Prevention in LTC

AP Dr RM Nugroho Abikusno, MD, MSc (nutr.sci),DrPH, C.Gerontol&Geriatr INIA, UN-Malta

InResAge Trisakti University
Medical faculty

Presented Webinar III Ministry of Health Republic of Indonesia, June 16th 2020
Scope of prevention in Geriatric syndrome
• Falls
• Malnutrition
• Depression may lead up to Dementia
• Immuno-senescence related to Infection

• All in some way or another is related to nutrition

 Prevention of Falls
• Proper foot wear
• Helmet
• Hip protector
 Factors affecting nutrition in the Elderly
• Socioeconomic
• Psychological
• Ethnic
• Physiological
• Pathological
Common nutrition problems in the Elderly
• Protein to retain muscle mass (sarcopenia)
• Poor dental health
• Poor immune system
• Inadequate intake of micro nutrients A B C D E folic acid and niacin
 Signs Elderly suffering from Malnutrition
• Depressed, Angry or Irritable
• Constantly tired
• Difficulty concentrating
• Lack of appetite and interest in foods
• Complains of being cold
• Losing hair
 List of nutrients needed by the Elderly
• Protein
• Calcium
• Vitamin D
• Iron
• Vitamin A
• Vitamin B12
• Folic acid
 Improving nutrition in the Elderly
• Make meals nutrient dense
• Adding extra calories without extra volume
• Use herbs and spices when preparing meals
• Make meals colorful and appealing
• Serve several small meals and snacks
• Do not fill up on non nutritious items
• Make meal time enjoyable and social
• Use supplements if necessary
 Chain of infection
• Agent
• Reservoir
• Port of exit
• Mode of transmission
• Port of entry
• Host
 Killing germs naturally
• Honey
• Garlic
• Turmeric
• Coconut oil
• Lemon
• Pineapple
• Ginger
 Preventing infection
• Cleaning heads (before/after)
• Cleaning & disinfecting environmental surfaces
• Removing soiled items
• Personal protective equipment (gloves, gown, mask and/shield)
 Scope of illness prevention
• Healthcare associated infections
• Prevent spread of infection to vulnerable residents
• Blood stream infections
• Hand hygiene
• Catheter associated UTI
• Elimination of methicillin resistant Staphylococcus aureus
• Infection prevention in LTC and LTC facilities

• APIC
 Standard precautions
• Preventing transmission of infectious agents in healthcare settings (CDC,
2007)
• Keep Hands clean
• Not touching the face & nose
• Covering coughs in sleeves
• Using safety needles and sharps
• PPE available at all times (gloves, gown, masks, eye protection)
 Standard precautions (2)
• Safe injection practices (asepsis for parenteral medication)
• Sterile instruments & devices
• Clean and disinfected environmental surfaces
 Droplet precautions
• Spread of infection through:
• Speaking
• Sneezing
• Coughing
• Compulsory use of mask
 Contact precautions
• Patient and their environment
• Use of PPE room before entry and discarding PPE before exiting to contain
pathogens
 Isolation precautions
• Contact
• Droplet
• Airborne

• Strict isolation
• Respiratory isolation
• Protective isolation
Mahalo
 Short Biodata
• Member National Commission on Older Persons 2004-2014
• Associate Dean for Development & Cooperation Faculty of Medicine Trisakti
University 2002-2007
• Acting Regional Advisor Nutrition, Food Safety & Ageing WHO/SEARO 2007-
2010
• Researcher InResAge Center for Community Health & Population Studies since
1998
• Associate professor in Community Nutrition focusing on Ageing since 2004
• Member expert group on older person health MoH since 2016