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Becky
Expert in nutrition for healthy aging
Recent Activity
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As the RDN for a continuing care retirement community, you have been asked to do a presentation and a booth on good nutrition for older adults at an upcoming health fair. The audience will include past rehabilitation patients from middle age to older adults with a diverse range of health issues – ranging from knee or hip replacement surgery and post cardiac events, to people with multiple chronic diseases including hypertension, diabetes, cardiovascular disease, malnutrition and unintended weight loss. Information about nutrition is everywhere, and as a result many people have misconceptions about the role that food and supplements can... Continue reading
Posted Mar 24, 2017 at Becky Dorner's Blog
Richard is an 88 year old male who was hospitalized post myocardial infarction (MI) for placement of a stent and management of heart failure. Other than a diagnosis of hypertension which has been under control with medications since age 70, he had been healthy and living independently with his wife in their home. Prior to the MI, he was eating a regular diet and either walking or using a stationary bike daily. However since the MI, his cardiologist has drastically restricted his physical activity, and ordered a low fat, low cholesterol, 2 gram sodium diet. His medications include 75 mg... Continue reading
Posted Jan 12, 2017 at Becky Dorner's Blog
Your 76 year old patient Edna proudly tells you that without even trying, her weight is down from 145 to 124 pounds in just 6 months. At 5’1” tall and 145 pounds her BMI was 27.4 which was considered overweight for her height. Now at 124 pounds she is in the normal weight category. So do you cheer for her? Or do you worry that she may have some serious health repercussions? Estimates indicate that more than 33% of people over 65 years of age (1), and almost 26% of newly-admitted nursing home patients are obese (2). Predictions are that... Continue reading
Posted Aug 15, 2016 at Becky Dorner's Blog
Have you ever swallowed and had food “go down the wrong way”? For an estimated 15-40% of adults over the age of 60 this is a constant concern. Dysphagia is simply defined as any difficulty or inability to swallow. It is not a disease, but a disruption of a normal process. Problems at any point during the swallow can result in difficulty swallowing. A person with dysphagia may have a delayed, incomplete or absent swallowing response. Potential causes include obstruction, nerve and muscle problems and miscellaneous issues such as trauma, medications, poor dentition and poor mouth care. Dysphagia can have... Continue reading
Posted Mar 23, 2016 at Becky Dorner's Blog
I do my best to stay positive in my communications however, I have to say that I was sadly disappointed in the meal service during a recent visit to a nursing facility. Was it because it was a Saturday evening meal and they had less staff? Is that an excuse for serving soggy, ground up pizza and overcooked mushy green beans to a person who is unable to articulately communicate her dislike of the food? Certainly not. Are your customers satisfied with their dining experience? National surveys in nursing facilities have indicated that almost a third of residents are unhappy... Continue reading
Posted Feb 11, 2016 at Becky Dorner's Blog
One of my RDNs posed this question recently related to BMI levels for older adults: I've been seeing transfer notes from the hospital and other nursing homes with diet/nutrition histories where RDNs are charting that BMIs of less than 23 is underweight. For example, one note documented that a BMI of 21.3 was underweight "for age" for a man who was 92. State surveyors are also asking for a list of residents with BMI under 21 and wanting to see interventions on them. The MDS does not trigger for a low BMI until under 19. Do we need to adapt... Continue reading
Posted Jan 19, 2016 at Becky Dorner's Blog
Most of us can say that our lives have been touched by Alzheimer’s Disease or dementia in some way, and with the aging of America, the number of people affected by this condition continues to increase. The term dementia describes a variety of diseases and conditions that develop when neurons in the brain no longer function normally, causing changes in memory, behavior, and ability to think clearly. There are many types of dementia, but Alzheimer’s disease (AD) is the most common form, accounting for 60-80% of dementia cases. About 1 in 9 people aged 65 and older, and 1 in... Continue reading
Posted Jan 7, 2016 at Becky Dorner's Blog
