6, 7 & 8 JUNE 2014 3 Days Professional Training Workshop "Care of People with Cognitive Impairment" Organized By ADFM

 

ADFM National Caregivers Support Network, sponsored by Lundbeck Malaysia and supported by the Geriatric Unit of  UMMC (PPUM), will be conducting a 3 days professional training workshop Titled “Care of People with Cognitive Impairment”.

DATE:  6, 7 & 8 June 2014 (3 DAYS)

TIME:  8.30AM - 5.30PM

VENUE:  Dewan Pulasari, Rawatan Utama (RUKA BUILDING), 2nd Floor, University Malaya Medical Centre (PPUM)

TRAINER:  Dr Gemma Law,  PhD CPsychol (UK), AFBPsS , CADC, is the Assistant Professor College of Life Science & Technology School of Professional & Continuing Education at Hong Kong University (HKU).  

Target Audience: Trained nurses, allied health professionals with some experiences in dementia care, or people who want to develop their knowledge and skills in Dementia care enroll to the program, and experienced volunteers.

CERTIFICATE OF ATTENDANCE with CPD points (A3 – 15 Points) awarded by the Malaysian Nursing Board will be issued by ADFM to participants at the closing ceremony on completion of the 3 days training.  

Introduction

People with cognitive impairment would go through different stage of disease progression following the medical diagnosis.  Clients will present with anxiety, depression and ineffective coping whilst family caregivers experiencing the caregiving burden due to inadequate knowledge on the condition and its needs of care at different stage. 

Therefore, the aim of the workshop is to equip professional staff and or volunteers with adequate knowledge and skill on care to meet the needs of people with cognitive impairment as well as to provide supports to family caregivers.

Learning Objectives:

Upon completion of the training, participants will be able:

1.         To discuss the disease progression from early to late stage and its treatment and care;

2.         To conduct needs assessment on people with cognitive impairment;

3.         To lessen the feeling of caregiving burden of family caregivers through

            Counseling;

4.         To design appropriate activity program for people of different stage of

            Condition;

5.         To identify the contributing factors developing the challenging behavior.

Teaching:

Lecture, case study and case discussion. 

Assessment:

1.   100% attendance.

2.   Oral Presentation (40%) – a 15 minutes presentation on a chosen scenario.

3.   An essay (60%) – Individual student is required to write a 1,200 words paper

       on a chosen topic. Give a rationale for choosing the topic, a brief description

       on the client’s presenting problem, and write a care plan on how to handle the  identified problems and to meet the needs of care.

Medium:   English

Day One

Day	Time	Topics	Trainer
Fri	8:30 -  8:45	Welcome and Registration Briefing on the course
	8:45 – 10:00	Updating the knowledge on the different stage of Cognitive Impairment – MCI, Early and Moderate stage	Dr Gemma Law
	10:00-10:15	Break
	10:15-11:30	Pharmacological Approach
	11:30-12;30	Conducting a comprehensive Assessment
	12:30-13:00	Lunch
	13:00 -14:30	Counselling to individual client and family members
	14:30-15:30	Case intake and report writing
	15:30-15:45	Break
	15:45-17:00	Case Discussion
	17:00–17:30	An Overview

Day Two

Day	Time	Topics	Trainer
Sat	8:30 -  8:45	Briefing on home assignment	Dr Gemma Law
	8:45 – 10:00	Care planning Practical Session
	10:00-10:15	Break
	10:15-11:30	Monitoring the progress on individual client Setting up a portfolio for the client
	11:30-12;30	Planning daily activity schedule at day center or residential homes
	12:30-13:00	Lunch
	13:00 -14:30	Reminiscence as a therapeutic activity
	14:30-15:30	Story Telling & iPad
	15:30-15:45	Break
	15:45-17:00	Group Discussion on planning an activity (indoor and outdoor)
	17:00–17:30	An Overview

