The Role of Nutrition in Maintaining Health in the Nation's Elderly

Malnutrition and obesity are both common among Americans over age 65. There are also a host of other medical conditions from which older people and other Medicare beneficiaries suffer that could be improved with appropriate nutritional intervention. Despite that, access to a nutrition professional is very limited.Do nutrition services benefit older people in terms of morbidity, mortality, or quality of life?Which health professionals are best qualified to provide such services?What would be the cost to Medicare of such services? Would the cost be offset by reduced illness in this population?This book addresses these questions, provides recommendations for nutrition services for the elderly, and considers how the coverage policy should be approached and practiced. The book discusses the role of nutrition therapy in the management of a number of diseases. It also examines what the elderly receive in the way of nutrition services along the continuum of care settings and addresses the areas of expertise needed by health professionals to provide appropriate nutrition services and therapy.Table of ContentsFront MatterExecutive Summary1 Introduction2 Overview: Nutritional Health in the Older Person3 Methods4 Undernutrition5 Cardiovascular Disease6 Diabetes Mellitus7 Renal Disease8 Osteoporosis9 Nutrition Services in the Acute Care Setting10 Nutrition Support11 Nutrition Services in Ambulatory Care Settings12 Nutrition Services in Post-Acute, Long-Term Care and inCommunity-Based Programs13 Providers of Nutrition Services14 Economic Policy Analysis15 Overall Findings and RecommendationsAppendix A: AcronymsAppendix B: GlossaryAppendix C: Workshop Speakers, Organizations Contacted, andConsultants to the CommitteeAppendix D: State Licensure Laws for the Practice of Dietetics (asof June 1999)Appendix E: The American Dietetic Association Foundation Knowledgeand Skills and Competency Requirements for Entry-Level DietitansAppendix F: Advanced-Level Credentials in NutritionAppendix G: U.S. Preventive Services Task Force Rating ofProfessionals to Deliver Dietary CounselingAppendix H: Summary of Cost Estimation Methodology for OutpatientNutrition TherapyAppendix I: Committee Biographical Sketches