Ondervoeding bij ouderen

 

Van de thuiswonende 65-plussers in Nederland is zeker tien procent ondervoed, meldt de NOS. Dat blijkt uit drie onderzoeken van de Vrije Universiteit in opdracht van het ministerie van Volksgezondheid. Ondervoeding bij ouderen werd niet eerder in kaart gebracht.

 

Volgens het onderzoek is een oudere ondervoed als hij of zij het afgelopen jaar meer dan vier kilo is afgevallen en honger- en vermoeidheidsverschijnselen vertoont. Als de diagnose van ondervoeding is gesteld komt een diëtist langs, die een schema opstelt om de oudere weer op gewicht te brengen.

 

Hoogleraar Marjolein Visser, verbonden aan het Institute of Health Sciences van de VU, zegt tegenover NOS.nl dat ze de percentages hoog vindt en wil dat er meer gedaan wordt om ondervoeding tegen te gaan. Volgens Visser ligt het percentage ondervoede ouderen in instellingen zoals ziekenhuizen en verpleeghuizen hoger, namelijk tussen de 18 en 33 procent. Relatief is het probleem daar dus groter, maar in absolute getallen niet. 95 procent van de Nederlandse ouderen woont namelijk thuis.

 

Bij ouderen die thuiszorg ontvangen ligt het percentage ondervoeding op 35 procent. Volgens Visser is dat logisch: „Het is een kwetsbare groep. Die ouderen zijn vaak chronisch ziek of ze hebben psychische problemen waardoor ze te weinig eten.” Als redenen voor ondervoeding noemt Visser een depressie of rouwverwerking, maar ook pijn die ouderen bij het eten kunnen hebben vanwege een slechtzittend kunstgebit.

 

© 2012, nrc.next

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Ondervoeding op een dag-dagelijkse manier aangepakt

Robert Mulders

Wageningen Universiteit en ziekenhuis Gelderse Vallei gaan de strijd aan met ondervoeding bij ouderen en patiënten. Het bedrijfsleven is ingeschakeld om nieuwe, verrijkte voedingsproducten te ontwikkelen. Ook mkb-ondernemers doen mee.

Nederland is een rijk land, maar aan de cijfers af te lezen lijken het Afrikaanse toestanden in de ziekenhuizen. Een op de vijf patiënten is ondervoed, de helft loopt het risico ondervoed te raken. Oorzaak: zieke lichamen hebben meer energie en voedingsstoffen nodig, terwijl door gebrek aan eetlust en smaakverlies veel patiënten juist minder gaan eten.

Het probleem kost jaarlijks naar schatting € 1,7 mrd aan langere opnameduur en herstelbehandelingen.Genoeg aanleiding voor Ziekenhuis Gelderse Vallei om het probleem bij de kop aan te pakken. Het project Cater with Care, dat onlangs van start is gegaan, beoogt voeding voor herstellende patiënten te verrijken en tegelijkertijd lekker eetbaar te houden. Vijf bedrijven is gevraagd die producten te ontwikkelen. Naast ketchupfabrikant Heinz en vleesbedrijf Van Drie Groep zijn dat drie mkb-bedrijven: Nizo Food Research, fruitsappenmaker Pure4You en brood- en snackmaker Carezzo. De bedrijven dragen € 1,8 mln bij aan het budget van ruim € 4 mln.

Het eerste resultaat is nu opgeleverd: brood met een hoog eiwitgehalte, 11 gram per twee sneeën in plaats van de gebruikelijke 5,5 gram. De juiste textuur vinden was een uitdaging, zegt directeur Fred Bergmans (61) van Carezzo. ‘Verrijkt brood is al heel snel compact. Ballerig, rubberachtig. Gewoon geen lekker brood. We zijn er nu in geslaagd om het luchtig en lekker te maken.’ Bergmans ontwikkelt het brood met het European Bakery Innovation Centre, onderdeel van bakkerijgrondstoffenleverancier Sonneveld.