 Day Three

Day	Time	Topics	Trainer
Sun	8:30 -  8:45	Briefing on the assignment	Dr Gemma Law
	8:45 – 10:00	Maintaining people with late stage at home or in residential home
	10:00-10:15	Break
	10:15-11:30	Pharmacological and non-medical Approach on challenging behaviour
	11:30-12;30	Nutritional value and physical exercise
	12:30-13:00	Lunch
	13:00 -14:30	Use of multi-sensory stimulation
	14:30-15:30	Preparation for death and dying Ethical issues on Dementia care
	15:30-15:45	Break
	15:45-17:30	Oral Presentation

Oral Presentation

Individual student is required to present a 15 minutes talk on their chosen topic.

The assessment will be based on the following criteria:

1.                  Presentation skill

2.                  Organization skill

3.                  Level of relevancy

4.                  Appropriateness on use of care approach

5.                  Discussion/Conclusion

Home Assignment

Individual student is required to submit an essay, not more than 1,200 words on their chosen client from work place such as day care or residential home.

The essay should consist of assessment, use of diagnostic and screening tests for confirming the diagnosis, treatment and care.

Student should attempt to describe on the type of intervention given to the client, and process to evaluate on the outcomes.  Justification must be provided to support the reason for delivering the intervention to the client and the family caregiver.

REGISTRATION FEE:  RM 150 Per Participant.

REGISTRATION & PAYMENT: 

1.    Closing date by 30 May 2014 on first-come first-served basis.

2.    For payment (Cash or Cheque), you can bank-in direct to ADFM Bank Account at CIMB, Account No. 1248 – 0009508 – 05 – 5.

3.   Email completed Registration Form together with the Payment Receipt to jenny@adfm.org.my or Fax to 03 7960 8482.

4.   Further information, email jenny@adfm.org.my or call 016 608 2513 / 03 7931 5850.

Alzheimer’s Disease Foundation Malaysia (ADFM)

May 2014

"The Saddest Goodbye" By Cartoonist, Tony Husband

Dear Caregivers,

Endless words are written on DEMENTIA.  "The Saddest Goodbye" is a very touching and poignant story beautifully illustrated in pictures by Cartoonist, Tony Husband on his family watching this dreadful disease steal away their father, Ron Husband.

In the words of Tony Husband, when their father, Ron Husband started to forget things - dates, names, where he'd put things - it took a while for his family to realize that this was a different kind of forgetting.  In fact, it was just the first sign of the dementia that gradually took their father away from them. 

To read further, click on the link -> "The Saddest Goodbye"

It relates the experience of all those families who have been through this sad journey with their loved ones.

(Source:  The Daily Mail, 9 May 2014)

SAT/24 MAY 2014 ADFM Monthly Talk and Caregivers Sharing Session

MONTHLY TALK & CAREGIVERS SHARING SESSION

SATURDAY, 24 MAY 2014, 2.00PM TO 5.30PM

ADFM PJ DAYCARE CENTRE

TALK TITLED “DELIRIUM”

By Prof. Dato’ Dr Raymond Azman Ali

Senior Consultant Neurologist

Dean of UKM Medical Faculty and Director UKM Medical Centre

&  

SHARING “IT IS THE DISEASE – NOT THE PATIENT”

By Mdm Mui Siew Koon from Penang

Primary Caregiver for her late Mom

PROGRAM:

1.30pm    Taking Attendance

2.00pm    Talk “DELIRIUM” by Prof. Dato’ Dr Raymond Azman Ali

3.00pm     Q & As

4.00pm     Sharing “It Is The Disease – Not The Patient” by Mdm Mui Siew Koon               

4.45pm     Q & As

5.15pm     Refreshment/End

SYNOPSIS:

