Geriatric nutrition clinic

The elderly nutrition clinic is not just a "health consultation office" that only prescribes recipes. It is a specialized clinic that specifically provides clinical intervention for diet-disease related issues for people over 60 years old. It can solve the core pain points of the elderly who cannot eat, do not take the right supplements, and the more they eat, the more chronic diseases become worse. It is much more efficient than following the trend to buy health products and believing in health rumors. It is currently one of the most cost-effective clinical intervention links in the management of elderly chronic diseases, postoperative rehabilitation, and elderly care.

The 72-year-old Aunt Zhang who was treated last week is a typical example. She has been suffering from type 2 diabetes for 11 years. She listened to the community health class and said that "to control sugar, you need to be vegetarian and eat less staple food." For half a year, she only had boiled vegetables and one or two grains of rice. She didn't even dare to eat more eggs. She bought it last month. Cai's feet fell and she suffered a fractured patella. When her son was brought here, she was shaking so weakly that she could talk. Her blood albumin was only 32g/L, and her body composition showed that her muscle mass was 24% less than the standard value for the same age. She was already suffering from moderate sarcopenia.

Many people's understanding of nutrition for the elderly is still stuck in the misunderstanding that "the elderly should eat lightly and take supplements." In fact, 80% of the problems we encounter every day in our clinic are caused by eating "too biased". It’s funny, we often encounter children forcing old people to come here. When the old people come in, they get embarrassed and say, “I’ve been eating for a lifetime and I still need you to teach me?” ”, we usually don’t just talk about this kind of thing, we first take it to measure the grip strength and individual composition. When the uncle and aunt saw that their muscle mass was much less than that of their peers, and their grip strength was not as strong as that of the 80-year-old lady next door, they didn’t need to say more, so they came over and asked how to eat.

Nowadays, the industry has different tendencies in nutrition intervention for the elderly. Some clinical nutrition doctors prefer "disease priority". For example, the elderly with stage three or above chronic kidney disease must strictly control their plant protein intake, and even animal protein must be accurately measured based on kilograms of body weight. Those with gout must not touch high-purine foods, and the intake of each bite must be very strict.； However, another group of nutritionists who provide care for the elderly prefer to "prioritize the quality of life." Especially the elderly over 85 years old, or the elderly with cognitive impairment who have a very poor willingness to eat, do not need to be so stuck. For example, the elderly who love sweets all their lives do not need to completely cut off sugar. A small piece of peach cake is given every day. As long as the total calories and protein intake are sufficient, even if the blood sugar level is slightly higher, it is better than eating bland food every day and entering the ICU due to malnutrition. Among the cases I have personally dealt with, the long-term prognosis of the latter is actually better, especially for the elderly with cognitive impairment. They eat happily, have much fewer tantrums, and have less pressure on their family members to take care of them.

There used to be an 89-year-old man with chronic obstructive pulmonary disease and Alzheimer's disease. The family was afraid that he would cough, so he only gave him white porridge with pickles. He lost 14 pounds in three months and often had fevers and pneumonia. When he came here, we adjusted the plan for him by breaking up all lean pork, eggs, broccoli, and carrots, adding whey protein and a small amount of Use a thickener to adjust the yellow rock sugar to a suitable consistency. Feed 150ml each time, 5 times a day. There is no need to strictly control sugar, and there is no need to completely avoid his favorite sweets. He has gained 5 pounds in two months. The latest follow-up visit from his family said that he has not been hospitalized for pneumonia in half a year, and he can occasionally sit up and watch Peking Opera on his own.

Of course, not all problems can be solved by nutrition clinics. For example, elderly people with severe swallowing disorders must first cooperate with the rehabilitation department for swallowing function training. If necessary, a nasogastric tube must be inserted, and forced feeding is not allowed.； If the serum albumin has dropped below 25g/L and edema occurs, you must first rely on intravenous albumin supplementation as an emergency. It cannot be brought back by eating alone. We do not myth the role of nutritional intervention. It is an auxiliary item for clinical treatment. However, if this auxiliary item is done well, it can save the elderly from many sins and help their families save a lot of treatment costs.

Last week, when an old man left, he carried the diet plan we gave him and muttered to his children, "If I had known this place existed, I would have spent more than 30,000 yuan on cordyceps and protein powder in vain." In fact, to put it bluntly, what the geriatric nutrition clinic does is this practical thing: it does not engage in mysterious health theories, but just focuses on the mouthful of rice in the elderly bowl, helping everyone eat comfortably and correctly, so that they can spend less money and live a more practical life.