Bergmans’ carrièretreintje passeerde een niet gering aantal stations in de voedingssector: via Mars, Peijnenburg en Kraft Foods belandde hij bij snoepjesfabrikant Van Melle, alvorens in 2002 voor zichzelf te beginnen. Hij adviseert klanten over de marktintroductie van nieuwe producten. Zijn verwachtingen rond het proteïnebrood zijn hoog: hij is in gesprek met verpleeghuizen in Noord-Brabant om ook bij hen het brood te testen. Met Gelderse Vallei onderhandelt hij nu over de prijs.

Pure4You, een joint-venture van de Brabantse voedingsbedrijven CH Food en Van Rijsingen, sleutelt ondertussen aan met proteïne en voedingsstoffen verrijkte ‘tussendoortjes’: fruitsappen, soepen en zuiveldranken. Directeur Wim van Cuijk (51) verwacht dat het project gunstig zal uitpakken voor de totale verkoop. ‘Als we dit goed aanpakken, kunnen we op termijn ook onze normale soepen en sappen aan zorginstellingen leveren. En andersom ook. Onze langetermijndoelstelling is dat onze verrijkte producenten ook in de retail terechtkomen, waar we nu al aan leveren.’ Door de vergrijzing zal volgens Van Cuijk ook buiten de ziekenhuizen en zorginstellingen de vraag naar verrijkte voeding toenemen.

Kennisbedrijf Nizo Food Research zal zowel Pure4You als Carezzo en Heinz adviseren over de technologie die erbij komt kijken om voedsel te verrijken. Je kunt wel extra eiwitten in voeding stoppen, maar dit mag niet ten koste gaan van de houdbaarheid en kwaliteit. ‘De producten moeten ook nog eens keer lekker zijn’, voegt businessmanager Koos Oosterhaven eraan toe.

Het valt op dat Gelderse Vallei en Wageningen Universiteit drie kleinere bedrijven hebben ingeschakeld om voedingproducten te ontwikkelen. Bedrijven die niet de grote financiële buffers hebben van voedingmultinationals als Wessanen, Unilever of Campina. ‘We hebben met multinationals gesproken’, zegt zegsvrouwe Menrike Menkveld. ‘Maar om verschillende redenen doen ze nu niet mee. Ze hebben soms andere agenda’s, of ze weten nog niet wat ze willen met de ouderenmarkt. Ze maken natuurlijk liever producten voor jonge, gezonde mensen.’ Grote producenten willen nog niet instappen in een kleinschalig project waarvan de uitkomst nog onduidelijk is, vermoedt Bergmans. ‘Het is vaak een rol die mkb’ers wél op zich willen nemen.’

Blijft de vraag wie het verrijkte voedsel, dat vanwege hogere productiekosten duurder is, gaat betalen. Ziekenhuizen en zorginstellingen zullen de rekening vermoedelijk doorschuiven naar de premiebetaler. Bergmans wijst erop dat het terugdringen van ondervoeding geld kan opleveren. ‘Er is nog maar één studie gedaan, in Maastricht. Maar daaruit blijkt dat iemand die ondervoed is een zorginstelling drie keer meer kost dan iemand die dat niet is.’ Van Cuijk hoopt niet dat verrijkte voeding buiten het zorgpakket zal vallen. ‘Als mensen het zelf moeten betalen komt dat de groei van deze markt niet ten goede.’

KADER
Het project Cater with Care is een publiek-private samenwerking tussen ziekenhuis Gelderse Vallei en vijf voedingsbedrijven. Naast Sodexo, Heinz en Van Drie Groep doen drie mkb-bedrijven mee: Nizo Food Research, Pure4You en Carezzo. Financiering komt vooral uit subsidies (€ 2,5 mln). De partners dragen zelf ruim € 1,8 mln bij.

What Wise Leaders Always Follow (Your Own NorthStar)

Prasad Kaipa is a senior fellow in center for leadership, innovation and change at the Indian School of Business, Hyderabad and is an advisor and coach to senior executives through his consulting company Kaipa Group. He is co-authoring a book on wise leadership for Jossey Bass.