Delirium, also known as an acute confusional state, is a medical emergency. While most cases are reversible, some may be fatal. Delirium may be the first sign of a diffuse brain dysfunction leading to drowsiness, seizures, coma and eventually, death. Up to a quarter of geriatric admissions to hospital are due to delirium, and anywhere between 5 and 40% of all inpatients become delirious during admission. In the early stages of delirium, patients may first complain of disorganized thinking and diminished attention. Later, their sleep-wake cycle becomes interrupted and they may have perceptual disturbances. In the advanced stages, patients have memory deficits and altered psychomotor activity, and may be violent and abusive. Depending on the cause, some patients may develop epileptic seizures. Finally patients become progressively drowsy and may lapse into a coma. There is a myriad causes of delirium; these include alcohol and alcohol withdrawal, non-convulsive epileptic seizures, brain infection, prescribed and recreational drugs and toxins, organ failure, uncontrolled diabetes, stroke, head trauma and metabolic disorders (e.g. hypoglycaemia and hyponatraemia). The investigations required for a delirious patient depend on what the doctor finds on physical examination and history gathered from family members and witnesses. The cornerstone of treatment of delirium is to treat the underlying cause. While some patients may require chemical or physical restraint because of violent behaviour, the majority will settle down while waiting for the underlying cause to be treated with simple general measures, such as the reduction of “environment unfamiliarity”, in the same manner that one would manage a demented patient.

Speaker’s Profile:

PROF. DATO DR RAMOND AZMAN ALI was born in 1960 in Penang, Malaysia.  Prof Dato’ Dr Raymond Azman Ali is A Senior Consultant Neurologist and Dean of UKM Medical Faculty as well as Director of UKM Medical Centre.

He graduated from Monash University, Melbourne, Australia, with an Honours MBBS Degree in 1984, and Masters of Internal Medicine from the National University of Singapore and UKM in 1989 and 1991 respectively. He then completed his Doctorate in Epilepsy Research at the Institute of Neurology, Queen Square in London in 1994, and was awarded an MD (Monash University) in 1996, the FRCP (Ireland), FRCP (Glasgow) and FAMM in 2001. He was Head of the Department of Internal Medicine from 1999 to 2001, and deputy Dean from 2003 to 2008. He is currently Chairman of the Epilepsy Council of Malaysia, Member of the Ministry of Health Committee on Drugs Used in Neurology, and Committee on Neurology Subspecialty Training in Malaysia, a Member of the Editorial Board of Neurology Asia, and Ad Hoc Reviewer of several international journals, including Annals of Neurology, European Journal of Neurology, BMC Neurology and the Singapore Medical Journal.

He delivered more than 280 lectures locally and abroad and published 72 full journal papers and over 150 abstracts, proceedings and book chapters related to neurology. He has won the Best Teacher (Pengajar Cemerlang) award for the Health Sciences 6 times, the last one being conferred in 2009. And, in the 39-year history of UKM, he is the only recipient of the highest award for teaching in UKM so far, the Tokoh Pengajar Award in 2002. In 2009, he also received the Anugerah Akademik Negara or National Best Teacher Award from the Ministry of Higher of Education, making him the best teacher in the Health Sciences for the whole country for that year. He was the first medical doctor to ever win this prestigious award, and no other doctor has since won this award again. In 2011, he was named Tokoh Merdeka of Malaysia and joined the parade of other joint recipients before the Prime Minister of Malaysia and in 2012, he was presented with the Tokoh Penyelidik award at the 14th Health Sciences Research Week of UKM.

PARTICIPANTS:

Priority will be for Caregivers and their families.  We open to Nurses / Carers from the nursing / community care homes who directly or indirectly are involved in the care of persons living with dementia. 

Certificate of Attendance will be issued by ADFM to participants who are nurses.

COMPULSORY PRE-REGISTRATION: (NO WALK-IN PLEASE)

1.  Click on "Registration Form" and email completed form to jenny@adfm.org.my or Fax to 03 7960 8482.

2.  SMS 016 608 2513 indicating (a) full name, (b) Caregiver  (Yes / No), and (c) Tel/mobile contacts, if you do not have access to email.

Further information, contact jenny@adfm.org.my or call 016 608 2513 / 03 7931 5850.

