Posted in Nutrition

Keeping those fluids up!

Posted by Julie Dundon AdvAPD on 13 February 2020
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Trying to meet hydration needs of older people is always challenging but it is even more challenging in the peak of Summer in Australia.  As described in the last article, many foods such as custard and soups provide fluid and some nutrition and these should be used as a priority.

Other practical strategies to increase fluid intake include:

  • Identify those at risk of dehydration
  • Record and review consumption
  • Encourage enthusiastically
  • Encourage residents to drink with others
  • Use familiar cups or mugs
  • Offer fluids at every meal and snack
  • Offer a wide variety of drinks
  • Offer preferred fluids - resident may drink cordial better than water
  • Offer iceblocks/ icecreams/ jellies
     

Quench that thirst!

Posted by Julie Dundon AdvAPD on 11 February 2020
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When the mercury hits above 40, it is challenging for all of us to meet our hydration needs.  It's even more difficult as we get older as our thirst is often reduced and we don't always know when we need more to drink.  Women need at least 8 glasses (2 litres approx.) of fluid per day and men need at least 10 glasses (2.5litres approx.).  In the hot weather it's likely those quantities increase even further.

Food has fluid too - up to 500 to 700ml depending on the food eaten, so the actual fluid that needs to be taken as drinks to prevent dehydration may only be 1200 to 1500ml.

Examples include

  • Soups
  • Custard, ice cream, junket, yoghurt
  • Stewed fruit, canned fruit, pureed fruit
  • Cereal with milk, porridge
  • Ice-blocks or icy-poles
  • Jelly

Water, tea, coffee and diet cordial drinks provide fluid but no nourishment.

It is a myth that tea and coffee are dehydrating for regular users. If someone drinks tea or coffee on most days then the body adapts to the potential diuretic effects- they are a good source of fluid.

Juice, milk, milkshakes and commercial supplements provide excellent nutrition at the same time as the fluid so are great choices.

Even ordinary cordial, soft drink and sports drinks provide sugar and some valuable calories when someone is underweight.

Nothing Standard About Standard Recipes

Posted by Julie Dundon AdvAPD on 23 January 2020
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Do you use standard recipes in your aged care home? There are many good reasons to use a standard recipe when cooking for older people. The 2 most important are:

  • to keep the residents safe and
  • to meet the expectations of the residents.

We all know that some Chefs or cooks can cook an amazing meal that no-one else can seem to replicate.  It is important that the recipe is documented so that others can get as close to their finished product as possible.  This should result in a high standard of quality across the whole menu.

Also, using a standard recipe will ensure that all the ingredients are available when needed, there will be enough food to feed all the residents and allergens can be managed.  This way all residents can enjoy the same meal with some modifications.

Make sure that the standard recipes are always available to all the cooking staff.  A clean folder in the office around the corner that no-one looks at, just might indicate that the recipes are not followed.  An easy to follow recipe which is available in the production area and that indicates the number of serves is a very useful tool.

People in residential aged care spend a lot of their time thinking about food.  If they expect a meal to look and taste the same way that they had previously, we need to ensure that we can do this every time.  A standard recipe should be able to deliver this!

About the Author Nutrition Professionals Australia is a team of Accredited Practising Dietitians who consult to aged care homes across Australia.  They have more than 40 years of combined experience in a range of roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.

Delicious Snacks for All!

Posted by Julie Dundon AdvAPD on 9 January 2020
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A goal in residential aged care is for residents to enjoy a range of meals throughout the day which includes delicious main meals, mid-meals and drinks.  As our appetite reduces, so the need to provide nutritious snacks becomes even more important.  The mid meal should be appealing and provide the nutrients that are likely to have been missed by having a smaller serve at the main meal. 

Options include:

  • a range of home baked cakes,
  • sweet or savoury baked items like scones and pikelets,
  • savoury plates with cheese and crackers and
  • items based on fruit and dairy foods, such as yoghurt, ice-cream or custard

When a resident commences a modified texture diet (soft, minced and moist or pureed) it is very common to find that mid meals are no longer offered! This can result in weight loss and malnutrition. Sometimes the only options offered are monotonous- the same fruit and custard or yoghurt every day with no variety.  This soon becomes very unappealing and the resident's appetite can fall even further.

We know malnutrition is high amongst those needing modified diets, so the mid meals are even more important to their overall quality of life.   It is important to continually look at interesting ways to present the main meals with molds, piping, layering, but it is also important to give the humble mid-meals the consideration that our residents deserve.

About the Author Nutrition Professionals Australia is a team of Accredited Practising Dietitians who consult to aged care homes across Australia.  They have more than 40 years of combined experience in a range of roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.

Allergies, Intolerance and Dislikes

Posted by Julie Dundon AdvAPD on 12 December 2019
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If a resident has an allergy, intolerance or dislike, these details MUST be documented very clearly and not be ambiguous in any way.  

It is essential any food allergy is taken very seriously.  It must be very clearly documented and able to be identified by all staff (lifestyle, volunteers, care and food service) in an aged care home.  A food allergy reaction can occur within seconds from minute quantities and is often life threatening   The typical food allergies are egg, nuts, fish and shellfish. We know the number of people with food allergies is on the increase.  We need to be vigilant about cross contamination and ensure that residents with food allergies receive the correct meal and are safe at all times.

If a resident has an intolerance, it is usually not life threatening but can leave the resident feeling uncomfortable from a range of symptoms. The resident may even be able to tolerate small quantities before they have any symptoms.

If a resident dislikes a certain food, these food preferences also need to be adhered to at all times.  It is their choice and right to request an alternate meal.

When preparing  a suitable meal, the meal component should not be just taken off and not replaced.  For example, if a resident is lactose intolerant, a lactose free custard should replace the regular custard.  If a resident has an egg allergy, then baked beans should be offered instead of eggs for breakfast.  And if a resident dilsikes beef, then fish or chicken can be offered.

All those who provide foods to residents must be sure that allergies, intolerances and dislikes are well documented and communicated at every stage of the food service.

About the Author Nutrition Professionals Australia is a team of Accredited Practising Dietitians who consult to aged care homes across Australia.  They have more than 40 years of combined experience in a range of roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.

 

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