This post is part of the HBR Insight Center, The Next Generation of Global Leaders.

What Wise Leaders Always Follow

Smart leaders make New Year resolutions and set quarterly milestones, charting progress against ambitious plans and goals. Wise leaders, however, take a different approach: they root themselves in a noble purpose, align it with a compelling vision, and then take action — not just for that year, but for the rest of their lives. That noble purpose becomes a North Star, giving direction when the path ahead is hazy, humility when arrogance announces false victory, and inspiration when the outlook seems bleak.

In India, we call the north star “Dhruv Tara” — or “Dhruv Star.” According to the story, Dhruv was a prince transformed into the ever-fixed star as a reward for his perseverance. But the idea of a guiding star can be found in many different religious and cultural traditions. North Star is a concept (pdf) that I have been using in my teaching and coaching for over 20 years to represent our highest personal aspiration — especially when it’s connected with a noble purpose. (Those of you familiar with Bill George’s “True North” concept may notice some overlap.)

One of the best examples of a wise leader is Dr. Govindappa Venkataswamy (also known as “Dr. V”), an ophthalmologist with crippled fingers who started the Aravind Eye Care System in 1976 — with no business plan, money or resources. Aravind now sees 2.7 million patients every year, and even more impressively, treats the majority of them for free. Aravind has become a business example of compassion, as well as proof that wise leaders can radically change the world by following their North Star. The case study written about Aravind has been required reading for all Harvard Business School students for over a decade.

We have a choice in creating the life that we desire. With our judgment, choices, actions we take, we change the course of our future and steer our destiny, moment by moment. Wisdom is not about focusing on the future, but rather about acting in the present, aligned with our North Star.

North Stars align our energy, emotions, and actions in the service of our vision. Though it is not always simple to find one’s North Star, once it appears, its guidance helps simplify one’s choices. As paradoxical as it may seem, wise leaders are, first and foremost, wise followers. Once they become clear about their North Star, it becomes their calling, and they serve that calling willingly, happily, and infectiously.

So what was Dr. V’s North Star? He dreamed a seemingly impossible dream: to eliminate needless blindness by providing appropriate, compassionate, high-quality eye care for all. Along with his siblings and their families, many of whom he had guided into medicine, he started his simple 11-bed clinic with three revolutionary guiding principles:

Turn no one away, regardless of whether they can pay or not;
Give everyone the same high quality of care;
Don’t depend on any outside sources for funding;
These constraints, despite coming from a deep conviction in his own values, seemed to destine him for limited impact.

Instead, Dr. V changed the face of eye care on the planet, and he did it by owning the entire problem — providing community outreach, eye care, training, eye banks, research and the production of inexpensive but high-quality eye care supplies. He realized that if he wanted to eradicate curable blindness from the world, he had to start thinking not only about his organization, but also about training others. Conventional wisdom would be to guard your secret sauce, but Aravind did the exact opposite. By giving away all its secrets, Aravind has trained approximately 15% of all ophthalmologists in India and thousands more from over 69 countries. The work of this one man is said to have touched 40% of eye care patients in the developing world to date.

I’ve had the opportunity to meet Dr. V and work with Aravind over the past several years. I am deeply touched, moved and inspired by the revolution he set in motion and sheer impact of his contributions on the world. How did Dr. V come up with his North Star? Was he a wise person to begin with? Can you and I do something that can have a significant impact like Dr. V?