Guest blogger: Mary Litchford PHD, RDN, LDN Myth # 1: I’m too busy to learn how to do Nutrition Focused Physical Assessment (NFPA). Keeping clinical skills consistent with current standards of practice in dietetics is essential. All nutrition professionals have a duty to demonstrate a level of clinical expertise that is consistent with current standards of practice in dietetics. If time is an issue, set a goal to sharpen your clinical detection skills over the next 6-12 months. There are numerous books, webinars and CE courses on NFPA available at www.beckyDorner.com to help you learn this vital component of nutrition... Continue reading
Posted Jan 13, 2015 at Becky Dorner's Blog
Guest blogger: Kathy Warwick, RD, CDE There is a big gray wave on the horizon and we need to prepare for the aging population. By the year 2030, one in five Americans or 72 million people will be over the age of 65. One in four of this group, or 10.9 million will have diabetes, and nearly half may not be aware they have it. Diabetes is a complicated chronic illness that threatens to bankrupt our healthcare system and is associated with many debilitating complications. As nutrition professionals, we will see a dramatic increase in the number of older patients... Continue reading
Posted Nov 18, 2014 at Becky Dorner's Blog
Guest Blogger: Mary Ellen Posthauer, RDN, CD, LD, FAND, Co-Chair Nutrition Guidelines Small Work Group In 2009, after a four year collaboration with the European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Ulcer Advisory Panel (NPUAP) published the Pressure Ulcer Prevention and Treatment Clinical Practice Guideline. I had the opportunity to chair the small work group along with Becky Dorner, RDN, LD, FAND, David R. Thomas, MD, FACP, FAGS, AGSF and Steven Black, MD. Guidelines are systematically developed statements to assist practitioner decisions about appropriate health care for specific situations, which in our case are nutrition interventions. The nutrition... Continue reading
Posted Sep 5, 2014 at Becky Dorner's Blog
Author(s): Becky Dorner, RDN, LD, FAND In the older adult population, the consequences of malnutrition can have a major impact on health, such as unintended weight loss, sarcopenia, frailty, and delayed healing of pressure ulcers. Serving healthful, nourishing meals is not always an easy task in long-term care settings, where staff are contending with food–medication interactions, anorexia, gastrointestinal issues, depression, chronic diseases, poor dentition, difficulty chewing and swallowing, and other issues affecting proper nutritional absorption. Overcoming these barriers is becoming increasingly important, as the literature continues to strengthen the association between good nutrition and overall health in older adults. There... Continue reading
Posted Jun 16, 2014 at Becky Dorner's Blog
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Older adults need additional calories, protein and other nutrients during periods of stress Critical illness or chronic conditions like trauma, injury, burns, wounds, pressure ulcers, major surgery, or sepsis cause a stress response that can result in hypermetabolism, increased catabolism, and loss of lean body mass (LBM). As a result, patients under stress may experience unintended weight loss and protein energy malnutrition (PEM), which contribute to immune impairment, weakness, and increased risk of pressure ulcers. Understanding the reasons why this happens can help practitioners understand how to treat patients under stress. Metabolic responses during stress or trauma have a dramatic... Continue reading
Posted Jun 15, 2012 at Becky Dorner's Blog
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Health care professionals who care for older adults can help prevent and treat Sarcopenia Approximately 45% of the older adults in the U.S. are affected by sarcopenia, the progressive loss of muscle mass, function, quality, and strength driven by the aging process (1). Sarcopenia can lead to diminished strength and decreased activity levels, and can contribute to mobility issues, osteoporosis, falls and fractures, frailty, loss of physical function and independence (2). From age thirty to sixty the average adult will gain a pound of weight and lose half a pound of muscle yearly for a total gain of 30 pounds... Continue reading
Posted Apr 11, 2012 at Becky Dorner's Blog
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The obesity epidemic challenges health care professionals who care for older adults. Our next great challenge in working with the nutritional needs of older adults in health care communities will be one that we have not worried about in many years: obesity. In the U.S., the prevalence of obesity in the general adult population is now at 67% (1); among adults over the age of 75 this rate was 26% for men and 27% for women in 2007-8. This may not sound alarming until you realize that this is an increase of 100% and 42% respectively since 1988-1994 (2). It... Continue reading
Posted Mar 21, 2012 at Becky Dorner's Blog
