Please read the following scenario:

Betsy, a 79 year-old woman, was evaluated in your office. She lives with her 81 year old husband who is her primary caregiver. He reports that approximately 2 years ago his wife began to lose interest in the things she enjoyed like shopping, cooking, and sewing. Gradually she become less interested in food and has lost 18 pounds in the past year. He has tried commercial nutritional supplements but has not been successful getting her to consume them. He stated he is not much of a cook but has been trying his best. He is frustrated and concerned about his wife’s weight loss and lack of appetite. He feels he is constantly trying to get her to eat. He does not have any family support as he and his wife never had children. Her medical evaluation revealed cognitive impairment using the Mini-Mental State Examination. She does not appear to have any chewing or swallowing problems but has not seen a dentist in over three years. She takes one prescription medication for her arthritis. This couple is on a fixed income from social security. Her height is 5’1” and current weight is 100 pounds. Past weight was 118 pounds (1 year ago).

Answer the following questions about Betsy. Your responses should be phrased as though you were counseling the client. This means explaining your answers in detail. Please refer to question one for an example of an acceptable response.

As Betsy ages, how has her body composition changed from when she was 50 years old until now? Example Response: Betsy as you age your body will go through a number of changes such as X,Y,Z. For example, when you were 50 years old you may have been able to do X, but now at 79 you may be a little limited in doing that function.

Based on Betsy’s scenario, what are at least two physiologic and at least two non-physiologic factors that are impacting her nutritional and health status?

Based on Betsy’s scenario, what are at least two socioeconomic factors that are impacting her nutritional and health status?

How do you determine Betsy’s energy and nutrient needs? What is the difference between her current energy and nutrient needs and when she was 40 years old?

Discuss at least two diseases that Betsy could be at risk for at her age. If she had these diseases, what would be your recommendations to reduce complications?

What are at least two nutrition benefits for Betsy to live in a senior center (retirement home, assisted living, or nursing home)? Would you recommend Betsy and her husband consider this?

Please read the following article:

Mueller, P.S., Hook, C.C., & Fleming, K. (2004). Ethical issues in geriatrics: A guide for clinicians. Mayo Clinic Proceedings, 79(4), 554–562.

http://search.ebscohost.com.lib.kaplan.edu/login.aspx?direct=true&db=edsbl&AN=RN147512568&site=eds-live

What are the ethical concerns for both Betsy and her husband, given her own personal rights as well as his concerns over her well-being? Answer this question thinking more about the nutritional aspects of ethics. Examples of ethical concerns could be safety and abuse (for example, not feeding her the proper consistency of foods).

What are the challenges with these dilemmas?

As a nutrition professional, what could you do to help resolve them?

Requirements

Responses are written in paragraph format.

Double spaced, 12 point, Times New Roman font

The minimum page limit is 3 pages or 900 words double spaced

The maximum page limit is 5 pages or 1500 words double spaced

Include at least two references. All references should follow APA style format

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