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Dietary resilience as described by older community-dwelling adults from the NuAge study "if there is a will -there is a way!".

https://arctichealth.org/en/permalink/ahliterature128482
Source
Appetite. 2012 Apr;58(2):730-8
Publication Type
Article
Date
Apr-2012
Author
Elisabeth Vesnaver
Heather H Keller
Hélène Payette
Bryna Shatenstein
Author Affiliation
University of Guelph, Department of Family Relations and Applied Human Nutrition, Macdonald Institute, Guelph, Ontario, Canada.
Source
Appetite. 2012 Apr;58(2):730-8
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Aged
Aged, 80 and over
Aging - physiology
Diet
Eating - physiology
Female
Food - economics
Health promotion
Health status
Humans
Independent Living - psychology
Longitudinal Studies
Male
Quebec
Residence Characteristics
Abstract
Many older adults experience age-related changes that can have negative consequences for food intake. Some older adults continue to eat well despite these challenges showing dietary resilience. We aimed to describe the strategies used by older adults to overcome dietary obstacles and to explore the key themes of dietary resilience. The sample was drawn from the five-year Québec Longitudinal Study "NuAge". It included 30 participants (80% female) aged 73-87 years; 10 with decreased diet quality and 20 with steady or increased diet quality; all had faced key barriers to eating well. Semi-structured interviews explored how age-related changes affected participants' experiences with eating. Thematic analysis revealed strategies used to overcome eating, shopping, and meal preparation difficulties. Key themes of dietary resilience were: prioritizing eating well, doing whatever it takes to keep eating well, being able to do it yourself, getting help when you need it. Implications for health professionals are discussed.
PubMed ID
22200412 View in PubMed
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Food security in older adults: community service provider perceptions of their roles.

https://arctichealth.org/en/permalink/ahliterature158582
Source
Can J Aging. 2007;26(4):317-28
Publication Type
Article
Date
2007
Author
Heather H Keller
John J M Dwyer
Vicki Edwards
Christine Senson
H. Gayle Edward
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON. hkeller@uoguelph.ca
Source
Can J Aging. 2007;26(4):317-28
Date
2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Community Health Services
Focus Groups
Food
Food Services - organization & administration
Geriatric Assessment
Health education
Health Services for the Aged
Humans
Ontario
Social Class
Social Support
Abstract
Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food security, and (c) opinions about constraints that influenced these roles. A constant comparison analysis identified key themes. The formal caregivers reported six roles for improving food security: (a) monitoring, (b) coordination, and (c) promoting services, (d) education, (e) advocacy, and (f) providing a social environment. The final theme summarizes these roles as "the need for personalization of service". Social and community service providers are involved in roles that can promote the health of older adults by addressing their food insecurity. Social service providers need to be acknowledged and supported in this health promotion role.
PubMed ID
18304920 View in PubMed
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Food tasting as nutrition education for older adults.

https://arctichealth.org/en/permalink/ahliterature143054
Source
Can J Diet Pract Res. 2010;71(2):99-102
Publication Type
Article
Date
2010
Author
Barbara Manilla
Heather H Keller
Margaret R Hedley
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada.
Source
Can J Diet Pract Res. 2010;71(2):99-102
Date
2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Exploratory Behavior
Female
Food Preferences - psychology
Health Promotion - methods
Humans
Male
Middle Aged
Nutritional Sciences - education
Ontario
Pilot Projects
Abstract
The likelihood of experiencing poor nutrition status increases as people age. Sampling new foods may promote a continued interest in food and enjoyment of eating. This pilot study was designed to describe and provide a preliminary evaluation of food-tasting activities integrated into nutrition displays directed at community-living older adults.
Three consecutive monthly nutrition displays incorporating a food-tasting activity were presented at a Guelph, Ontario, recreation centre for seniors. Seniors had an opportunity to taste two recipes at each of three displays; 226 food samples and 155 copies of recipes were taken. Feedback forms were used to determine participants' interest in making the recipes, and whether tasting influenced their interest in preparing the food.
Among 54 participants who completed feedback forms about the program, 75.9% indicated that they intended to prepare one or both of the recipes tasted at the display; 70.4% indicated that they would not or may not have made the recipe without tasting it beforehand.
Dietitians working with community-living older adults could use food tastings to help translate key educational messages into practice, and to encourage eating enjoyment as people age.
PubMed ID
20525423 View in PubMed
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Hospital diagnosis of malnutrition: a call for action.

