Nutrition and Palliative Care in Aged Care
Nourishing comfort, one moment at a time.
When discussions around palliative care arises, at times it may seem very gloomy – when actually, it is all about living as much as possible and as long as possible. But, let’s be frank – life might not always be a picnic, but we can still make sure the sandwiches are cut just right.
What does palliative care look like in aged care
Palliative care is an approach with the goal to improve quality of life through comfort, dignity and respect. It involves the family and the person who has an active, progressive or advanced diseases with little no prospect of cure. Palliative care identifies any symptoms that affects the person’s physical, emotional, spiritual and social wellbeing and treating each aspect accordingly.
Well, what does that mean in aged care?
Palliative care is not any different whether the person is residing in their own home, hospital or in a residential aged care home. Elderly people are being supported with high-quality care from the multidisciplinary team of doctors, nurses, allied health professionals and care staff to ensure the elderly are choosing the care they wish to have and have the right sources to do so.
Why should Dietitians be involved at times?
Nutrition is a source of comfort and pleasure, and with the help of Accredited Practising Dietitians, we know how to step up the plate. Food is not always about trying to achieve the healthiest diet, diet plans, losing weight and minimising the development other diseases. In palliative care, nutrition in applied in different ways.
How do Dietitians help
Relieving gastrointestinal discomfort such as nausea, bloating, constipation, diarrhoea
Collaborating with chefs on food ideas that aligns with resident’s goals and wants
Improving and supporting meal enjoyment
Guiding families and carers on tricky food situations and decisions
Educating carers and families on optimising meal and dining experiences
We support family members, with reassurance and letting them understand certain behaviours are normal and is part of the process – including when residents eat less and there is no need for added pressure.
Examples of Dietitian involvement in palliative care in aged care
Dietitians optimise meal experiences through creative ideas, here are some examples:
Food fortification: often residents have a very low appetite, by adding foods that are packed with nutrition into meals, this improves the quality of food in every bite.
Observing how residents eat - from the moment they sit down, pick up their cutlery and how they chew. Dietitians may suggest a smoother texture of foods to reduce chewing fatigue or suggest sippy cups if the glass cups are too heavy.
Most importantly, Dietitians listen first on what residents actually want to eat – even if that means ice-cream for breakfast or porridge for dinner.
But, what if residents who are on textured modified and wants ice cream but this is against Speech Pathology recommendations? Dietitians will speak out and refer to the Speech Pathologist to recommend the eating and drinking acknowledgement risk form, in some homes known as the Dignity of Risk form. Otherwise, Dietitians can suggest similar desserts such as yoghurt or no-melt ice-cream.
Dietitian Bite-sized Tips
Listen and follow – if a resident wants small plate of food, let’s go with it.
Ask! ‘What would you like for breakfast’, ‘how can I make lunch better for you’?
Food first approach – go for nourishing food and drinks as it is tastier and there’s more variety to offer. Limit the reliance of ‘the quick fix’ of commercial supplements
Think restructure, not restriction – if a resident wants biscuits but they are on a modified texture, how can we change those biscuits to suit their needs? For example, pureed biscuits or biscuits softened with milk.
Be adaptive and active for the resident – life can change from day to day, month to month or even from lunch to dinner. Watch out for signs, seek advice and set out strategies when needed.
The palliative process is not an end for all - it’s another approach to life with comfort and dignity at the forefront. With the help of many health professionals including Accrediting Practising Dietitians, all forming part of the process of achieving the resident’s goal at every bite.
Reach out to our team of Accredited Practising Dietitians for support!
