Healthcare Assistant: Nutrition

Table of Contents:                                               Page

Background                                                                                                      03

Water                                                                                                                04

Fibre

Specialised Diets                                                                                               05

     Diabetes                                                                                                       

     Coeliac                                                                                                          06-07

     Avoid all food and drinks containing

Generally the following should be avoided

Salt

Consequences of Malnutrition                                                                        07

Detection of Malnutrition

Healthcare Assistant’s role in promoting good nutrition                              08

Summary

Nutrition

Background:

Mealtimes are an important time for residents both providing a healthy balanced diet and for social interaction with fellow residents and the care team. Eating well is vital for everyone at all ages. So daily food choices can make an important difference in your health and in how you look and feel. However as people get older, their bodies change. They can develop health problems or chronic diseases and may take more medications than they used to.

Optimal nutrition is especially required in older people. The challenge for the elderly is to meet the same nutrient needs as when they were younger, yet consume fewer calories. The answer to this problem is to choose foods high is nutrients in relation to their calories. Such foods are considered “nutrient-dense”. For example, low fat milk is more nutrient dense than full-fat milk. Its nutrient content is the same, but it has fewer calories because it has less fat. Some people lose interest in eating and cooking because their senses of taste and smell change with age. Foods a person once enjoyed might seem less flavourful as he or she gets older. Some medicines can change the sense of taste or make a person feel less hungry.

The food pyramid should be used in terms of the quality and amount of food consumed.

Water:

Water – Seniors are prone to dehydration because their bodies lose some of the ability to regulate fluid levels and our sense of thirst is dulled. Hydration helps to avoid urinary tract infections (UTI), constipation, and even confusion.

Fibre:

Add fibre to avoid constipation, lower the risk of chronic disease, and feel fuller for longer by increasing their fibre intake from foods such as fruit and vegetables, whole grains and beans. Adequate dietary fibre as opposed to increased use of laxatives will maintain regular bowel function and not interfere with the digestion and absorption of nutrients, as occurs with laxative use or abuse.

Specialised Diets:

Diabetes:

Diabetes is a chronic disease in which the body cannot make or properly use insulin. Insulin is a hormone that helps control the sugar, or glucose, in your blood. Glucose is the main source of fuel for your body. When you have diabetes, the levels of blood glucose are too high, causing symptoms such as blurred vision, frequent urination, increased thirst, unintended weight loss, slow healing sores, and feelings of hunger and tiredness. But some people with diabetes have no symptoms at all diabetes is a serious disease. Over time, diabetes that is not well controlled causes serious damage to the eyes, kidneys, nerves, and heart and blood vessels, gums, and teeth.

Diabetes means your blood glucose (often called blood sugar) is too high. Diabetes is a disease that prevents the body from properly converting foods into the energy needed for daily activity.

When you eat, your body changes most of the food into a form of sugar called glucose. Glucose travels through the blood stream to feed your cells. It is the main source of fuel for your body. For glucose to get into cells, insulin must be present. Insulin is a hormone made by the pancreas, a large organ behind the stomach. If your body does not make enough insulin or if the insulin does not work the way it should, glucose cannot get into your cells. As a result, the amount of glucose in the blood increases, while the cells are starved of energy. The level of glucose in your blood then gets too high, causing diabetes.

People with diabetes should have their own meal plan. Making healthy food choices is very important to help keep their blood glucose level under control. Ask your doctor to give you the name of a Dietician or a diabetes educator who can work with you to develop a meal plan. .

In designing a meal plan for you, a Dietician will consider several things, including your weight and daily physical activity, blood glucose levels, and medications. If you are overweight, a plan to help you achieve a weight that is right for you will help control your blood glucose. Your dietician can help you plan meals to include foods that you and your family like to eat and that are good for you. People with diabetes do not need to eat special foods. The foods that are on your meal plan are good for everyone in your family. Try to eat foods that are low in fat, salt, and sugar and high in fibre, such as beans, fruits, vegetables, and whole grains. Making healthy food choices will help you reach and stay at a weight that's good for your body, keep your blood glucose in a desirable range, and prevent heart and blood vessel disease.

Coeliac:

A gluten-free diet is a diet that excludes the protein gluten. Gluten is found in grains such as wheat, barley, rye and triticale (a cross between wheat and rye).