https://arctichealth.org/en/permalink/ahliterature152268
Source
Can J Diet Pract Res. 2009;70(1):37-41
Publication Type
Article
Date
2009
Author
Mary Ann Bocock
Heather H Keller
Author Affiliation
Department of Family Relations and Applied Human Nutrition, University of Guelph, Guelph, ON.
Source
Can J Diet Pract Res. 2009;70(1):37-41
Date
2009
Language
English
Publication Type
Article
Keywords
Aged
Canada
Clinical Competence
Diagnosis, Differential
Diagnosis-Related Groups - classification - statistics & numerical data
Dietetics - standards - statistics & numerical data
Female
Hospitalization
Humans
Male
Malnutrition - diagnosis - epidemiology
Abstract
The Canadian Institute for Health Information (CIHI) provides accurate health information needed to establish sound health care policies. The CIHI mandate is to develop and co-ordinate a uniform approach to health care information in Canada. The institute uses the International Classification of Diseases (ICD) system to record the most responsible diagnosis for each hospital admission. This investigation was conducted to determine if six ICD protein-calorie malnutrition (PCM) codes could be used for health care utilization analyses. Aggregate data (1996 to 2000) from the CIHI discharge abstract database were used. The data analyzed were the most responsible diagnoses data for the six PCM codes and a single summary statistic for all other "non-malnutrition" diagnoses for all long-term care facility residents aged 65 or older who were transferred to an acute care facility. In this population, fewer than five hospital admissions per year were assigned a PCM code. There were too few PCM cases to do trend analyses for morbidity or mortality. This study suggests a lack of recognition and documentation of PCM as a specific health condition in older adults. Lack of tracking of this diagnosis prevents documentation that could lead to policy changes to support older adults' nutrition.
PubMed ID
19261205 View in PubMed
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Meal programs improve nutritional risk: a longitudinal analysis of community-living seniors.

https://arctichealth.org/en/permalink/ahliterature168518
Source
J Am Diet Assoc. 2006 Jul;106(7):1042-8
Publication Type
Article
Date
Jul-2006
Author
Heather H Keller
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada N1G 2W1. hkeller@uoguelph.ca
Source
J Am Diet Assoc. 2006 Jul;106(7):1042-8
Date
Jul-2006
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Cohort Studies
Female
Follow-Up Studies
Food Services - utilization
Geriatric Assessment
Health status
Humans
Interviews as Topic
Linear Models
Longitudinal Studies
Male
Mass Screening
Nutrition Assessment
Nutrition Surveys
Nutritional Status
Ontario
Questionnaires
Risk assessment
Social Support
Abstract
To determine the independent association of meal programs (eg, Meals On Wheels and other meal programs with a social component) and shopping help on seniors' nutritional risk.
Cohort design. Baseline data were collected with an in-person interview and subjects were followed up for 18 months via telephone interview.
Cognitively well, vulnerable (ie, required informal or formal supports for activities of daily living) seniors were recruited through community service agencies in southwestern Ontario, Canada. Three hundred sixty-seven seniors participated in baseline interviews and 263 completed data collection at 18-month follow-up; 70% participated in meal programs at baseline.
The 15-item Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN) questionnaire identified nutritional risk at 18 months.
Descriptive and bivariate analyses were performed and significant associations (P
PubMed ID
16815120 View in PubMed
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Mealtimes as active processes in long-term care facilities.

