As federal regulations tighten, nutrition is positioned to become even more critical in its role of providing better outcomes for dementia residents.
By Susan Saldibar
Nutrition has always been a key element of dementia care. Now, however, as federal regulations tighten, nutrition is positioned to become even more critical in its role of providing better outcomes for dementia residents.
Gordon Food Service, a Senior Housing Forum partner, recently published a white paper Memory Care: Improving Outcomes Through Nutrition. The paper looks at some of the recent regulations through the lens of dining strategies and proper nutrition. More specifically, it focuses on how nutrition can become a tool for senior care providers to ensure compliance.
What are you doing to optimize nutrition and dining in your community?
Here is the checklist Gordon Food Service suggests senior living communities use to make sure they’re optimizing their nutrition and dining programs for those with BPSD (Behavioral or Psychological Symptoms of Dementia).
Are you doing these?
Accommodate individual preferences and routines to provide a sense of comfort and control.
Offer choice, but limit appropriately and include favorite foods.
Provide small, but frequent meals.
Use texture modification, such as pureeing foods or providing finger foods.
Use fortified foods and nutrition supplements when indicated.
Promote self-feeding with visually contrasting dishes, adaptive equipment, verbal prompts, assistance with cutting, etc.
Promote hydration with hydration stations and nutritious beverage “happy hours”.
Ensure that eyeglasses, dentures and hearing aids are providing optimal help.
Optimize the dining environment by limiting distractions, allowing enough time to eat, and ensure that plate presentation, aromas and lighting support good eating habits.
Create a calm space that allows for dining with dignity and appropriate social interaction.
Offer family-style meals and have the caregiver eat with the resident.
Offer personal assistance when necessary.
Include nutrition recommendations and support services in transition of care planning.
Gordon Food Service also recommends training your Food and Nutrition staff on interacting with residents with BPSD. This benefits you in two ways: 1) it increases chances for eating more, and 2) it manages behavior to help prevent the need for psychotropic drugs.
Just in case you feel you are “up to par” on your dining program…
Take note of the following scenario from an article in Long-Term Living, written by RN, Lisa Hohlbein:
“A resident has a diagnosis of end-stage Alzheimer’s disease. She is ambulatory and wanders around the nursing facility all day but has lost the ability to recognize hunger. Consequently, she won’t sit down at mealtimes to eat. The nursing staff document the resident as “refusing meals” and the MDS nurse codes Rejection of Care in E0800. Are the resident’s needs being met? Was every effort made to help the resident consume food or snacks? Perhaps the nursing staff could have offered the resident half a sandwich as she wanders. It is possible she would take the sandwich and begin to eat it automatically as she continues to walk around the nursing facility. This would be considered a resident-centered intervention to be included on the care plan.”
So how does your community stack up? Are you compliant? Moreover, are you competitive?
Ask yourself how your nursing and caregiving staff would handle the above scenario. Are they taking all possible actions to ensure that residents are getting proper nourishment? Better yet, are they going over and above the mandated standards towards setting a higher standard of care?
Organizations, like Gordon Food Service, are working with senior living communities to help them develop nutrition strategies that position them to meet or exceed CMS standards. They are also helping communities create a dining experience that sets them apart from the competition.
In light of the tightening federal requirements and the increased focus on nutrition by prospective residents and their families, taking a second look at your dining and nutrition programs, might not be a bad move.
For more information on nutrition and dining strategies, please visit the Gordon Food Service website.
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