Beck, A. M., Damkjær, K., & Beyer, N. (2008). Multifaceted nutritional intervention among nursing-home residents has a positive influence on nutrition and function. Nutrition, 24(11-12), 1073-1080. doi:10.1016/j.nut.2008.05.007
This journal article focuses on multifaceted interventions to address nursing home nutrition, weight, and function. The study was conducted over an eleven week period with 121 subjects in a randomized control study. It used oral supplements, group exercise programs, and oral care interventions to improve the status of nutrition and overall physical functioning. The interventions used did show positive impact in each area addressed except dental care, as the results were the same as before the study was conducted.
This journal was very helpful because it
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focused on several elements of health for those in a nursing home environment.
The information is somewhat dated, but additional studies are currently being conducted and more recent studies show slightly different variables. This article would be very useful to dieticians, nutritionists, and therapists in nursing rehabilitation.
This study was conducted with 121 seniors from 7 different nursing facilities, with varying medical conditions, physical and mental incapacities. The group receiving the intervention started with 62 participants; 6 withdrew in the last week of the study and 15 died during the 11week period. In the control group no one withdrew and only 8 died. The oral supplement intervention was a high protein homemade chocolate given daily, with no placebo given to the control group. The physical intervention was 45-60 intervals of
exercise 2 times a week. Oral care included cleaning and tooth/denture care in case of complications. The areas of review for those receiving interventions were in the areas of cognitive functioning, physical capacities, dependent dining, and chewing/swallowing disorders. Most of the procedures were conducted by the staff of the 7 nursing homes, with a few specialists brought in for assessments and evaluation. The information was collected and assessed by nursing staff through the Minimum Data Set and compounded for nutritional, functional, medical, psychological, cognitive, and social status changes. The multidisciplinary interventions had a positive impact on each category assessed except dental care; dental treatments had the same outcome as base with no positive increase in mental or physical health. All residents (intervention group and control group) experienced weight loss after the study concluded as noted by follow-up period notes. Current studies are being conducted with some variations to further the research into multifaceted interventions in nursing home residents for nutritional and physical functioning.
A Mini Nutritional Assessment (MNA) was completed on Anne. The MNA is a tool used to provide a rapid assessment of elderly patients’ nutritional status. The MNA is made up of simple measurements and a few brief questions that can be completed by the patient in no more than ten minutes. The nutritional status of a patient is evaluated using a two-step process to accurately determine a patient’s nutritional status (McGee
Within the U.S. Healthcare system there are different levels of healthcare; Long-Term Care also known as (LTC), Integrative Care, and Mental Health. While these services are contained within in the U.S. Healthcare system, they function on dissimilar levels.
Touhy, T. A., & Jett, K. (2012). Toward healthy aging: Human needs & nursing response (8th ed.). St. Louis, MO: Elsevier/Mosby.
When it comes to operating nursing home facilities, there are many stakeholders involved depending on whether the institution is for-profit, non-profit or government owned. Majority of nursing homes are for-profit organization and they account for almost 70 percent of nursing homes, while non-profit nursing homes account for less than 30 percent and less 6 percent are government owned (Nursing home data Compendium, 2015). Nearly 95.5 percent of nursing homes across the state are dually certified, meaning they have both Medicare and Medicaid certifications (Center for Medicare and Medicaid, 2015). Nursing home funding comes from four different sectors. Nearly fifty percent of their revenue come from Medicaid, followed by Medicare which counts for twenty percent, and the rest of payments come from a mixture of private-long-term care insurance and out of pocket (Yoder, 2012).
