Are your home care patients malnourished?

National Nutrition Month reminds us to celebrate good nutrition, but what about those who aren’t getting good nutrition? As a home care provider, you see your patients on a regular basis, often enough to notice if changes due to malnutrition are taking place. Whether you are a home health aide, PCA, therapist or RN, you can identify malnutrition, and you can help.

Pay attention when you’re helping him get dressed. If his clothes fit more loosely than before, this could be a sign of weight loss caused by malnutrition.

Keep an eye out for bruises. If she bruises easily, she might be malnourished.

Wounds that are slow to heal are another sign of malnourishment.

If you discover that a patient is not getting adequate nutrition, make sure that this is documented and that everyone involved is made aware of the situation so that a solution can be put into place. Here in the United States, we have access to so much healthy food–no one should go hungry!



What is your relationship with vegetables?

My good friends at the Visiting Nurse Service of New York alerted me to the fact that March is National Nutrition Month, which is great because it gives me a chance to blog about one of my favorite things: cooking. I really enjoy cooking, and I think learning how to cook can change your relationship with food.

It’s no secret that most people in this country don’t eat the right amount of vegetables. I can’t help but think that the shift to convenience foods that was made in the middle of the 20th century is responsible for this. When I was growing up, vegetables were usually steamed from frozen and served as side dishes. We rarely ate anything fresh, except for corn during the summer, and that too was steamed in the microwave. More often than not, we ate those mixtures of corn, peas and orange cubes that are supposed to be carrots.

Now that I’m all grown up, I hardly ever buy frozen vegetables. Instead, I buy fresh kale and slow-cook it with garlic and olive oil. I roast Brussels sprouts in the oven until the outer leaves get crispy. I brighten up just about any dish with red, yellow and orange bell peppers. We never had kale at home when I was a kid; now I crave it. Kale has a very high nutritional value as it contains beta carotene, vitamin K, vitamin C, lutein, zeaxanthin and calcium. It also contains sulforaphane  which is known to fight cancer. I get all these things on a regular basis, all because the way I view vegetables has changed.

So what’s your relationship with things that are green? And how do you help other people change the way they view food, so that that they learn not only to eat healthier but to enjoy it?

(Note: if you need some advice on how you, as a caregiver, can cook healthy meals for your caree, read these tips from VNSNY, 10 Cooking Tips for Caregivers).


Dementia and Eating Disorders

Earlier this week, we talked about the causes of eating disorders in elderly people. One cause for eating disorders that we didn’t cover: dementia. Studies show that eating disorders are among the behavioral changes that can be caused by dementia. The severity of impairment will vary from patient to patient–one patient may simply be forgetting to turn on the oven, while another may have lost the ability to use eating utensils. It is important to evaluate the patient’s level of independence and or severity of impairment before deciding how best to intervene. A patient with a greater degree of independence will be resentful of too much intervention where it’s not needed.

One way to help a patient who had trouble using forks and spoons is to simply eliminate the utensils. Give the patient finger foods to eat instead: sliced bananas, grapes, cheese, meat cut into small chunks, cucumber slices, hardboiled eggs peeled and sliced, berries, and carrot sticks. (These are but a few examples.) Remeber: when it comes to making sure the patient is properly nourished, neatness doesn’t count.

When you decide on a proper strategy for getting your dementia patient to eat, consider typing up the plan and giving it to the patient’s family. If the patient’s family members are involved in caregiving, it will be important for you to go over the plan with them.

Do you have your own ideas for how to handle eating problems in dementia patients? Post them in the comments!