From:  ADFM National Caregivers Support Network

May 2014 

SAT/26APR14 - ADFM Free Talks on "The Behavioural & Psychological Symptoms of Dementia" & "Use of Medication for Dementia"

Dear Caregivers and families, 

ADFM National Caregivers Support Network will be holding the following two talks by Assoc Prof Stephen Jambunathan for the monthly Caregivers Sharing Session in April 2014. 

TOPIC: 

(1)  “The Behavioural & Psychological Symptoms of Dementia – Understanding the Big Picture of Dementia”, and  

(2)  “The Use of Medication for Dementia”

Date:  Saturday, 26 April 2014

Time:  2.30pm – 5.00pm  

Venue:  ADFM PJ Daycare Centre, No. 6 Lorong 11/8E, 46200 Petaling Jaya.

PROGRAM:

1.30pm   Taking Attendance

2.00pm    Video Presentation Titled "Ah Kong" 

2.30pm

·         “The Behavioural & Psychological Symptoms of Dementia – Understanding the Big Picture of Dementia”

Q & A Session

·         “The Use of Medication for Dementia”

 Q & A Session

5.00pm   Refreshment/End

Speaker’s Profile:

Assoc Prof. Stephen Jambunathan is a Counsultant Psychiatrist & Psychotherapist with University Malaya Medical Center [UMMC] and University Malaya Specialist Center [UMSC].

He began his career in 1992, at the Seremban Hospital. His area of expertise is in Psychodynamic Psychotherapy and Cognitive Behavioural Therapy (non-pharmacological psychotherapeutic interventions). He is affiliated to a number of professional organizations, including the international Asian Bipolar Educational Committee, Committee Member, and the International Harm Reduction Association. He has published two books and recent contributions include publications in the Annals of General Psychiatry, and the ASEAN Journal of Psychiatry. He has participated in 15 research projects, as well as consulted on 21 others. He was awarded the Anugerah Cemerlang, University Malaya in 2007.

PARTICIPANTS: Caregivers and all those who directly or indirectly are involved in the care of persons living with dementia.  

COMPULSORY PRE-REGISTRATION :  

Click on Registration Form and email to jenny@adfm.org.my or Fax to 03 7960 8482. 

Further information, email jenny@adfm.org.my or call 016 608 2513 / 03 7931 5850.

Kindly register early by 21 April for logistics arrangement.

From:  ADFM National Caregivers Support Network

April 2014 

UK GOVERNMENT APPOINTS WORLD DEMENTIA ENVOY

In A News Release on 28 February 2014, Alzheimer’s Disease International (ADI) welcomes the appointment of Dr Dennis Gillings as the World Dementia Envoy, who plans to create a World Dementia Council to raise funds for Alzheimer’s research. The announcement was made by the UK government as part of a new dementia package which aims to speed up diagnosis, fund research and encourage businesses and services in the country to become dementia-friendly.

Dr Dennis Gillings is Founder of Quintiles, the world’s largest provider of biopharmaceutical development services, and has provided consultancy to numerous companies and health organisations, including the National Cancer Institute and the Institute of Medicine.

As the global voice on dementia, ADI hopes the World Dementia Envoy will generate new funding streams around the world, helping to sustain the crucial collaborative action that is now required from all nations. 

Marc Wortmann, Executive Director of Alzheimer’s Disease International comments:

“ADI is very pleased that the British government is taking steps towards improving diagnosis and stigma tackling for people with dementia. We believe that timely diagnosis and involving businesses in developing more dementia friendly environments will make a difference to the everyday lives of people with dementia and their carers. To stop the growing dementia epidemic, we need significantly higher research budgets like the world has provided for cancer and HIV/AIDS.  The appointment of the Envoy and the creation of a World Dementia Council will boost research and innovation and should help to take advantage of increasing funding opportunities provided by governments, encourage the public to donate more to Alzheimer associations, many of which already fund research, and reach out to sources that have not been involved before.”

Alongside the Envoy, ADI will continue to lead, with its member associations, a global task force that focuses on facilitating research, developing dementia friendly communities and awareness initiatives, and improving health and social care systems.

