Nutrition Flashcards
Why is nutrition important?
Higher risk of skin breakdown
Impaired immunity
Reduced functional reserve
What does vit C deficiency lead to?
Scurvy
What does thiamine deficiency lead to?
Wernickes and korsakoffs
How do you measure/detect malnutrition.
MUST score
Weight, height, BMI
Mid upper arm circumference to estimate BMI
Ulnar length= estimation of height
How does a MUST score work?
Each step scores out of 2 and there are 3 steps…
Step 1= BMI
Step 2= unplanned weight loss
Step 3= acute illness and decreased intake for 5 days
How do you use MUST score to manage a patient?
Score 0 = low risk: repeat weekly in hospital, monthly in care homes, yearly in community for at risk groups (including the over 75s)
Score 1 = medium risk: food chart for 3 days – if intake adequate then monitor w/screening as above (except in community do 2-3 monthly), if intake inadequate – formulate plan for increased intake
Score 2 or more = refer to dietician, set goals to improve nutritional intake, monitor regularly weekly, monthly, monthly.
How can oral health affect malnutrition?
There is an independent association between oral health and malnutrition in older adults in long term care
May affect nutrition due to dry mouth, mouth ulcers, poor dentition, ill fitting dentures
How can you optimise nutrition in dementia patients?
High Protein oral nutritional supplements
Background music/aquarium
Enhanced menus/ decentralised food service
Environmental adaptation- high contrast plates, small dining rooms
Staff education
Systematic review called EDWINA (Eating and Drinking Well IN dementiA!)
Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking.
43 controlled interventions included and none were judged to have low risk of bias.
Oral nutritional supplements had short term but unclear long term benefit
Food modification and dysphagia management: small studies, low quality with little evidence of improved nutritional status
Eating assistance evidence was inconsistent
Studies of social element although small and of low quality provided consistent suggestion of improvements in aspects of quality of life
Overall quality of studies poor but promising interventions include: Oral nutrition supplements; pureed and reformed foods; thickened fluids; individual mealtime or between-meal assistance; family style meals and meals shared with staff or carers; meals with a facilitated social element; reminiscence cooking; finger food provision.
What are some simple things which can help someone with dementia eat?
Finger food – high calorie content is good!
Food stations around the places – need to be non-perishable items.
Fortification of food – porridge, build-up drinks etc
Smaller portions – can be problematic with delivered meals
Plate colour – to provide contrast against food colour
Sitting with patients and eating with them
Person centred care e.g. eating in dining room vs alone – what does that person normally do?
Different textures / temperature food
Sweet things first then savoury (If preferred)