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Health care communities are making person-centered dining programs the center of attraction! Nursing homes and assisted living facilities alike are embracing the concept of changing their internal culture from institutional-based care to person-centered care where the individual is at the center of making decisions about their daily lives. Dining can be an important part of the transition to person centered care, and can in fact, dining can take center stage in a facility’s culture change movement. The goals of culture change are to encourage people to thrive in their later years, to live in more home-like atmospheres with fewer people,... Continue reading
Posted Mar 8, 2012 at Becky Dorner's Blog
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It’s been a while since I last blogged about our efforts to assist the hospital in Port au Prince Haiti. The nurse we were working with has moved back to the U.S., but continues to assist with making sure our nutrition funds get to those in need. We are now working with Jo Cherry, MD who is from the UK. Dr. Cherry was kind enough to send us a detailed email and photos of just one of the patients that has had success with the help of improved nutrition care. With her permission (and the patient’s), I am sharing this... Continue reading
Posted Sep 14, 2011 at Becky Dorner's Blog
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Picture this: Disaster strikes… Your pre-prepared emergency plan is in place, your staff has been trained. But when the time comes the plan falls apart because emergency services can’t get in to help you—and you can’t get out. You may have to wait for days before help comes. Do you have enough water? Food? Supplies? There have been so many horrendous disasters in the past year, that we really have to check and double check to be sure that we have a plan A, B, and C. I recently had the opportunity to speak to a wonderful group of food... Continue reading
Posted Jul 27, 2011 at Becky Dorner's Blog
Despite the fact that it has been more than a year after the devastating earthquake in Haiti, people there are still in desperate need of help. It’s amazing to realize that even a small donation can save a life. Let me give you a little background. One of my staff RDs, Jill, has a sister named Karen, who is an RN working with Project Medishare in Haiti. Karen is in charge of the ICU at the Port au Prince Hospital in Haiti. Karen informed us that the hospital was in very short supply of tube feeding formulas and other essential... Continue reading
Posted Mar 11, 2011 at Becky Dorner's Blog
The Institute of Medication (IOM) of the National Academies, Food and Nutrition Board released new recommendations for vitamin D and calcium on November 30, 2010. Health claims have been made for cancer prevention, diabetes, falls, preeclampsia, and more, so the committee reviewed 25 potential health outcomes for vitamin D and calcium. There is no substantiated research to support these health claims at this time. However, there is strong research to support the role of vitamin D and calcium working together to build strong bones. The RDAs are developed based on current evidence and variation needed to cover approximately 97.5% of... Continue reading
Posted Dec 6, 2010 at Becky Dorner's Blog
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Hot Topics in Nutrition Care for Older Adults from ADA FNCE 2010 The American Dietetic Association (ADA) held its annual Food and Nutrition Conference and Exhibition (FNCE) in Boston November 6-9, 2010. It was a great meeting with lots of new information! Hot topics in nutrition care for older adults included the ADA Evidence Analysis Library project on Unintended Weight Loss in Older Adults, the new ADA position and practice papers on Nutrition Interventions for Older Adults in Health Care Communities from the Oct. 2010 JADA (we shared the link in our October e-zine); sarcopenia/sarcopenic obesity and the role of... Continue reading
Posted Nov 15, 2010 at Becky Dorner's Blog
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The long awaited MDS 3.0 is finally here and all nursing homes must be ready to implement on October 1, 2010. That means a whole new process and many changes in data collection, interview process, evaluation and terminologies. As my friend Brenda Richardson says, “The CATs ate the RAPs” and there are many other changes to this new resident assessment instrument. On a positive note, the tool is much more resident-focused with increased input from residents -- which will hopefully lead to enhanced resident-centered care. For nutrition professionals, it means a brand new section K. One thing remains the same:... Continue reading
Posted Sep 17, 2010 at Becky Dorner's Blog
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Mar 16, 2010