Nutrition

1
Nutrition Dementia

• No One Should Go Hungry

2
No One Should Go Hungry

• Eating well means the person has the amount of
  energy (calories) and nutrients ( protein etc.)
  that they need to maintain their body processes
  and to protect them from illness.
• Evidence indicates poor diet is related to
  illness, premature death and health conditions
  that affect the quality of life
• In order to eat well people need a variety of
  foods .. This is where our challenge begins.

3
Risk of under nutrition

• Identified by Nutritional Assessment
• Those at greatest risk
• Have lost weight recently
• Started to leave food on the plate
• Lost their independence in eating

4
How to address this

• Its easy to focus on the facts and reasons why
  its a problem but how to address this is more
  proactive

5
PLEASE

• P Presentation Colourful and appetising
  meals, small and frequent portions required.
• L Liquids and Hydration Offer regularly, not
  enough leads to dehydration which can add to the
  confusion.
• E Environment A pleasant atmosphere, minimal
  distractions
• A Assistance Specific to the resident, aids
  and adaptations, allow time to finish the meal,
  verbal prompting and reminders.
• S Senses Meal times should stimulate all of
  the senses.
• E Eating Skills Promote independence. Ability
  to eat a wide range of foods.

6
Senses

• Meal times should stimulate all the senses
• Hearing music, radio could be played.
• Smell Smell of the dinner
• Taste Taste of the dinner
• Touch Encourage users to maybe butter their
  own bread if possible.
• Sight We eat with our eyes
• Care homes should have a bread maker the
  smell is very popular and stimulates the senses

7
Protected

• Dining should be a protected experience.
• Principles behind Protected Meal Times include
• Staff focus their attention on making mealtimes
  a success.
• Anything that supports and assists people to eat
  is encouraged.
• Anything that interferes with the meal time, and
  reduces the amount eaten is discouraged. There
  should be no doctors and no drugs trolleys being
  wheeled around.
• The more residents feel at home, the more likely
  they are to enjoy mealtimes. Often older people
  can have previously experienced a very planned
  eating pattern this should be considered and
  protected.

8
Case Study

• A care home in Leeds decided to look at their
  lunch time experience as both service users and
  staff were finding it a difficult, stressful
  experience.
• They decided to split the lunch.
• The first half have their lunch at 12.00, and the
  second at 12.30pm, they found making this change
  took a little while for the users to get used to,
  but found everyone was much more relaxed during
  and after their lunches.
• As they have the room, if users want to stay and
  drink tea whilst the others have their lunch they
  are able to.

9
Remember

• Forgetting what foods are
• A fairly simple solution is to create picture
  menu cards showing the days meal choices, as it
  is helpful to see what food looks like.
• People will choose what they think looks good.
  The words shepherds pie may not mean anything
  to a person with dementia, until they see and
  recognise exactly how this appears.

10
Support

• Staff guide and encourage older people to choose
  a balanced diet
• Staff join service users at the table, to help
  encourage people to eat, help people to copy
  their actions if theyve forgotten.
• Main objective still giving people choice, and
  independence.

11
Dining Experience

• Slow eaters table, service users are leaving
  their meal if someone has already finished. Sit
  the service user with other people who eat at a
  similar speed.
• Encourage family meals, if room, have a small
  dining room where the family can sit and eat
  together.

12
Why How

• Dementia - It is thought that around 25 of the
  costs of caring for this group may be
  attributable to the time carers spend helping
  with eating and drinking.
• Encourage participation in the social and
  practical activities surrounding preparing and
  serving meals.
• If you have to assist a person to eat and drink,
  talk about what you are offering them to help
  remind them of tastes and flavours.
• Ensure that food is available for the person,
  which is easy to see, both within eyesight and in
  clear contrast with the plate.

13
Time has not allowed us to mention

• Texture modification of foods
• Food fortification
• Finger foods
• Feeding and drinking aids
• Specific nutritional care staff training
• These requirements all need to be considered as
  part of the assessment of a persons needs

14
Further Supporting Materials

• Eating Well Supporting older people older
  people with dementia Practical Guide
• Caroline Walker Trust
• How to comply with CQCs Outcome 5 Meeting
  Nutritional Needs
• NACC
• Menu Planning Special Diets for Care Homes
  Manual
• NACC

15
Thank you

• Derek Johnson
• Past Chair NACC
• www.thenacc.co.uk