https://arctichealth.org/en/permalink/ahliterature175638
Source
Can J Diet Pract Res. 2005;66(1):5-11
Publication Type
Article
Date
2005
Author
Amie J Gibbs-Ward
Heather H Keller
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
Source
Can J Diet Pract Res. 2005;66(1):5-11
Date
2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Dementia - physiopathology
Food Services - standards
Humans
Long-Term Care
Middle Aged
Quality of Life
Residential Facilities
Abstract
Mealtimes are central to the nutritional care of residents in long-term care facilities. There has been little Canadian research to guide interdisciplinary practice around mealtimes. This study included a grounded theory approach to explore mealtime experiences of 20 people with dementia living in two long-term care facilities, and the meal-related care they received from registered nurses, health care aides, and dietitians. Theoretical sampling directed the collection and analysis of data from mealtime observations in special care units and key informant interviews with care providers. The constant comparison method was used to analyze and conceptualize the data. A substantive theory emerged with three key themes: 1. Each mealtime is a unique process embedded within a long-term care facility's environment. 2. Residents are central to the process through their actions (i.e., arriving, eating, waiting, socializing, leaving, and miscellaneous distracted activities). 3. Internal (i.e., residents' characteristics) and external (i.e., co-resident, direct caregiving, indirect caregiving, administrative, and government activities) influences affect residents' actions at mealtimes. The theory suggests that optimal mealtime experiences for residents require individualized care that reflects interdisciplinary, multi-level interventions.
PubMed ID
15780150 View in PubMed
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Menu planning in long-term care: toward resident-centred menus.

https://arctichealth.org/en/permalink/ahliterature133938
Source
Can J Diet Pract Res. 2011;72(2):83
Publication Type
Article
Date
2011
Author
Kate Ducak
Heather H Keller
Author Affiliation
Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada.
Source
Can J Diet Pract Res. 2011;72(2):83
Date
2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Female
Health Promotion - methods
Homes for the Aged
Humans
Long-Term Care
Male
Menu Planning
Nursing Homes
Patient-Centered Care
Abstract
Factors that influence the menu planning process in Ontario long-term care (LTC) homes were studied, as were key informants' perspectives on how this process could be improved to promote resident-centred menus. Key informants were interviewed by telephone to obtain qualitative data through standardized open-ended questions. The key informants (n=35) were randomly selected nutrition managers of Ontario LTC homes. Selected registered dietitians from the Ontario Long-Term Care Action Group also participated (n=5). Descriptive thematic analysis was completed on data provided. Three over arching themes emerged from the data as drivers in the menu planning process: resource limitations, Ontario Ministry of Health and Long-Term Care standards, and the accommodation of diverse and evolving preferences. Challenges involving resources include insufficient food labour and raw food funding, the workload involved with altering menus, and providing food items for special diets or preferences. In terms of ministry standards, participants reported barriers to complying with rotation and portion standards. Other common obstacles within LTC homes include accommodating personal preferences, cultural preferences, and therapeutic diets. Ontario LTC homes face numerous challenges in the planning of menus for residents, regardless of a home's size, location, or profit status. Suggestions are aimed at improving the menu planning process and providing high-quality, palatable, and culturally appropriate food in these homes so that menus are resident-centred.
PubMed ID
21645428 View in PubMed
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Nutritional risk in vulnerable community-living seniors.

https://arctichealth.org/en/permalink/ahliterature182387
Source
Can J Diet Pract Res. 2003;64(4):195-201
Publication Type
Article
Date
2003
Author
Heather H Keller
Jacquelyn D McKenzie
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, ON.
Source
Can J Diet Pract Res. 2003;64(4):195-201
Date
2003
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Canada
Female
Geriatric Assessment
Humans
Male
Nutrition Assessment
Nutrition Surveys
Questionnaires
Risk assessment
Risk factors
Abstract
The purpose of this study was to quantify nutritional risk in a convenience sample of vulnerable, community-living seniors, and to determine patterns of nutritional risk in these seniors. The sample consisted of 367 seniors who provided health, functional, and nutritional risk information during an interview in which the Seniors in the Community: Risk Evaluation for Eating and Nutrition questionnaire was used. The majority (73.6%) of the sample was female, and the mean age was 79 years. Nutritional risk was identified in 68.7% of the sample, with 44.4% being at high nutritional risk. Common nutritional risk factors were weight change, restricting food, low fruit and vegetable intake, difficulty with chewing, cooking, or shopping, and poor appetite. Principal components analysis identified four independent components within the Seniors in the Community: Risk Evaluation for Eating and Nutrition questionnaire; these components can be described as low food intake, poor appetite, physical and external challenges, and instrumental activity challenges. Data are sparse on nutritional risk in community-living Canadian seniors; despite methodologic limitations in the recruitment process, this study provides some indication of the level of nutrition problems. The patterns of nutritional risk identified in this vulnerable population may help providers identify useful strategies for ameliorating risk. The Seniors in the Community: Risk Evaluation for Eating and Nutrition questionnaire could be used to identify risk and patterns of risk in Canadian seniors, so that treatment could be individualized.
PubMed ID
14675500 View in PubMed
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Nutritional risk needs assessment of community-living seniors: prevalence of nutrition problems and priorities for action.

