SERIES: NUTRITION ISSUES IN LONG-TERM CARE
Using Evidence-Based Organizational Strategies to Prevent Weight Loss in Frail Elders : Page 4 of 4
Optimal resident dining experiences require individualized care with multilevel interdisciplinary strategies.57 Nutritional support teams have been shown to improve outcomes and safety, although they are not well used.58 Dietitians, occupational therapists, physical therapists, and activity staff are all instrumental in facilitating pleasant dining and social experiences. Dining room observation by professionals from several disciplines could provide assistance in meeting the needs of individual residents. Dietitians can help monitor each resident for early detection and treatment of changes in eating patterns or behaviors, and they can suggest and oversee food and mealtime interventions. Physical and occupational therapists can consider client needs and environmental factors to help develop effective strategies to facilitate residents’ independence at mealtime. Speech therapists can monitor and observe swallowing difficulties. Activity staff, who plan social events usually involving food, can meet residents’ needs if they have knowledge of nutritional issues during the planning process. DONs need to facilitate open communication and teamwork with the interdisciplinary team to promote quality improvement and quality care for residents.36
Unintentional weight loss is a multifactorial problem for frail elders, but it is a cardinal feature of frailty and must be addressed with urgency and individualized care. Undesirable weight loss can increase the risks of mortality and morbidity and also decrease quality of life in long-term care residents. Evidence-based clinical practices to prevent and treat unintentional weight loss in frail elders are well known, whereas organizational strategies to prevent and treat weight loss are not as well known and therefore underutilized. Nurse leaders have been less aggressive in implementing management and leadership decisions that are evidence-based and could lead to organizational improvements. The potential impact of organizational strategies is far greater than the impact of a single clinician using evidence-based clinical interventions for one resident. Residents at risk of unintentional weight loss deserve to benefit from the implementation of evidence-based organizational strategies.
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The authors report no relevant financial relationships.
Address correspondence to:
Mary J. Dyck, PhD, RN, LNHA
Mennonite College of Nursing
Illinois State University
Campus Box 5810
Normal, IL 61790-5810