(Source:  ADI, News Release, 28 February 2014)

REPORT SHOWS UNDER NUTRITION AS A MAJOR PROBLEM AMONG PEOPLE WITH DEMENTIA

A new report, released on 11 February 2014, highlights that under nutrition is a major problem among people with dementia, and stresses the importance of recognizing nutrition as a potential key factor in the well being of people with dementia.

Research reviewed in the report finds that 20-45% of those with dementia in the community experience clinically significant weight loss over one year.

Alzheimer’s Disease International (ADI) and Compass Group commissioned a team of researchers, led by Professor Martin Prince from the King’s College London Global Observatory for Ageing and Dementia Care, to produce the report ‘Nutrition and dementia: a review of available research’.

The report reviews existing research on dietary factors across the life course that might increase or decrease the risk of developing dementia in later life. While obesity in mid-life may be a risk factor for developing dementia in late life, weight loss tends to become a more significant issue in the decade leading up to the clinical onset of the disease and accelerates thereafter.

The report also details actions that could improve the nutrition of people with dementia through diet and external factors such as modifying the meal time environment, and supporting and training carers. Given the evidence for effective interventions, there is much untapped potential to improve the food intake and nutritional status of people with dementia.

Professor Prince, from King’s College London, says: “For older people, under nutrition is arguably a greater health concern than obesity, and it is particularly common among people with dementia. This is a neglected area of research with important implications for quality of life, health and functioning. While weight loss in dementia is very common and can be an intrinsic part of the disease, it could be avoided and we should be doing more to tackle the problem.”

Marc Wortmann, Executive Director, ADI, says: “I am very pleased that ADI and Compass Group commissioned this report. We believe that a focus on diet, nutrition and well being is a positive approach to supporting people with dementia and carers of this devastating disease. The report also shows we need more research into the potential role of nutrition in reducing the risk of developing dementia.”

The Report recommends that:

·      The adoption of nutritional standards of care for people with dementia should be considered throughout the health and social care sectors. These could include regular monitoring of weight, as well as assessments of diet and feeding behaviors, and the need for feeding assistance.

·      Family and professional carers should be trained and supported to understand and meet the challenges involved in maintaining adequate nutrition for people with dementia.

·      Evidence-based advice should be provided to inform consumer choices regarding the balance of risks and benefits associated with the use of nutritional supplements claimed to protect cognition in late life, before or after the onset of dementia.

·      More research should be conducted into the effective components of a diet that might prevent dementia and the progression of mild cognitive impairment.

(Source:  ADI, News Release, 11 February 2014)

Dear Caregivers,

Please be advised that ADFM National Caregivers Support Network has organized the following two talks for the monthly sharing session in March 2014. 

Date:  Saturday, 22 March 2014

Time:  2.00pm – 4.30pm

Venue:  ADFM PJ Daycare Centre, No. 6 Lorong 11/8E, 46200 Petaling Jaya.

PROGRAM:

1.30pm   Taking Attendance

2.00pm   Talk “Incontinence in Persons Living with Dementia” by Dato  Dr Selvalingam Sothilingam, Consultant Urologist, Hospital KL  and Tunku Mizan Military Hospital, Sessional Consultant of Pantai  KL Medical Centre  

2.45pm   Q & A Session

3.15pm  Talk “Pelvic Floor Muscle (PFM) Rehabilitation for Persons with Incontinence” & work out session by Puan Suhaila Shohaimi, Physiotherapist, PPUKM

4.30pm  Refreshment/End

SYNOPSIS:

(1)  Incontinence in Persons Living with Dementia 

As dementia progresses into the middle stage, some people may begin to experience loss of bladder or bowel control (incontinence).  While the nature and severity of incontinence can vary among individuals, all persons with dementia will experience incontinence in the late stage of the disease.  There are many causes, as well as ways to help manage incontinence. How you respond can help the person with dementia retain a sense of dignity.

