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Monday, 15 August 2016

Older people living in residential care require nutritional plans that cater to their changing physiology

Malnutrition is thought to affect 10% of people over 65 in the UK. The key to getting food and nutrition in care homes right is respecting the diversity of the residents and their care needs.  Our organisation provides guidance across our care homes in the UK, but it is crucial for individual homes to tailor their food and nutrition provision to the individual. With this in mind, here are some guidelines for how best to approach food and nutrition in care homes.

Talking from recent observations in both the NHS and Care, We find it concerning to find so many people being taken off eating normally because they have difficulties in swallowing food.
In the main we wonder if this might be more of a concern of staff fears and confidence when dealing with people when they see people choking if they are not taught the right skills in nursing and caring and understanding the body’s anatomy and physiology?
We also questions whether this is an easy option for doctors and nurses turn to soft and restricting foods and supplementary drinks and whether care really understanding the
knock-on effect it might have, and if not the complete answer when actually it might result in long term hunger and malnutrition?
We also believe this raises a number of issues. Not least that a good nutritional diet in the first place will make a huge difference to this and the well-being of our frail and vulnerable people. Particular when current research points to reducing the intake of sugar, salt and foods high in the GI Index which directly contribute to diabetes and heart disease.
We can remember both my own husband and my father-in-law having periods of choking on food. When the muscles in their neck had weakened and the stomach reflex caused food to come back up for it to be swallowed into their airway. It was normally caused by food, which had not been easily digested, still left in the stomach.
We find it frightening, but we also found it to be only temporary; until the acid built up in stomach subsided, and whilst the energy cells in the muscle regain strength.  In our experiences reassurance and aid to help remove the food, reducing the concentrates of acid in their stomach, (that potentially can eat through the stomach wall and leak the built up toxins into the gut, blood stream and liver), and a neck collar supporting their neck muscles, helped considerably to get them back to normal.
We personally would like to see a more thorough analysis of understanding the causes and outcomes of treating this health problem, and in educating health practitioners in best practice, which relies on a more frequent and closer review of fluctuating changes in health patterns.
If only a temporary condition, and once swiftly overcome it allows for people to start quickly eating normally again, there should be no need for long term restrictions on food intake; only monitoring to making sure people eat healthily and avoiding those foods they know they cannot tolerate.    
It also worries us that we rely on manufactured supplements to receive the vitamins and nutrients the body needs without really knowing if these are giving all the benefits people need. Perhaps others that have experience of this, or their loved ones who were placed on soft diets or restricted food intake would like to comment themselves?

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