Expert Advice: Nutrition and Hydration in Care

Leading social care consultant Tim Dallinger discusses promoting Nutrition and Hydration Week 2016

Nutrition and Hydration Week is taking place 14th – 20th March 2016 and my blog this month is focussed on this vital aspect of care provision.

The aim of the week is to promote the following:

  • The 10 key characteristics of good nutritional care
  • Protected mealtimes
  • Nutritional advocates for each health or social care setting
  • The minimum standards for good nutrition in all settings
  • Sharing good hydration and nutrition practices
  • Continued Professional Education and Development.

Food and drink is of course an essential component to physical and mental well-being and meeting the nutritional and hydration needs of people is a legal requirement under the Health and Social Care Act 2008, Regulations 2014. It requires care providers to both identify and meet the nutrition and hydration needs of people in their care. This includes taking into account likes, dislikes, preferences, and methods of taking nutrition and hydration, as well as considering religious and cultural backgrounds.

The complications that can arise from poor nutrition and hydration are many and include:-

  • Weight loss
  • Weight gain and the development of associated health conditions such as diabetes
  • Pressure sores
  • Mobility issues
  • Confusion and delirium
  • Infection, especially urinary tract infections if the person does not drink enough

For care providers, meeting the nutrition and hydration needs of people can be a big challenge. Gaining the trust of people with dementia is the ultimate key to providing them with effective and stress-free care. But it can also be one of the hardest things to achieve. Issues may arise from the following:

  • Personal preferences may mean a resident will only choose to eat the sweet puddings and refuse other aspects of a balanced diet
  • Difficulties in managing the need to be adequately hydrated with continence management
  • Providing meals for many residents and their individual preferences in a reasonably short time period which is typically 1-2 hours per meal sitting.

The staff team at Ashbrook Court Care Home is committed to providing high-quality nutrition and hydration to all residents based on their individual needs and has a risk assessment process in place to identify malnutrition. Care staff are fully trained on the subject and taught to understand how issues can arise, such as why people with dementia forget to eat or why they may lose food recognition.

Following admission into the home, residents are continually monitored for weight change and are assessed for risk of malnutrition and requirements are captured in personalised care plans Actions are taken as required:

High risk residents – weight and food and fluid intake is monitored weekly and level of risk is continually assessed

Medium risk residents – weights are checked monthly, food and fluid intake is monitored daily

For residents that are at high and medium risk, our Chefs are updated on their diets regularly and will implement an action plan to include the following in weekly menus:

–         Milkshakes every other day

–         Chocolate flakes

–         Cheese plate every suppertime

–         Fortified meals

Low risk residents – weights are checked monthly, food and fluids intake does not need to be monitored closely.

This procedure has proven very effective in that residents are achieving a healthy weight, they are appropriately hydrated and there is a significant reduction in the incidences of pressure sores, all of which are the result of effective nutrition and hydration.

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