OLDER PEOPLE Risk factor Poverty Psychosocial factors Mobility Functional constraints


• Inability to access good food • Inability to afford good food


• Isolation / Loneliness • Confusion • Depression


• Poor mobility • Poor transport links


• Inability to prepare food • Sensory disability


• Difficulty reading food label


than focusing on the risk of falls, it is better to talk to an older person about the benefits of improving strength and balance, staying active and maintaining mobility and independence. People are more receptive to the advice provided only if they can choose the activities and advice that will suit their specific needs, abilities and lifestyles. Pharmacists can support independent living in frail elderly patients by giving advice on how to maintain wellbeing and by signposting to practical and social support groups such as Age Scotland. Social care and support services available to elderly patients include the provision of: equipment, community support and activities, day centres, home adaptation and home help, residential care and occupational therapists.


NUTRITIONAL CHALLENGES IN THE ELDERLY It is good to promote a nutrition strategy for the elderly and frail, especially those in long term care. In Scotland, a survey was conducted and the results showed that people over 65 years and in long term care have a higher risk of malnutrition[10]


.


Risk factors that could influence this result would be: GI changes, changes to senses, reduced swallowing, dental problems, reduced physical activity and lower metabolic rate, thus reducing their appetite. The consequences of a reduced appetite are: restricted diet, weight loss and vitamin and mineral deficiencies. People with long-term conditions (eg, kidney disease, chronic lung disease), chronic progressive conditions (eg, dementia, cancer, those who abuse drugs or alcohol), and those who use multiple prescriptions and over-the-counter medications (polypharmacy) are also at risk of malnutrition.


In order to encourage healthy eating, patients should:


• Have balanced and a variety of healthy ingredients


• Have regular meals


• Have their five a day (mostly vegetables as fruit contains a lot of sugar).


• Eat starchy, complex carbohydrates at every meal


• Protein sources daily • Hydration


Beside changing the diet, other creative and innovative ways of addressing malnutrition are[11]


:


• Lunch clubs and community cafés - these clubs and community cafes are sometimes tailored to the needs of specific groups, for example: carers, people with dementia and those


who are housebound


• Community gardening - focuses on the importance of growing their own food


• Home shopping services - more relevant to housebound elderly


• Cooking classes - again, tailored to the needs of specific groups, for example: widowed men and older people with special needs


• Food co-ops - these are often linked to healthy eating initiatives within local communities, and address both poverty and access issues.


• Linked offerings - include linking food-based services with practical support in the home, or linking learning about food preparation to other skills such as computer literacy skills


• Anxiety • Dementia


• Bereavement • Disability


• Difficulty accessing local shops • Poor dental/oral health


• Difficulty using food containers Example REFERENCES


1. Up and About or Falling Short? - A Report of the Findings of a Mapping of Services for Falls Prevention in Older People [Internet]. Gov.scot. 2017 [cited 20 January 2017]. Available from: http://www.gov. scot/Publications/2012/05/6979/3 2. Age - Demographics [Internet]. Gov. scot. 2015 [cited 20 January 2017]. Avail- able from: http://www.gov.scot/Topics/ People/Equality/Equalities/DataGrid/Age/ AgePopMig


3. Scotland N. Optimising Older People’s Quality of Life: an Outcomes Framework Strategic outcomes model [Internet]. Healthscotland.scot. 2014 [cited 20 Janu- ary 2017]. Available from: http://www. healthscotland.scot/


4. Polypharmacy Guidance March 2015 [Internet]. Sign.ac.uk. 2015 [cited 20 January 2017]. Available from: http://www. sign.ac.uk/


5. Polypharmacy Guidance [Internet]. NHS Scotland. 2012 [cited 20 January 2017]. Available from: http://www.central. knowledge.scot.nhs.uk/upload/Polyphar- macy%20full%20guidance%20v2.pdf 6. Traffic Light System (TLS) – Medicines Management [Internet]. Medicinesman- agement.doncasterccg.nhs.uk. 2017 [cited 21 January 2017]. Available from: http:// medicinesmanagement.doncasterccg.nhs. uk/traffic-light-system/


7. Scott I, Hilmer S, Reeve E, Potter K, Le Couteur D, Rigby D et al. Reducing Inap- propriate Polypharmacy. JAMA Internal Medicine [Internet]. 2015 [cited 20 January 2017];175(5):827. Available from: http:// www.smgg.es/images/articulos/polyphar- macy.pdf 8. Duerden M, Avery T, Payne R. Polyphar- macy and medicines optimisation Making it safe and sound [Internet]. The King's Fund. 2013 [cited 20 January 2017]. Available from: https://www.kingsfund.org.uk/ 9. Falls in older people: assessing risk and prevention | 1-Recommendations | Guidance and guidelines | NICE [Inter- net]. Nice.org.uk. 2013 [cited 20 January 2017]. Available from: https://www. nice.org.uk/guidance/cg161/chapter/1- Recommendations#preventing-falls-in- older-people-2


10. Older People Eat Well – Literature Review [Internet]. 1st ed. Glasgow: Com- munity Food and Health Scotland; 2014 [cited 20 January 2017]. Available from: www.communityfoodandhealth.org.uk/ 11. Wood R,Bain M. The Health and Well- Being of Older People in Scotland - Insights From National Data [Internet]. 1st ed. Edinburgh: NHS Scotland; 2001 [cited 20 January 2017]. Available from: www.scot. nhs.uk/


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