Case Study: Agnes is 84-year-old woman who lives at home in St. Paul Minnesota. She is 5'1" and weighs 97 lbs. Her husband of 51 years passed away 8 months ago, and her daughter Brenda lives about 4 hours away, but tries to visit once a month. Brenda has noticed that Agnes has lost weight in the past few months (about 6 pounds) and is worried about her health. Agnes doesn't seem to enjoy eating the way she used to, when she cooked dinner for her husband and family every single night. She has also started avoiding liquids after lunch in an attempt to minimize the number of trips to the bathroom in the middle of the night.
Agnes says she feels overall healthy, but she gets tired easily and is afraid of falling so she minimizes her activity.
Medications:
- Sertraline
- Prinivil
- Multivitamin
- Miralax
Her daughter wrote down her food intake for one day (Agnes stated it is pretty typical day):
6:00 am: 1 pear; 4 ounces decaf coffee
9:00 am: 6 ounces orange juice with medications
11:15 am: sandwich (2 Oscar Myer ham slices, 2 slices Sara Lee white bread, 2 tablespoons mayonnaise); 8 ounces orange juice
5:00 pm: Marie Callender's Frozen Pot Pie Dinner; 4 ounces water
Agnes is on a fixed income, so she doesn't have a lot of money to spend on groceries. Once a week she walks a quarter of a mile to the corner store to pick up groceries and her daughter Brenda brings frozen dinners once a month.
Q1. What are factors that put Agnes at nutritional risk?
Q2. What is polypharmacy and is it a concern for Agnes? How can her medications impact her nutritional status?
Q3. What is the current weight status of Agnes? What is her BMI and grade of "thinness"? Would you consider her to have "unintended weight loss", why or why not?
Q4. Should we be concerned for her weight, why or why not? What are 3 consequences to her weight/weight loss?