1. Nursing Assistant Monthly Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Nutrition and Feeding Challenges July 2009

2. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Feeding challenges July 2009 2 Malnutrition risk in older adults Older adults need:  fewer calories.  the same or higher levels of daily nutrients, such as vitamins and minerals. Therefore, every meal counts!

3. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Feeding challenges July 2009 3 Barriers to proper nutrition Resident barriers  Physical problems –Weakness –Digestive issues (swallowing problems, nausea, constipation) –Chronic pain –Dental and chewing problems –Vision loss (cannot see the food, utensils)  Cognitive problems –Inability to self-feed (dementia, arthritis in hands) –Behavior problems, such as resistance to feeding –Unable to communicate preferences continues

4. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Feeding challenges July 2009 4 Barriers to proper nutrition, cont’d Environment  Unpleasant odors, sights, sounds  Noisy or chaotic environment  Unappetizing food –Unfamiliar food, not hot enough, bland  Conflicts with other residents –For example, when dining partners don’t get along well

5. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Feeding challenges July 2009 5 What to watch for §Food left on plate at end of meal §Turning head away or closing mouth when being fed §Coughing, choking during meals §Refusing meals §Refusing to go to dining room §Spilled food §Weight loss

6. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Feeding challenges July 2009 6 Your role as a CNA §Help create a pleasant dining environment. –Examples: soft music; quiet atmosphere; pleasant conversation involving the residents, not just the staff §Assist residents to prepare for eating: toileting, wash hands. §Make sure dentures are in place if resident wears them. –Report any signs of ill-fitting or loose dentures §Focus on residents during meals. –Is everyone happily eating? –If not, try to find out what’s wrong.

7. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Feeding challenges July 2009 7 More about your role §Encourage residents to go to the dining room, but don’t insist. –It’s the resident’s choice where to eat. §Encourage family members to join their loved one for meals. §Share information with the nurse or dietitian about the residents’ food and beverage preferences. §Report to the nurse any signs of problems with eating. §Be creative in finding ways to make dining the highlight of the residents’ day!