To my mind, Dr. V was not born wise — he became wise because of his decisions and actions. Here is an extract from Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion by Pavithra Mehta and Suchitra Shenoy (a special note: Read this book!):

To Dr. V, the cultivation of empathy, the effort toward equanimity and self-awareness, the stepping back from ego, and the attempts to align with a clear-sighted, inherent wisdom are all part of his larger aspiration to be a perfect instrument.
His story provides tremendous inspiration and guidance for those looking to follow their North Star. His story also flouts many conventional rules of business. Wise leadership does not fit the strict patterns of smart analysis, but instead taps into an intuitive part of who you are at the core, unearthing counterintuitive principles:

Compassion doesn’t have to come at the cost of efficiency — it can actually drive systems and operational excellence. You don’t have to separate Corporate Social Responsibility (CSR) goals and project goals. You can make CSR the strategy or even the end goal for your business growth.
If you truly focus on service, resources do organize themselves — if your main interest is in solving a problem, then there’s no question that cooperation beats competition. Businesses should focus on the customer, not on profit or business model.
When individuals (and especially leaders) stay rooted in inner transformation —being true to one’s calling, paying attention to one’s values and being aware of one’s emotions and actions — it fundamentally alters the way in which organizations develop. Leaders aligned with their own North Star inspire their teams to do the same, not simply by words but by the power of their example.
In order to identify and then follow your own North Star, you have to ask powerful questions of yourself. Those questions will yield new insights for you and help you find inspiration in the most unthinkable places. For Dr. V, inspiration struck when he learned about McDonald’s. Due to his experience as a government doctor with rural camps, he knew that he had to develop highly efficient, scalable, repeatable processes to treat the masses that came. In McDonald’s, he saw that throughout the world McDonald’s franchises had similar quality meals for low prices. “If McDonald’s can do it for hamburgers, why can’t we do it for eye care?” And sure enough, he developed systems that allow Aravind surgeons to do more than five times the number of cataract surgeries done by the average Indian doctor (and ten times that of an average US physician).

Following your North Star can also lead to quixotic decisions. When intraocular lenses (IOLs) came on the scene in the West in the early 1990s, global health professionals called it a luxury that developing countries could ill-afford. Dr. V saw the value of IOLs and literally manufactured a revolution. At a time when India was far from being the hotbed for technology outsourcing that it is today, Aravind started manufacturing these IOLs at world-class quality, driving the global price down from $150 to $10. Aravind now makes 7% of all IOLs in the world.

I hope Dr. V’s story brings you closer to your own North Star. The key to making 2012 a special year is to first find our North Star, our noble purpose, and then to execute on it as if it is the only thing that matters — because it is. Wise leadership comes from identifying our own North Star, then using the light to enable others to find their own.

What is your North Star? And how can you be the perfect instrument of a higher calling? Share it with us here.

I received a lot of help in writing this blog from Viral Mehta and it is much appreciated.

Prasad Kaipa is a senior fellow in center for leadership, innovation and change at the Indian School of Business, Hyderabad and is an advisor and coach to senior executives through his consulting company Kaipa Group. He is co-authoring a book on wise leadership for Jossey Bass.

Leadership from the Godfather

An Offer You Can’t Refuse: Leadership Lessons From “The Godfather” BY LYDIA DISHMAN | 04-02-2012 | 11:30 AM