When residents have been allowed to participate in their diet decisions, they have been found to have increased appetites and enjoyment of food, both of which are equated with quality of life. Alternatively, strict diets have been shown to result in lower intakes leading to weight loss and undernutrition. (Dorner, Niedert, & Welch, 2002). Offering a wide variety of foods with 24/7 access to allows active participation in choosing their own diet. Eliza Jennings homes were assured resident health was not compromised as a result of person-centered care by performing regular Accu-Checks and other diagnostic checks to monitor the health of the residents (“Case Studies in Person-Directed Care”,
Houde, S., & Melillo, K. (2009). Caring for an aging population. Journal Of Gerontological Nursing, 35(12), 9-13. doi:10.3928/00989134-20091103-04
For instance, there have been several nutritional interventions implemented in health care facilities. Specifically, screening can be effective in health care facilities to aid in identifying poor nutrition among the elderly, which is often undetected. Additionally, screening tools has been used to establish appropriate nutritional meals. One study by researchers Babineau, Jolyne, Villalon, Laporte, Manon, & Payette (2008) showed that the introduction of screening in a general hospital raised awareness of nutrition-related care. In this intervention dietitians conducts a full nutritional assessment and implemented a nutritional care plan for patients aged 65 or older (Babineau et al., 2008). The nutrition care program included nutritional screening, timely intervention, and close dietitian
Elderly Culture and Nursing Homes Nursing homes offer a wide range of long-term care assistance for older adults to be able to meet their everyday needs. Older adults from different cultural backgrounds experience conflict with their decision to participate in a nursing home, catalyzing the underlying stigma different cultures hold towards nursing homes. In many cultures, older adults look for family as their primary source of care. However, when their needs cannot be met due to disability and mental health issues, it begins to take a toll on the person’s instrumental activities of daily living (IADL). IADLs are complex daily actions that are needed to live (Cavanaugh & Blanchard-Fields, 2015).
“It is estimated that up to 45% of patients institutionalized with dementia have some degree of swallowing difficulty. Dysphagia affects up to 68% of elderly nursing home residents” (Sura, Madhavan, Carnaby & Crary, 2012.) My grandfather suffered from Alzheimer’s and spent the last few years of his life in a nursing home. Toward the end of his life, actually, two weeks before he passed away, he could no longer remember how to swallow and developed pneumonia. “Common complications of dysphagia in dementia patients include malnutrition and pneumonia” (Sura, Mahajan, Carnaby & Crary, 2012.) My grandmother was given several options such as inserting a feeding tube, which she knew my grandfather would not have wanted. She chose diet modification of thickened liquids. The nurses and staff who managed him faced difficult challenges when working with him. When a small amount of food was placed in his mouth, the nurse would take her hand and move his cheeks arou...
Darby, S. Marr, J. Crump, A Scurfield, M (1999) Older People, Nursing & Mental Health. Oxford: Buterworth-Heinemann.
Patients under the care of advanced nursing professionals who were advised to take an proactive role in the development of management plan under the supervision of their nurse practioners and medical doctors. were more effective in their compliance than those While no significant differences were in the outcomes that included A1C and the levels of triglyceride, there were notable increases in patients who comply with activities related to caring for self and willingness to make healthy lifestyle changes in the areas of increased physical activity and nutritional intake.
Having a group of senior citizens following you around for dinner most likely doesn’t sound like a fun night. However, working at a nursing home doesn’t feel like an actual job at all; I actually enjoy spending my nights at the Grand Residence. Not only has this job given me responsibility, but I also have built relationships with many residents. While spending my evenings at a nursing home throughout my high school career, I have come to the realization that I am comfortable and genuinely happy with pursuing a career in patient care in the foreseeable future.
5. Williamson, C. Dietary Factors and Depression in Older People. British Journal of Community Nursing, 14:422-426, 2009.
...istead of just getting their residents to eat. A lot of possible solutions are given to certain problems, but we have to be realistic about weather these solutions would actually work. Some suggestion given are not realistic, the cost of putting these solutions into place would be way to high. The cost to live in a nursing home is already way too high, and many elderly run out of money and end up living off of medical assistance before they have reached the end of their natural life. Other sol,utions could easily be put into place without much extra cost, so all solutions are not created the same. Maybe as nurses, nurse aids, or just family, we could all work together to improve the quality of life and reduce malnutrition in care centers. A few things to consider when thinking about the end of life are troubles with eating, the meal services, and possible solutions.
Malnutrition in the elderly is often underdiagnosed. Careful nutritional assessment is necessary for both the successful diagnosis and development of comprehensive treatment plans for malnutrition in this population. My residents prefer to eat traditional Korean food and they go grocery shopping once in twice week and spend around $100 each. They receive extra foods such as canned goods, juices, cerealetc. from the nutrition program for senior.Although they maintainhealthy eating with balanced diet with variety of food sources, their BMI are less than body requirement. Thus, from the short assessment for nutritious condition of my residents (nutritional history, dietary restriction or history, medical history) and from the grocery shopping assessment, I recommend them theimportance of maintaining adequate caloric intake; minimum Kcal 2000 per day including the basic four group of food as well as vitamins and mineral adequately, provide referral to community nutritional resources such as Meals-on-Wheels or hot lunch programs for seniors as indicated and encourage exercise to increase appetite. Lastly, I recommend them to establish appropriate short and long range of goal otherwise they may lose interest in addressing this