Psychosocial Health & Nutrition for Seniors – Case Study- Mrs. Linda Lim is 79 years old, and lives alone in a one-room studio apartment, Singapore

Case Study

Mrs. Linda Lim is 79 years old, and lives alone in a one-room studio apartment. Her children visit her once a week on Saturday. She used to be a school teacher, but has retired since she turned 65 years old. She started having overall weakness and lethargy and experienced occasional giddiness in the past six months. Mrs. Lim also reported feeling moody and a lack of interest in the daily activities of living

Mrs Lim weighed 58kg eight months ago before she had a Transient Ischemic Attack (TIA). Since then, she had lost some weight and currently weighs 47 kg at 1.6 m tall.

Below are the results of her recent medical check-up:

Fasting blood glucose 8.9mmol/L
Total blood cholesterol 6.0mmol/L
LDL cholesterol 4.7mmol/L
HDL cholesterol 0.8mmol/L
Triglycerides 2.3mmol/L
Blood pressure 135/80 mm Hg
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Due to the recent onset of weakness and lethargy, she avoids going out by limiting grocery shopping to once a week, or asking neighbour for help to buy food. She stays at home mostly and sits in front of the television all day.

As a Care Coordinator at Sunshine Senior Activity Centre, you are tasked to help Mrs Lim for dietary and lifestyle modification, to help her with oral intake and nutritional status. Mrs. Lim is lactose-intolerant and avoids meat because of a lack of dentition.

Refer to the following document for her 3-day food record.

Based on the information provided,

a) Calculate and interpret her current BMI, weight loss and current weight status.

b) Based on current self-reported physical activity level, estimate Mrs. Lim’s current calorie requirement.

c) Calculate Mrs. Lim’s protein requirement to prevent muscle loss.

d) Analyse Mrs. Lim’s 3-day food diary and rationalize the adequacy of her diet.

e) Identify and explain Mrs. Lim’s causes for weight loss and onset of weakness. Provide dietary strategies to assist Mrs. Lim in managing and overcoming her weight loss.

f) Based on the average calorie intake you have calculated for the 3-day food record, What is the caloric deficit Mrs. Lim was consuming compared to her current energy requirement?

i. Justify how much extra calorie you would plan for Mrs. Lim per day, in order to promote weight gain.

ii. Plan a 1-day meal plan (with calories breakdown) that can achieve weight gain.

g) Based on the information provided in the case study, identify potential chronic diseases that Mrs. Lim may have, and provide dietary strategies to manage these potential chronic diseases.

h) Using recommendations from “My Healthy Plate”, develop a 1-day meal plan that meets Mrs. Lim’s requirement.

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