Aged Care Dietitians

02/05/2021

Constipation is a common problem in aged care residents. This webinar covers practical management advice from experts in the field. Presented by Dietitians New Zealand. Registration $20 for non-members. To register: https://bit.ly/3tYK9oa

26/04/2021

This is a really good article from JAMA on managing cachexia in people with chronic disease. Well worth a read.

Approach to Management of Anorexia and/or Cachexia in Persons With Advanced Illness
Assess
Appetite and global functioning; review medications in detail

Eating habits and any difficulties with eating and involve a registered dietitian if available and indicated

Symptoms that may affect appetite and ability to eat and/or drink (ie, nutrition impact symptoms), taste and smell changes, mucositis, oral ulcers, nausea, constipation, pain, and depression

Address
Stop medications that may decrease appetite, if possible

Recognize that medications to treat 1 symptom may worsen others (eg, opioids may be associated with constipation, corticosteroids with mood changes, and β-blockers with changes in taste)

Specialty palliative care is helpful for complex symptom management

Recognize that certain nonpharmacologic interventions may have better risk and benefit profiles for treating symptoms than pharmacologic interventions5

Before suggesting frequent calorie-dense meals to optimize caloric intake, focus on listening

First, Listen
Ask about patient and caregiver concerns and needs related to eating, such as:

“What are your concerns about eating?”

“What is bothering you?”

“Tell me more.”

Then, Counsel (even a few minutes can help)
Acknowledge that across cultures, eating and food are emotional issues that are intimately connected to the expression of love, care, hope, and control

Inform that cachexia is a wasting disorder, driven by and reflecting the underlying disease process, not simply a lack of caloric intake

Avoid jargon, eg, use “eating” instead of “nutrition”

Do not medicalize nutrition and explain that extra calories generally cannot reverse the disease process and can be burdensome

Assure that lack of eating and weight loss are neither the fault of the patient nor the caregiver

Do not recommend routine enteral or parenteral tube-feeding, which may be associated with net harm, especially in patients with limited prognoses

Discuss how the caregivers may support patients if they have a desire to eat, such as offering favorite foods and having social meals that are for pleasure (ie, taste, not caloric intake)

Clarify that caregivers should not pressure or force patients to eat because these could worsen appetite and strain the patient-caregiver relationship

Suggest alternate methods of caring for and/or helping patients who do not want to eat, eg, holding hands, providing lip balm, massage, companionship, and so on

Patients and caregivers should both be counseled, separately if they are experiencing conflict and/or poor communication

16/07/2019

https://www.smh.com.au/national/fresh-herbs-fried-onions-real-custard-what-aged-care-food-could-look-and-smell-like-20190716-p527ov.html

Can we be doing better when it comes to feeding our residents. Maggie Beer thinks so. First priority is to increase the aged care meal budget.

It may sound like the menu of a hearty gastro pub in the country but celebrity cook Maggie Beer believes that kitchens in aged care homes could be delivering better food to residents that is still affordable.

19/01/2019

https://www.weforum.org/agenda/2019/01/an-aging-workforce-isnt-a-burden-its-an-opportunity/

Time to celebrate the older worker

For the first time since 1948, retirement-age employees outnumber teenagers in the American workforce. It's time to embrace the five-generation workplace.

21/09/2018

Best to call on a dietitian If you have vegan residents to ensure their nutritional needs are met

Health organizations have praised the new legislation

17/06/2018

Very interesting research coming from university of Otago

A spot of cooking could help prepare New Zealand for an older, frailer future population.

01/04/2018

The secret to a long and happy life? nothing wrong with starting the day with a big bowl of hot porridge!

With 109 years of life, Jessie Gallan was officially the oldest woman in Scotland. Recently, she revealed the secret for longevity, which is surprisingly funny and simple. Namely, if you want to live a long

24/12/2017

Merry Christmas 🎄 everyone, look after grandma!
Stay away from reindeers. Enjoy!

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15/12/2017

https://www.facebook.com/OddCouplesDodo/videos/1856559047937230/

Now, that’s sure to bring smiles to aged care residents!

08/11/2017

Are you a dietitian who has a caseload that includes patients on thickened fluids and texture modified foods? This systematic review might be of interest.

'Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia - An updated clinical guideline'.

This systematic review by Dr Anne Marie Beck and the team in Copenhagen, Denmark explored whether thickened fluids and textured modified foods are effective in individuals with oropharyngeal dysphagia.

You would be hard pressed to find a dietitian who hasn't encountered a patient struggling to meet their hydration needs orally whilst on thickened fluids. There have been significant advances in how thickened fluids are presented (ready to drink), their appearance and flavour. They are also heavily advertised and no doubt the commercial thickened fluid market is quite lucrative however I digress. Given such advances in this area, the clinical importance of aspiration and the patients requiring thickened fluids often being at increased nutrition risk, you would expect this systematic review in Clinical Nutrition to be bursting with studies. The number included?

TWO! From 2008. Neither conclusive and one actually stating there is a real need to consider the long term impact of short-term prevention of aspiration. So it appears texture modified food gets the thumbs up from the authors and thickened fluids get the thumbs down.

The commercial companies will have to invest in future adequately powered randomised trials to demonstrate thickened fluids are indeed effective at preventing aspiration and more effective at providing fluid than texture modified fluid-rich foods.

https://www.ncbi.nlm.nih.gov/pubmed/28939270

08/11/2017

Is it time for a Menu Audit? DietitiaNZ offers a comprehensive and affordable menu audit service. Want to find out more? Read our Blog
http://dietitianz.com/5-good-reasons-to-get-your-aged-care-menu-audited-by-a-dietitian/