(2)  Pelvic Floor Muscle (PFM) Rehabilitation for Persons with Incontinence

To increase awareness of PFM and its function.  To educate proper technique of PFM exercise.  Strengthening your pelvic floor muscles will help you actively support your bladder and bowel, improves bladder and bowel control and can reduce or stop leakage of urine and bowel motions.

PARTICIPANTS:

Caregivers and their families, Nurses/Carers from Allied Health Sector & all those who directly or indirectly are involved in the care of persons with dementia.  

Certificate of Attendance will be awarded to participants from Allied Health sector. 

COMPULSORY PRE-REGISTRATION :  First-Come-First-Served Basis:

1.   Email Registration Form to jenny@adfm.org.my or Fax to 03 7960 8482.

2.  SMS 016 608 2513 indicating full name, Caregiver  (Yes / No), and Tel/mobile contacts, if you do not have access to email.

Further information, contact  jenny@adfm.org.my or call 016 608 2513 / 03 7931 5850.

From: National Caregivers Support  Network 

VIDEO – DEMENTIA FRIENDLY STORE

Take a few minutes to watch this inspiring Video produced by the Taiwan Alzheimer's Disease Association (TADA) and the Taiwan Rotary International 3520.   

Click On ->  DEMENTIA FRIENDLY STORE VIDEO

The Future of Retail for the Persons Living with Dementia?

English Version:

Ms Wong, a retiree, takes care of her 88 years old Mom diagnosed with dementia. Her mother is very active, and often runs out and loses her way home.

Ms Wong approached her neighbourhood business community for help. She asked that they allow her dementia afflicted Mom to eat in their food stalls if she came there, and at the same time to contact her. She would then come and take her Mother home, and make the payment to them for any food her mother had ordered.

Her 88 year old Mom also frequently likes to visit the same grocery shop. She liked to buy and take home things like coat-hangars and other provisions by the dozens. The whole family was very disturbed. Ms Wong arranged with the grocery shop owner to allow her Mom to take home the goods. The family would then return the goods intact in exchange for other provisions which the family required. Understanding the challenges and hardship of the caregiver and family, the owner of the grocery shop readily agreed to help the family.

The Wong family was very grateful and hoped that more and more businesses would come forward to offer their help to the caregiver families of persons living with dementia and older adults in their neighbourhood.

This joint family and community effort will not only greatly alleviate the mental stress and hardship of home-caregivers but also help towards creating a friendly society and environment for dementia afflicted persons and older adults.

[Note] : " Rui Chi " stands for valuing the life and past contributions of elderly persons living with dementia; reducing the stigma; helping society to accept and include them; empathizing and offering help and support to caregivers and families caring for persons with dementia and older adults.

Mandarin Version:

退休的黃女士照顧85歲失智的媽媽，媽媽行動能力強，經常往外跑­，已多次走失。黃女士請社區商家老闆們協助，如果看到媽媽自行出­門，請老闆協助留下媽媽並請她吃東西，事後黃女士買單。同時請老­闆與她聯絡，讓她順利帶媽媽回家。 88歲的陳奶奶經常至同一家雜貨店買衣架，她家裡衣架有數十打，­令家人十分困擾。於是家人與雜貨店老闆商量，如果媽媽買重複的東­西，由家人原封不動拿回來與老闆換等值之其他物品。老闆體諒家人­照顧之辛苦，欣然答應幫忙。 我們感謝這麼多好心的商家，更期盼連結更多商家，藉著社區鄰里守­望相助，發揮老吾老以及人之老之精神，共同照顧快速增加的失智長­者，減輕家庭照顧壓力。同時未來照顧人力減少，無法單靠家庭來照­顧，勢必要靠整個社區共同互相照顧。此計畫期盼將日常生活中食、­衣、住、行、育樂各商家串連起來，一起加入共同照護網絡，不但能­減輕失智家庭照護的辛苦，也能為商家提升業績及公益形象。

【註】：「瑞智」意涵 - 看重失智長者之生命價值，肯定長者過去對社會之貢獻，減少污名化­，幫助民眾接納與包容失智長者，同理家屬們之辛苦，並給予支持力­量。

(Source:  Taiwan ADA)

Think Twice About Giving Elders Nutritional Drinks or Shakes

"My elderly mother isn't eating and she has lost a lot of weight.  Should I give her a nutrition supplement drink to replace the meals she should be eating?"