A gluten-free diet is used to treat celiac disease. Gluten causes inflammation in the small intestines of people with celiac disease. Eating a gluten-free diet helps people with celiac disease control their signs and symptoms and prevent complications. People with celiac disease who eat a gluten-free diet experience fewer symptoms and complications of the disease. People with celiac disease must eat a strictly gluten-free diet and must remain on the diet for the remainder of their lives.

Avoid all food and drinks containing:

·         Barley (malt, malt flavouring and malt vinegar are usually made from barley)

·         Rye

·         Triticale (a cross between wheat and rye)

·         Wheat

In general, avoid the following foods unless they're labelled as gluten-free or made with corn, rice, soy or other gluten-free grain:

·         Beer

·         Breads

·         Cakes and pies

·         Candies

·         Cereals

·         Cookies and crackers

·         Croutons

·         French fries

·         Gravies

·         Pastas

·         Salad dressings

·         Sauces, including soy sauce

·         Seasoned rice mixes

·         Self-basting poultry

·         Soups and soup bases

·         Vegetables in sauce

Generally the following should be avoided:

Avoid skipping meals- this causes the metabolism to slow down, which leads to feeling sluggish and making poor choices later in the day.

Salt:

Reduce salt to help prevent water retention and high blood pressure. Remember to season meals with garlic, herbs and spices, instead of salt.

Problems with chewing, digestion, or gas can make an older person lose interest in eating. In addition, some older adults don't eat well because they find it hard to shop for food or cook. Others don't enjoy meals because they often eat alone. Not eating enough or avoiding some foods could mean that a person misses out on needed vitamins, minerals, fibre, or protein. Not eating enough could also mean that the person doesn't get enough calories.

Consequences of Malnutrition:

·         Increased risk of infections;

·         Delayed wound healing;

·         Impaired respiratory function;

·         Muscle weakness and depression

Detection of Malnutrition:

The best indicators of poor nutrition are measurements of weight and height. Body Mass Index (BMI) is a good indicator. As a primary Carer it is my responsibility to weigh the residents’ assigned to me during the first week of every month. I give the results to the Nurse on duty, who in turn uses this information to produce effective Care Plans.

Healthcare Assistant’s role in promoting good Nutrition:

I choose to examine one Resident who is compos mentis and likes to have her breakfast in bed. Her breakfast consists of tea, orange juice, porridge with flaxseed, wholegrain toast and a boiled egg. Firstly, I smear some petroleum jelly on her lips to keep them moist and it will also make fitting the dentures easier. I always take her dentures from the bathroom where they have been soaking over night and ensure they are not causing pain and are fitted correctly. While she is able to feed herself I always ensure to pour out the tea into her beaker to prevent her from burning herself. I also pour milk on her porridge. I encourage her to eat everything. I make sure I enter what she has eaten on the Epicare system so that her nutritional intake can be monitored by her Primary Nurse. Throughout the day I encourage her to take frequent sips of water.  During lunch she eats in the dining room with the other residents.  She likes to wear a bib to protect her clothing. I create a more relaxed atmosphere by sitting at the resident’s eye level and making eye contact during feeding. I do not interrupt the resident during mealtime. I only assist her when she asks for example cutting her meat. Every resident including this lady can choose from a daily menu of what they would like to eat the following day. Again food eaten or refused is entered into the Epicare system. I encourage all residents before going to bed to drink more water.  This particular resident frequently suffers from constipation, so it is very important for her to drink more water and I have explained this to her. Her Primary Nurse is evaluating her diet so that an effective diet plan can be put in place, such as encouraging her to snack on fruits between meals and also as a desert after dinner.

Summary:

As a Healthcare Assistant one of my core duties is to enhance the services provided in the Nursing Home. One simple way to ensure that a varied and interesting menu exists is by giving our suggestion to the chef. Assistance tailored to meet individual needs and circumstances for example with this Resident it was important to ensure she was wearing her dentures and that the Primary Nurse was made aware of her ongoing constipation issues. To support the resident in carrying out tasks which they might otherwise find difficult, such as pouring out her drinks and ensuring her meats was cut into manageable bite size pieces. All in all, nutrition is vital for all, however, some people will have different nutritional needs depending on their health and dietary requirements such as Diabetes and Coeliac disease.