics, and African-Americans - at particularly high risk of developing the disease (HORNICK & ARON, 2008). Diabetes is the fifth leading cause of death by disease in the United States, killing approximately 225,000 people each year. The direct cost of diabetes is $92 billion a year, representing 11 percent of total health care expenditures in the U.S. (Hayashi, 2007). At least 20% of persons 65 years of age or above and 26% of long-term care facility residents have diabetes, and the annual cost of caring for the latter is estimated at $6 billion (American Diabetes Association, 2008) (Pandya, 2003). Older diabetics are two to three times more likely to need hospital admission than their non-diabetic counterparts (Damsgaard, Froland, & Green, 1987). An analysis of the 1999-2004 National Health and Nutrition Examination Survey (NHANES), including subjects over 65 y.o. and type 2 DM, found an alarmingly high prevalence of comorbid conditions in this population: 31.5% had renal insufficiency, 20.2% had a history of myocardial infarction, and 17.9% had heart failure (Suh, Kim, Choi, & Plauschinat, 2007). Physiologic and pathologic changes of ageing may concur to induce malnutrition. After the age of 65, weight loss occurs at rate of up to 0.65 kg/year (Lehmann & Bassey, 1996), although there is substantial variation between individuals. A decline in muscle mass begins from 30 to 40 years of age, and continues into advanced old age (Elia, 1992). Failure to thrive in the elderly was described as "a syndrome manifested by weight loss greater than 5% of baseline, decreased appetite, poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol levels." (Lonergan, 1991) It is estimated that 15 to 50 percent of Americans over the age of 65 consume too few calories, protein or essential vitamins and minerals for good health. (2007) The various causes of malnutrition can be summarized in a useful mnemonic "Meals On Wheels"(2007): Medications, including digoxin, diuretics, anti-inflammatory agents, antacids, H2-blockers, antidepressants, anticonvulsants etc, which may induce side effects like anorexia, nausea, vomiting, diarrhea, cognitive disturbance and increased metabolism, Emotional problems, such as depression, Anorexia (loss of appetite), commonly due to age-related changes in taste and smell, Late-life paranoia, Swallowing problems (dysphagia), that may arise from poor teeth, ill-fitting dentures, gastroesophageal reflux disease, stroke, Parkinson's disease, or throat tumors, Oral factors, like tooth loss and periodontal disease, Neoplasia, Wandering, in the setting of Alzheimer's disease and other forms of dementia, which are often associated with poor feeding, Hypermetabolic disorders, Enteric problems or malabsorption, Eating difficulties, because of impaired vision, disturbed motor function, or physical disabilities like arthritis or Parkinson's disease, Low-salt and low-cholesterol diets, often resulting in reduced intake due to poor taste, Social problems, including poverty, lack of care, and poor living conditions. There are severals

Women Stepping Up In American History Essay Example | Topics and Well Written Essays - 1750 words

Women Stepping Up In American History - Essay Example Of course, this was not by choice; therefore, they decided to take a stand, and when both World Wars came, their prayers were answered. Nevertheless, the paper will focus on discussing the role of women in American business, from 1900 until now. After finally making their way into the manual labor force in America and overseas, women took further steps towards equal pay and became subjects of propaganda. Although the fight for equal pay continued, once all wars ended women were then immediately expected to give away their jobs and settle back into their caregiver role. This did not run smoothly in the eyes of women, and they revolted in strikes since they knew that their efforts would prove to be triumphant, hence leave an interminable mark on American society. After the two wars, women were free to create their own lives, able to vote and allowed the right to a full education, and this increase in freedom led to an increase in occupied American women. Not only were they evolving in the work force, but also over the last century, fashion in America has experienced continual upheavals and radical changes. Ranging from dress length to head pieces, women used fashion as another way to express themselves and make their unique m ark throughout history. Historically, women earned their living by keeping boarding houses while others were in occupations that were available to men. In this case, some of the women were doctors, lawyers, teachers and writers, and by the end of the nineteenth century, there was acceptable for women’s professions, though there were few women working in factories or as domestic workers. Nevertheless, there was an exclusion of women from their profession apart from working as writers or teachers, for instance in the medical profession, there was a changed attitude during nineteenth and twentieth century concerning the occupation, which was suitable for women.