https://arctichealth.org/en/permalink/ahliterature190678
Source
J Community Health. 2002 Apr;27(2):121-32
Publication Type
Article
Date
Apr-2002
Author
Heather H Keller
Margaret R Hedley
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, Ontario, Canada. hkeller@uoguelph.ca
Source
J Community Health. 2002 Apr;27(2):121-32
Date
Apr-2002
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Community Health Centers - organization & administration - utilization
Deficiency Diseases - epidemiology
Eating
Female
Geriatric Assessment
Health education
Humans
Male
Middle Aged
Needs Assessment
Nutrition Surveys
Nutritional Sciences - education
Ontario - epidemiology
Prevalence
Recreation
Risk assessment
Weight Loss
Abstract
A random mailed survey was sent to 425 members of a seniors recreation center in Guelph, Ontario for the purpose of identifying the prevalence of nutritional risk, specific nutrition problems, and educational format preferences of these seniors. This needs assessment was used to plan an education initiative called "Action Nutrition." SCREEN, a 15-item nutritional risk screening instrument, demographic data, participation in current recreation programs, and frequency of visits to the center were included in this survey. The response rate was 62%, average age was 72 years and 59% were female. Respondents attended on average one activity per month, 60% visited the center at least once per month and 79% read the monthly newsletter. 56.7% of respondents were considered to be at nutritional risk using SCREEN and common problems were: significant weight change in 6 months; low intake of fruits and vegetables and milk products; and restriction of the diet due to health reasons. This survey determined that nutrition problems and risk are prevalent among community-living seniors, justifying the development and implementation of educational initiatives in this setting.
PubMed ID
11936757 View in PubMed
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Nutritional risk predicts quality of life in elderly community-living Canadians.

https://arctichealth.org/en/permalink/ahliterature182036
Source
J Gerontol A Biol Sci Med Sci. 2004 Jan;59(1):68-74
Publication Type
Article
Date
Jan-2004
Author
Heather H Keller
Truls Østbye
Richard Goy
Author Affiliation
Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada N1G 2W1. hkeller@uoguelph.ca
Source
J Gerontol A Biol Sci Med Sci. 2004 Jan;59(1):68-74
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Canada
Female
Frail Elderly
Humans
Male
Middle Aged
Nutritional Status
Prognosis
Quality of Life
Risk factors
Time Factors
Abstract
Although nutrition parameters have been linked to quality of life (QOL), few studies have determined if nutritional risk predicts changes in QOL over time in older adults.
367 frail older adults were recruited from 23 service agencies in the community. Baseline interview included nutritional risk as measured by SCREEN (Seniors in the Community: Risk Evaluation for Eating and Nutrition), as well as a wide variety of covariates. Participants were contacted every 3 months for 18 months to determine QOL as measured by three questions from the Behavioral Risk Factor Surveillance System (BRFSS), a general whole-life satisfaction question, and a general change in QOL question. "Good physical health days" from the BRFSS was the focus of bivariate and multivariate analyses, adjusting for influential covariates.
Seniors with high nutritional risk had fewer good physical health days and whole-life satisfaction at each follow-up point compared with those at low risk. In general, participants reported decreases in general QOL from baseline, with those in the moderate nutritional risk category most likely to report this change. Nutritional risk predicted change in good physical health days over time. Other important covariates include: gender, number of health conditions, perceived health, and age.
Nutritional risk is an independent predictor of change in health-related QOL. The results also indicate a relationship between nutrition and the more holistic view of QOL. Evaluation studies of interventions for older adults need to include QOL measures as potential outcomes to further demonstrate the benefits of good nutrition.
PubMed ID
14718488 View in PubMed
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15 records – page 1 of 2.