A site for practical nutrition information for student dietitians, DTRs and RDNs…featuring guest blogs from students or RDNs who would like to gain writing experience.
4/20/2020
Topic 1: The Importance of Meal Rounds in Long-Term Care
Long-term care RDNs rely heavily on observation to identify and address feeding issues in residents. As a student, I was surprised to find just how important meal rounds are. As I assisted my preceptor in meal rounds, I learned a lot about the feeding issues that older adults often face and the various tools an RDN may use to treat them.
Among older adults living in nursing homes, it is estimated that 40-60% experience feeding difficulties.1 This is not surprising, given that an estimated 47.8% of nursing home residents have Alzheimer’s or other dementias.2 Dementia leads to many feeding difficulties, as it often leads to pocketing of food, increased energy expenditure due to pacing, food refusal, agitation, and forgetting to eat.3 What’s more, dementia and other conditions can cause dysphagia, which involves difficulties swallowing food and/or fluids. For residents with motor neuron diseases like Parkinson’s, the physical act of getting food from their plate to their mouth can be laborious. With a population susceptible to unintended weight loss and malnutrition, all of these feeding issues pose a very high risk. This is what makes meal rounds such a powerful tool for RDNs.
By observing residents as they eat, an RDN or intern may notice one of the following situations:
When one of these situations occurs, the RDN may take action by:
When an RDN conducts meal rounds, their primary goal is to help every resident get adequate energy and nutrient intake. The golden rule is, “food first”. If, however, every option above is exhausted and a resident is unable to meet their nutritional needs (as evidenced by significant weight loss or other signs of malnutrition), the RDN has a few other tools to use. First, CNAs and diet aides can be instructed to always offer residents whole or chocolate milk with their meals. The additional calories and protein in milk can make up for deficits caused by feeding issues. If the resident refuses or it isn’t enough, drinks like Ensure or Boost may be warranted. After prescribing one of these nutritional supplements, the RDN will assess the resident’s intake of them at future meal rounds.
Students learn much in their classes about nutrition assessments and nutrition-focused physical exams. Another important tool for RDNs that doesn’t receive as much coverage, however, is meal rounds. During my time as a student-intern, I learned how critical of a practice it is to observe residents as they eat.
References:
Jessie is just completing her undergraduate work at the University of Alabama and will be interning with the University of Delaware this fall.
Dementia Mealtime Assessment Tool
The Foodie Dietitian
Soulful and Spirit Filled
Fresh. Practical. Scientific.
My journey and experiences, to help your journey. For the aspiring or accomplished Registered Dietitian.
helping you feel energized with crohn's & ulcerative colitis through nutrition
Helping Women Find Their Happy Weight & Ditch Dieting for Good
The Inside Scoop on All Things Lose It!
Powered by ADSA (Association for Dietetics in South Africa)
Research Your Future - Strategic Career Planning for Schools & Colleges
Thoughts and stories of failures, successes, school and life of a registered nurse
Debunking myths and uncovering the truth on food and nutrition by a Registered Dietitian
Discovering Myself!
Nutrition consultations from a registered dietitian
A site for practical nutrition information for student dietitians, DTRs and RDNs...featuring guest blogs from students or RDNs who would like to gain writing experience.
Eating healthy no longer means your family has to go broke.
Live well, eat clean, go vegetarian!
Well said
Wendy Rice
Sent from my iPad