Download Dining assistant-proper nutrition and hydration

Dining assistant-proper nutrition
and hydration
• Nutrition is how the body uses food to
maintain health.
– Need a well balanced diet with essential nutrient
and plenty of fluids
– Helps grow new cells, maintain normal body
function and provide energy for activities
– For the ill or elderly: helps maintain muscle and
skin tissues, prevent pressure sores and promote
healing of wounds.
What affects the intake of food?
Loneliness or depression- little interest in food
Weaker hand and arm muscle strength due to
paralysis or tremors –make it difficult to eat
Poor ability to chew or swallow- may not want
to eat or can’t eat well
People slow down- affects appetite
Loss of vision- decreases appetite, makes it
difficult to feed self well
Weakened sense of smell or taste-affects
appetite
Medications side effects –affect appetite
Decrease saliva production- affects chew and
swallow ability
Dentures, tooth loss – make chewing difficult
Digestion takes longer- affects appetite
Feeling rushed- negatively affects intake
Not being allowed to finish- affects intake
A lack of socialization- can decrease intake
Tiring out- can affect intake
Sense of thirst diminishes with age- affects
intake
Six basic nutrients
• Protein- for tissue growth and repair and for
energy. Source: fish, poultry, meat, eggs,
milk, cheese, nuts, peas, beans
• Carbohydrates- for energy, for fiber. Source:
bread, cereal, potatoes, rice, pasta,
vegetables, fruits, sugars, syrups, jellies.
• Fats- help store energy, help absorb vitamins.
Source: butter, margarine, salad dressings,
oils, animal fats.
• Vitamins- essential to allow the body to
function. Sources: foods of all types.
• Minerals- form and maintain body cell
functions, provide energy and regulate
processes. Sources: many foods
• Water- assists in the digestion and absorption
of food, helps eliminate waste, maintains body
temperature. Sources: water and many foods
Six food groups/ Food Guide pyramid
• Grains: bread, cereal, rice, pasta- 6-11
servings per day
• Fruits: 2-4 servings per day
• Vegetables: 3-5 servings per day
• Dairy products: 2-3 servings per day
• Meat, poultry, fish, beans and nuts; 2-3
servings per day
• Fats, oils, and sweets- be sparing
Dietary department
• Plans, considers needs of individuals, prepares
and presents food.
• Prepares diet cards containing: name,
allergies, food likes and dislikes, special diets,
other instructions
• Follow infection control in preparation
Water- essential for life
• Most residents: should drink at least 8 glasses,
or 64 ounces, of water or other fluids a day.
• Helps prevent constipation and urinary
incontinence, also helps prevent confusion.
• Prevents dehydration
Preventing dehydration
• Report observations and warning signs to the
nurse immediately
• Encourage residents to drink every time you
see them
• Offer fresh water and other fluids often
• Be aware of what they like and offer
substitutions that they enjoy. Report if they
don’t like something.
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Offer gelatin, ice chips or popsicles often.
Give fluids without ice if they prefer it.
Offer sips of liquids between bites of food
Make sure a pitcher of water and cup are
nearby and light enough to lift and use.
• Offer assistance for those who need it.
• Report if the resident drinks little or no fluids
at meals.
What to report ?
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If a resident needs help drinking from a cup
If a resident has trouble swallowing liquids
If a resident is easily confused or tired
If a resident has a dry mouth
If a resident has cracked lips
If a resident has sunken eyes.
Special fluid orders
• Force fluids- encourage the resident to drink
more fluids.
• Restrict fluids- the person is allowed to drink
but must limit the daily amount to a specific
level set by the doctor. Do not give them any
extra fluids, do not give them a water pitcher
unless the nurse approves it.
Unintended weight loss
• Can lead to skin breakdown, pressure sores,
poor wound healing… is a serious problem.
How can I help prevent unintended
weight loss?
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Encourage residents to eat
Talk about food in a positive tone and words
Honor food likes and dislikes
Help those who need it
Allow enough time for them to finish
Season foods according to their preference
Ask about it if they seem sad or have not
appetite.
What to report about food?
• If resident needs help eating/drinking
• If resident eats less than half of the food
served
• If a resident has mouth pain
• If the dentures aren’t fitting properly
• If a resident has difficulty chewing or
swallowing
• If a resident coughs, or chokes while eating
• If a resident is sad, has crying spells, or
withdrawn from others
• If a resident keeps clearing their throat
• If a resident is confused, wanders, or paces
• If the resident drools or has nasal discharge
during meals
Special diets
• Therapeutic, modified or special dietsordered by the doctor for specific reasons.
• Dietitian then plans the diet.
Examples of special diets
• Low- sodium diet- might be on the diet slip
as: Low Na to restrict certain foods or NAS,
which means no added salt (people with heart
disease, kidney disease)
• Low-protein diet- (people with kidney
disease)
• Low-fat/low-cholesterol diet- Low fat/low
chol. (people with gallbladder disease, liver
disease)
• No Concentrated Sweets: NCS for diabetics of
need for keeping blood sugar under control.
Will use artificial sweeteners, etc.
• ADA diets- will show the number of calories
followed by ADA (American Diabetic
Association)
• Modified calorie diet for weight loss- Low-cal.
• Full liquid diet- usually ordered for a short
time , includes cream soups, milk, ice cream
and clear liquids.
• Clear liquid diet- includes clear juices, broth,
gelatin, popsicles
• Soft diet- soft in texture, easier to chew and
swallow, consists of soft and chopped foods
• Pureed diet- blended into a past of baby food
consistency, good for those who have
difficulty chewing or swallowing more
textured foods.
• NPO- nothing by mouth
• Thickened liquids:
– Nectar thick- thicker than water like a thick juice
– Honey thick- pours slowly, like honey consistency
– Pudding thick- semi-solid, like pudding, will need
a spoon.
How to record meal intake
• It is important for the staff to observe what
and how much the resident is eating.
• The method of recording this varies in each
facility
– Some use percentage method
• 0%, 25%, 50%, 75% or 100%
– Some use letters to correspond
• R (refused), P (poor), very little food eaten; F (fair), half
of the food eaten; G (good), most of the feed is eaten;
A (all) entire meal is eaten.
– Some use percentage of specific foods like,
protein, fats, carbohydrates, etc.
Document carefully
Report to the charge nurse if a resident eats 25% or
less of his or her meal.
How to record fluid intake
• A healthy person needs to take in 64-96
ounces (oz) of fluid each day.
• If it is less, he or she an become dehydrated.
• To record intake, you need to know how much
fluid is in the cup or glass or bowl (jello etc)
• You need to know how much of the fluid the
resident consumed.
• Fluids are usually measured in cubic
centimeters (cc’s). Ounces (oz) are converted
to cc. To convert, multiply by 30. (30 cc= 1 oz)
• 1 cubic centimeter equals 1 milliliter (1cc=
1ml) (cc’s measure space taken up, ml
measure liquid volume) (30cc or 30 ml = 1 oz)