Nutrition and Dietetic Service Community Clinics in Reading and Newbury and Wokingham Domicillary visits Home enteral feeding Dietitian Specialist Learning Disability service

Undernutrition Problems with chewing/swallowing Physically unable to feed themselves Physical symptoms; nausea, vomiting, Dementia Depression, withdrawal or disinterest in food Leading to a low food intake, weight loss and a Must Score > 2

Reasons for Increased Nutritional Requirements Infection Cancer Post surgery Pressure sores Malabsorption Hyper activity– high activity levels

Fortifying Food First Add extra butter/margarine and/or grated cheese to mashed potatoes, vegetables, on soup, Milk powder can be added to full cream milk and used in drinks, cereal, pudding etc. (4 tbsp to 1 pint) Add sugar/jam/honey to cereal, porridge, puddings Stir cream into soups, milky puddings, porridge, pureed fruit Make up jelly with evaporated milk instead of water Pay special attention to altered texture diets - Use high energy liquids for pureeing. Pureed diet – lower in energy and less palatable Avoid overcooking before blending Use high energy liquids for liquidising e.g. Fortified full cream milk, cream, melted butter, olive oil, cheese and white sauce, rich gravy, mayonaise, full cream yogurt 9/22/2018 11:15:37 PM

3 small meals and 3 snacks Soft diet Whole diet Soft diet Eggy bread or peanut butter or pate on toast. Hot chocolate, milky coffee , smoothies. Cheese and biscuits Fromage frais Fruit cake or bakewell tart. Full cream yoghurt Mousse or angel delight Tinned fruit and cream. Pureed tinned fruit + cream

Weight Gain and Diabetes often related to lifestyle, loss of mobility or medication.

Diet Healthy eating

Fresh foods from 4 food groups

Constipation or Diarrhoea Irritable Bowel syndrome . Inflammatory bowel disease Coeliac disease Bowel surgery

Visiting and monitoring Home enteral Feeding patients (Tube feeding) and advising on oral nutritional supplements

For referral to a Dietitian Ask your GP to make a referral to Community Dietetic Service via the Health Hub. Ask your Community Team for People with Learning Disabilities or GP to make a referral to LD dietitian