RNY and Alzheimers

Just wondering about the geriatric aspects of RNY postcare.  How are Alzheimers and other geriatric patients that have had RNY cared for?  Are nursing homes up to speed on the needs of RNY patients? I ask this because I know that even as I had surgery, I was brought inappropriate food and beverages while recuperating from RNY surgery.  It is a concern to me, as I wonder what my future care may be.  I do not have Alzheimers, but family members have, so I do not rule  the possibility out.  Thanks.

That is an interesting thought. I am a home health aid for the elderly. I have never had a client that had RNY but have had many clients with special diets. I am not a nurse so when I go into a situation, I pretty much depend on what the family tells me and follow their guidelines. I guess whether you or a family member were at home with an aid or in assisted living or nursing home, you would have to really trust who was caring for you and whether or not they think they already know your dietary needs, make sure they are documented so there is no excuse. I hope that it never comes to that for you but I like that you are thinking ahead.

Someone would need to let your caregivers know about your dietary needs, either you yourself or your family or whomever was arranging for your care.  The dietary needs of all RNY patients are not the same.  For instance, most RNY patients eat a high protein diet, and that often includes lots of meat.  I had RNY, but I am a vegetarian.  Some RNY patients dump on too much sugar, while others don't.  I have reactive hypoglycemia, so too many carbs without enough protein causes my blood sugar to crash.  But not all RNY patients have RH.

Of course, that's the way it is for Alzheimer's patients with any special dietary needs.  If no one tells the nursing home that a patient is lactose intolerant (as some RNY patients are, but not all) or that they are allergic to tree nuts or soy, the nursing home won't know.

I tried to ask my surgeon similar quesions in my initial consultation (not so much Alzheimers as aging in a nursing home) and he just said "Without this surgery you won't even get that old." Not a hugely helpful answer, but it told me I was on my own in this regard. I'm hoping that if I keep decent health records, they will convey with me and positively influence my care.

I appreciate how you replied to the topic above. I, too, have concerns about future care for myself when I get old. I was told not to worry about things so far in the future, but I do because it's a valid concern & I've not had this surgery yet. Thank you!

 

I worked as a PSW for about 15 years in both home care & long term care facilities. 

I, too, had thoughts about when I am older. At this point, every resident has a chart & it would list any diet restrictions, allergies, etc. What I was thinking, was, would they know what the diet looks like for a person that has had RNY?  Sure the chart could say RNY diet, but, will anyone know what that means??

Hopefully, if I am unable to express myself, my family or trustees will let the staff know what I need! I do plan to have the information listed in my Personal Care Directive (kind of like a living will-says what you want if you can't).

I am leas concerned about the specific case lf dementia, and more concerned about the overall nutritional status as we age. The complete lack of studies on the effects of a gastric bypass (whether DS or RNY) when we become elderly -- whether dementia is involved or not -- is one of the reasons that I didn't want a surgery with a  bypass of any kind (but didn't have a choice) and the reason that, if I were making the decision now that the sleeve is available, I would choose the sleeve.

Hopefully, within the next few years there will be enough older RNY patients hat someone wills able to do a study on nutrition and elderly RNY patients.

Lora

Thank you for your candid response to the topic. The RNY is the only valid option for me, according to the surgeon I interviewed. I, too, have lots of concerns for aging with the RNY if I pursue this route. Your time to respond to others is much appreciated by me so that I can learn through others' experiences.

I'm thinking we will be healthier than the average non-WLS person in our old age, provided we keep eating and taking our vitamins like we are supposed to.  I mean, we eat healthier than the average American, right?  And the types of vitamins we take, like calcium citrate as opposed to calcium carbonate, are not only absorbed better in RNY folks, but also in elderly folks, who produce less stomach acid as they age, just like we produce less stomach acid after RNY.  And we get labs done at least once a year (or we should be doing that anyway), including checking our B12 level, and B12 deficiency has been found to cause dementia in elderly people (in some cases, it's been misdiagnosed as Alzheimer's).  I'm thinking as long as we do the things we're supposed to do, we'll be healthier than average in our old age.

I used to work in nursing homes as a dietitian, and can tell you...
While I never had a RNY pt in the NH I saw every kind of diet restriction, allergy, and intollerance you can imagine. We did everything in our power to ensure safe food for our patients, and to encourage them yo comply with their diet.
Since leaving nursing homes and moving into the dialysis world I have had the opportunity to work with several people who had gastric bypass... some date back to the early part of the 1970's. Some were or are in nursing homes and some are in their home. The NH's I dealt with recently have all been very good with meeting the pt's needs and making modifications for the individual. Smaller portions, more protein. Low or lactose free options, appropriate supplements if needed and desired, honoring food preferences and intollerances, and allowing/encouraging foods brought in by family and friends... just to name few considerations I see routinely. I see these considerations for the post op pts as well as all other residents.
This is what I see in NH's I work with. I'm sure not all will be the same, but there are a lot of good ones out there. And they should all have a registered dietitian at least on a consultant basis, who should work to ensure individual needs are met.