Emily Stuart, apetito Dietitian
Good nutrition and hydration play a critical role in the health and wellbeing of residents. The right nutrition and adequate hydration can not only prevent unintentional weight loss but can help control the symptoms of on-going conditions such as gastrointestinal difficulties and can help to prevent falls and other common issues among older adults.
It is important to provide residents with regular, nourishing meals which provide impactful levels of energy and protein, with due consideration also given to the overall balance of the meal, including the inclusion of starchy carbohydrates and adequate fruit and vegetables to help them meet their 5-a-day.
Providing residents with smaller meals, that are energy dense, may be a recommended option, particularly for those with small appetites and who are malnourished or at risk of becoming so. Making snacks available to residents which are high in energy and protein between meals is also a simple and effective way to increase their dietary intake. Puddings should also be encouraged after main meals for most residents, as they can contribute valuable energy to a person’s diet and can be a more manageable portion size (alongside being very tasty).
When planning menus to provide energy dense options, it is important care homes take all dietary requirements into consideration, including allergens, religious and cultural requirements, and lifestyle choices (e.g., veganism) to ensure all residents at risk of malnutrition receive a nutritious meal. Care homes may also consider making therapeutic diets, such as finger foods, available to residents who may struggle to use cutlery, for example those living with dementia or with dexterity issues.
What’s more, hydration is a key part of a resident’s wellbeing and is essential for preserving health. Good hydration can help to prevent and treat urine infections, reduce the risk of dizziness, headaches and falls, and assist in optimum healing of pressure ulcers. It is paramount that residents stay hydrated throughout the day, and that they have easy access to drinks at any time and place, or are frequently offered drinks if they cannot initiate providing themselves with a drink. Drinks are not limited to just water, however, and fluid needs can be met by enjoying other drinks as well, such as squash, fruit juice, tea, and coffee. Additional considerations may need to be given to the caffeine or sugar content of these additional fluids, although for many, they can provide a refreshing change to plain water.
Supporting residents recovering from COVID-19
For residents recovering from Covid 19, it is important to recognise that they are at a high risk of developing malnutrition. Care homes should ensure a sufficient provision of energy dense meals is available on menus to cater for these residents, and make sure they have access to food suitable to support their recovery.
If a resident has been admitted to hospital and spent a prolonged period intubated on the ICU, they may well be at risk of dysphagia (swallowing difficulties). As such, texture modified meals may form a part of their treatment and be crucial to recovery for those people who are on an oral diet.
When catering for residents living with dysphagia, it is important to provide them with a safe texture modified meal which contains adequate nutrition. When meals are blended in-house, this can often lead to diluted nutritional content of meals and can increase portion size thus leading to less nutritional value per gram. One way this can be overcome is through food fortification (a technique which can also be used for malnourished residents consuming a regular diet).
Fortifying a meal simply means boosting the nutritional content of your meals by adding extra calories and other nutrients via the use of certain ingredients. Simple ways to fortify a meal include adding milk, cheese, butter, or sugar to
a meal or dessert. Alternatively, caterers could use pre-prepared texture modified meals, which are created by expert food developers and in consultation with specialist dietitians, to meet industry standards and provide caterers with the reassurance that these meals are both safe and nutritious.