Improving Resident Nutrition and Reducing Supplement Needs

PACAH 2015

Goals for today

A. Examine Nutrition TRENDS among the elderly in America

B. Think about SUPPLEMENT USAGE in the long term care setting

C. Consider ideas to implement a FOOD FIRST approach

Aging in AmericaThe elderly population in the United States is growing. The population 65 and over has increased from 35.9 million in 2003 to 44.7 million in 2013 (a 24.7% increase) and is projected to more than double to 98 million in 2060.

(Administration on Aging)

Facts about Older AmericansPersons reaching age 65 have an average life expectancy of an additional 19.3 years (20.5 years for females and 17.9 years for males).

(Administration on Aging)

Nutrition Snapshot

It is estimated that more than 22% of the population over the age of 65 is malnourished. Malnutrition in the elderly is often not recognized or diagnosed.

(Nestle Nutrition Institute, MNA website)

(

(Furman,, E.F. Journal of Gerontological Nursing.)

Elderly in theCommunity:

5 – 10%are malnourished.

Elderly in the Hospital:

60% are malnourished.

Elderly in LongTerm Care:35 – 85%

are malnourished

Causes of Malnutrition

Physical Aspects of agingSocial Situations

DepressionMedical ConditionsFinancial Concerns

Hospitalization

What’s your Go-To approach?

Is it a Food First Approach?

VS

Are supplements evil?

Or are they good?

Step upto aBetter Dining Experience

1. Assess the Individual2. Upgrade the Dining Program3. Implement Quality Food

Programming

Steps to Success

• Food Preferences• Food Texture• Personal Schedule • Eating Environment

Assess the Individual

The Dining Room

Why is a Well Designed Dining Room Program so important?• Greater choice• Greater attention from staff• Socialization• Lighting & atmosphere• Staff observation and cues• Staff notices declines faster• Food can be served in “courses”• Seconds & alternates are more

available• Better able to eat with family &

visitors

• “Copy - cat” : people eat more when they see others eating.

• Positioning improves

• Need for Assistance• Impact of Medications•Medical Conditions & Pain

Assess the Individual

Borun Center for Gerontological Research

40%

10%

50%SnacksNo ChangeAssistance

Isolation Helplessness

Boredom Grief & Loss

Assess the Individual

1. Assess the Individual2. Upgrade the Dining Program3. Implement Quality Food

Programming

Steps to Success

Upgrade your Dining Program

What’s HOT

What’s NOT!

Upgrade your Dining Program

Decentralization Greater Food Availability

More Food ChoicesStaff Crossover

Hot…

Upgrade your Dining Program

Medical ModelAssigned SeatingLimited Choices

Strict Meal timesLimited areas of access to food

1. Assess the Individual2. Upgrade the Dining Program3. Implement Quality Food

Programming

Steps to Success

Always Available Menu

For your dining pleasure…

Puree ProgramFortified

Foods Program

Finger Foods ProgramMenu Alternates

Quality Food Programming

Puree Food Program

“We saw a dramatic increase in our

resident’s food consumptions.

The nursing staff also really enjoyed

telling the residents what they were

eating.”

Puree chocolate peanut butter delight

Puree lasagna, garlic bread and spinach

Fortified FoodsRegularMashed Potatoes120 calories, 2 g protein

Fortified Mashed Potatoes252 calories, 9 g protein

Regular Oatmeal150 calories, 5 g protein

Fortified Oatmeal534 calories, 9 g protein

Whole milk 150 calories, 8 g protein

Fortified Milk,218 calories, 19 g protein

• Variety• Eye Appeal

• Soup to Nuts

Nutritional Density

Finger Foods Core Concepts

Fing

er F

oods

mak

e Ea

ting

Easi

er

Alternative Dining Selections Menu

Special Food Events

Summer Crab Bake!

Summer Crab Bake!

Special Food-Related Events Like Cookouts and Farmer’s Markets

Chef Displays, Dining Discoveries and Cooking Classes

Holidays, Special Events and Themed Meals

Taste Test Time!Chicken Salad SlidersChocolate Peanut butter Pudding