What does a real-life CEO have in common with the central figures of a fictitious Mafia crime family in The Godfather? According to Justin Moore, CEO and founder of Axcient, plenty.
Moore is a serial entrepreneur, early-stage advisor, and angel investor. He’s currently at the helm of Axcient, a company he founded that provides backup, business continuity, and disaster recovery services to the small and mid-sized business (SMB) market. Right now, Axcient is protecting more than 2 billion files and applications for businesses across North America.
Moore also happens to think that The Godfather is “one of the best movies ever made” and had a chance to watch it again when the film was aired extensively last week to mark the 40th anniversary of its premiere. Though a decade had passed since the last time Moore watched it, his recent viewing offered an unexpected reward. This time he found the film rife with teaching moments for CEOs running a business today.
“I certainly don’t endorse crime or violence, and I’m not suggesting business should operate like the Mafia,” explains Moore, “but there are some universal themes in the movie I can relate to as a CEO.” Moore says The Godfather offers valuable lessons in community and team building, making tough decisions, and playing to win while not neglecting friends and family.
Here are five essential leadership lessons Moore distilled for Fast Company.
1. Build a powerful community.
Someday, and that day may never come, I’ll call upon you to do a service for me. ~Vito Corleone
Uttered in the iconic rasp of Marlon Brando, the words of Vito Corleone illustrate how he creates a loyal community among those he has helped. Moore says, “By granting these favors and helping people with their problems, Vito Corleone is building a network of influence–relationships that may or may not deliver a specific or quantifiable return, but all which serve to strengthen his power base and which have the potential to be reciprocal in the long run.”
Moore says building strategic partnerships enables companies to work through challenging markets and fast-track overall success. “As a CEO, I see it as part of my job to be a super connector, networking with the technology and investment community without an expectation of reciprocation. Partnerships forged through time, trust, and mutual benefit–such as those Axcient has built with HP, Ingram-Micro, and a vast network of service providers and resellers–are the types of community relationships that bring about the greatest returns.”
2. Hold people accountable.
What’s the matter with you? I think your brain is going soft. ~Vito Corleone
The Godfather reminds us of the importance of being tough when necessary. “As soon as Vito Corleone allowed a few moments of weakness to be seen by his enemy, they attempted to assassinate him. And it was largely because of failures of his team,” Moore observes.
“In business, accountability isn’t achieved by a murderous rampage. But the lesson is this–to be successful in business you have to be tough, and you have to be extremely focused on hitting goals and getting results,” says Moore. That doesn’t mean patience and understanding don’t have a place, he says, but ongoing tolerance of low-performing people or products just eats away at the success of the entire company. “You are ultimately responsible for all of your employees and shareholders, and that requires tough and swift decisions.
3. Don’t get emotional.
It’s not personal, Sonny. It’s strictly business. ~Michael Corleone
“Many people don’t like to talk about the fact that in business, there are winners and losers. When Sonny Corleone reacts impulsively and emotionally, he gets taken out. In business, if you don’t take the opportunity to out-sell, out-bid, or out-market your competitor, they’ll take you out. I’m not suggesting doing anything outside the boundaries of morality or rightness–simply pointing out that when people make emotional decisions, they start making bad decisions. To lead successfully, you have to take your emotion and ego out of the equation.”
Likewise, Moore says it’s important to play to win. In business, that translates to knowing the competition and always staying at least one step ahead. “Operate your business with integrity and have respect for competition, but you also need to seize opportunities to eliminate your competition and win.”
4. Be decisive.
Moore says that he, like most people who appreciate The Godfather, watch the movie with a combination of shock and respect. “Shock because he is so ruthless that he kills his own family member, but respect for the fact that Don Corleone knows exactly what he wants, executes decisively, and commands respect through unwavering leadership.”
While you don’t have to kill anyone to prove a point, as soon as you know what choice to make, move forward. “Know who on your team is making the right choices, and trust them to take decisive action as well. Hesitation too often leads to missed opportunities.”
5. Spend time with your family.
Do you spend time with your family? Because a man who doesn’t spend time with his family can never be a real man. ~Vito Corleone
Moore isn’t endorsing 1940s machismo, but he is decrying 100-hour workweeks that many entrepreneurs fall prey to in hot pursuit of the next big thing. Though he’s been dedicated like that in the past, Moore finds it’s not sustainable in the long run.
“A leader can’t be successful in creative problem-solving and making excellent decisions unless that person is connected to people and passions outside of work. I find that it’s often time with family and friends that gives me the perspective I need to build the relationships and make the decisive actions required for continued success in business,” says Moore.Image

De blog van gribling365

Dit is de blog van gribling365. Een door Francesco Gribling in februari 2012 opgerichte bedrijf.

gribling365 helpt organisaties bij het vinden van hun nieuwe horizon.

En blogt over Blue Ocean strategieen, leiderschap, mooie retailconcepten en over nog veel meer andere zaken waar gribling365 zich graag over verwondert.