15 Chapter 14: Eating Issues in Long Term Care
Tracy Everitt; Megan Davies; and Shannon Roode
Chapter 14 Learning Objectives
At the conclusion of this chapter, students will be able to:
Learning Objectives
- Describe the common eating issues seen among older adults in long-term care.
- Illustrate the meal and menu planning process in LTC.
- Explain the purpose and use of IDDSI.
- Describe what a ‘liberalized approach’ means for residents’ diets in LTC.
- Explain how policy development can help improve the eating outcomes of residents in LTC.
14.1 Eating Issues in Long Term Care
There are many factors affecting long-term care residents’ desire to eat. These can include issues with chewing or swallowing, lack of strength to cut food or use utensils, poorly fitting dentures or oral pain, depression, the disease process (dementia or Alzheimer’s disease), and constipation. Best practices in nutrition, food service and dining programs incorporate the home’s vision to create a better dining experience for older adults. This is done by supporting, promoting and respecting residents’ rights, safety, security, comfort, choice, autonomy and decision-making abilities. This can be done by considering the following:
- Recognizing that quality nutrition, hydration and pleasurable dining enhance the “quality of life” and the “quality of care” for residents in long-term care.
- Embracing a holistic approach, recognizing that food, beverages and pleasurable dining influence residents’ psychological, social, and physical well-being.
- Considering a residents’ history and how it influences their food preferences.
- Recognizing that feeding oneself contributes to feelings of self-worth and autonomy.
- Incorporating a supportive and restorative dining component to maintain and/or regain residents’ self-feeding skills.
In addition, embracing both interprofessional collaboration and an interdisciplinary care team approaches can support resident‘s health and well-being.
Please read the Dietitians of Canada paper (2019) and answer the following questions.
Dietitians of Canada. Ontario Long Term Care Action Group. (2019). Best practices for nutrition, food service and dining in long-term care homes. Dietitians of Canada/Les diététistes du Canada.
Sections:
Organization and Administration (pp. 2-3)
Menu Planning (pp. 4-9)
Standardized Food Production (pp. 10-11)
Nutrition and Hydration Care (pp. 12-33)
Meal Service and Pleasurable Dining (pp. 34-41)
Learning Questions from Dietitians of Canada Paper (2019):
- What are the primary mealtime goals for staff in LTC, and how can these goals be accomplished?
- What elements should be considered when meal planning in LTC?
- What is the purpose of the IDDSI framework?
- How can the IDDSI framework be applied in LTC?
- What is the significance of standardized food production in LTC?
- What is meant by a ‘liberalized approach’ for residents’ diets in LTC?
- How can policy development aid in overcoming common nutrition and hydration care challenges in LTC?
- What is meant by Continuous Quality Improvement (CQI)?
For further information on menu planning in long-term care, here is the Dietitians of Canada ‘Menu Planning in LTC’ document which incorporates Canada’s Food Guide (2019).
References
Dietitians of Canada. Ontario Long Term Care Action Group. (2019). Best practices for nutrition, food service and dining in long-term care homes. Dietitians of Canada/Les diététistes du Canada.
Dorner, & Friedrich, E. K. (2018). Position of the Academy of Nutrition and Dietetics: Individualized Nutrition Approaches for Older Adults: Long-Term Care, Post-Acute Care, and Other Settings. Journal of the Academy of Nutrition and Dietetics, 118(4), 724–735. https://doi.org/10.1016/j.jand.2018.01.022