Under-nutrition due to lack of eating is a common problem among elderly people. It is also dangerous. Under-nutrition and extreme thinness can lead to higher mortality rates, according to a study published in the American Journal of Clinical Nutrition. It is a problem that can't be ignored.

Geriatricians (specialists in treating the elderly) take weight loss among the elderly very seriously and caregivers should, too. However, some caregivers feel that feeding their parent a nutrition supplement drink, such as Boost, in lieu of meals ensures the elderly loved one is getting the nutrition they need. This isn't the case, according to Dr. Amy Ehrlich, Associate Professor of Clinical Medicine and Interim Division Head of Montefiore Medical Center's Geriatrics Division.

"Just giving them a can of Ensure for dinner isn't enough," she says. "It is always better to try to use regular food to maintain a person's weight." If a caregiver wants to use nutrition drinks, they should be used between meals, as a snack or supplement to add calories to the senior's diet – not as a meal replacement.

Work with a doctor to determine elder's nutrition needs

Weight loss is a marker of frailty. However, it is not a normal part of aging. Dr. Ehrlich stresses that it is critical to find out what is causing the senior's loss of interest in food. A doctor should conduct a detailed medical evaluation to determine the cause of loss in appetite and weight loss. "There are a variety of treatable conditions that could be the culprit: ulcers, thyroid disease, dementia, depression, even ill-fitting dentures. All are treatable, so rather than immediately turning to a supplement, work with your doctor to address the cause of the problem," Dr Ehrlich says.

If a caregiver does decide a nutrition drink is right for their elderly loved one, a doctor should still be consulted to determine the type of supplement to use. For example, diabetics must choose a low-sugar product.

Frail elderly have different nutrition requirements

There is a misperception that frail elderly people should adhere to the same low-fat, low-calorie diet that is recommended for the general population. However, Dr. Ehrlich says that for frail elderly who have substantial weight loss, the opposite is true. "I'll see a 94-year-old person who is losing weight and he is restricting everything, eating a low-calorie, low-fat diet. It would be better to eat a bowl of ice cream, for the caloric intake!"

Elders who have experienced weight loss should eat what they like. And don't be afraid to incorporate eggs, cheese, peanut butter…even ice cream into the diet.

There is no need for low-fat milk or cheese.

Elders often can't (or don't want to) eat three large meals a day. Rather, encourage them to have smaller, more frequent meals, including snacks, even before bed.

Nutrition drinks and supplements can interact with medications

Supplements, including nutrition drinks, can cause dangerous drug interactions in the same way prescription medications do.

If an elder is taking prescription and over-the-counter drugs and supplements, the drugs may conflict and, basically, go to war against each other, while also damaging otherwise functioning body organs and systems. Check with your doctor to avoid interactions. "I encourage my patients to bring in all their medications, supplements and vitamins, so I can check for possible interactions. I call it the 'brown bag visit," Dr. Ehrlich says. As an example, vitamin supplements may negatively interact with blood thinners like Coumadin. 

The bottom line is that nutrition drinks are not a magic fix for lack of eating or under-nutrition. These products are not bad when used as a dietary aid and supplement to regular meals. However, they should not be used as a meal replacement for elders – especially those who are frail or thin.

(Source:  Agingcare.com - Dr. Amy Ehrlich MD is Geriatrics Fellowship Program Director for Montefiore Medical Center's Geriatrics Division in New York and an Associate Professor of Clinical Medicine. She is board certified in Geriatric Medicine and Internal Medicine.)

(POSTED 16 FEBRUARY 2014)