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Nutritional Issues

Apples and Oranges Welcome to
Apples and Oranges "
Are you wondering why "Apples and Oranges"? Apples and oranges are alike. They are fruits, edible and nutritious. They are different. They differ in color, shape and taste. In discussions we often compare Apples with Apples, and in arguments we try to compare Apples with Oranges-and all this led to the creation of the Title of the Net Program and to our net names, "Apples" and "Oranges". We are by profession, Registered Dietitians. Our experience as dietitians extends from Consultants in long-term Care Facilities to Hospital Dietitians and anything in between. "Apples and Oranges" is a new adventure for us. Our mission, is to inform you of nutritional issues and information to help you make intelligent decisions to enjoy eating and remain healthy.

Food is important to all of us. After all, we have been eating all our lives. Food and fluids are essential for life. They provide needed calories, protein, vitamins and minerals. Nutrition is defined as

1. The process of nourishing or being nourished, especially the process by which a living organism assimilates food and uses it for growth and for replacement of tissues.

2. The science or study that deals with food and nourishment, especially in human beings.

3. A source of nourishment; food.

A daily diet of foods that contain the nutrients we need will give us a good start toward feeling good and being healthy. The nutrients in the foods we eat affect every cell in our body. It affects our skin, bones, teeth, brain, heart, eyes, kidneys, liver and other organs, blood, and a lot more. This is a great reason to eat right. After all, we want to have our entire body as healthy as possible.

Today's topic: You, Your Family, and the Dietary Department in a long-term Care Facility

Are you thinking of becoming a nursing home resident? Or are you looking to place a family member or friend in a nursing home? We think you should know, or at least be aware of :

  • Who to talk to from the dietary department
  • Questions to ask the dietary staff
  • What to look for, and What You Should Expect from the Dietary Services

Remember-Eating and Enjoying Meals and Snacks are foremost to our Quality of Life.

Who to talk to from the Dietary Department

There are two key people in the dietary department we recommend you talk to: the Food Service Supervisor (some facilities name the position as Food Service Director) and the Registered Dietitian. Of course, anyone else would also be a good choice, like the cook.

Generally, the Food Service Supervisor is responsible for the purchasing of food, supplies and equipment; food preparation (cooking and preparing foods); the meal service (the delivery of food to the resident); and the sanitary conditions in the dietary areas (kitchen, refrigerators, food storage area).

The Dietitian provides the Nutritional Services for the residents. He/she approves the menus for nutritional adequacy, which means the menus must meet the standard as set by the Regulations for Licensure. He/she is responsible for the nutritional care of the resident. One of the Registered Dietitian's responsibilities, is evaluating each resident for his/her nutritional status, make appropriate recommendations to maintain the nutritional status if normal, or improve the resident's nutritional status when needed. In case we've lost you, please, be patient, I'll try to explain. Remember we stated that nutrients are essential. Each nutrient has a role to play in keeping us healthy. Well, if we have low stores of a nutrient or nutrients in our bodies, our nutritional status is abnormal The signs and symptoms related to nutrient deficiencies, depending on the nutrient(s), may be physical such as being weak and tired, underweight, and showing evidence of slow wound healing, or observed in laboratory tests such as blood tests. The Registered Dietitian evaluates the physical symptoms and laboratory tests results. He/she then provides recommendations to the MD and facility staff, and then develops a plan for the nutritional care of the resident. Another responsibility of the Registered Dietitian, is to approve the therapeutic diet menus for nutritional adequacy as well as insure that the therapeutic diet menus are in accordance with the Diet Manual and accepted practices.

Questions to ask the dietary staff

Ask the Food Service Supervisor to see the menus, you may want to ask for a copy. Take a good look at the foods listed. There should be a second or alternate item on the menu for each noon and night meal. Do you or your family member like the foods on the menus? That's very important. Three meals a day, seven days a week you better like the foods offerred. Ask the Food Service Supervisor if the resident is visited on admission and periodically for food preferences, and are the foods served to the resident. The Food Service Supervisor should be able to tell you if the menus are followed, and how the resident gets the alternate food item if he/she wants it. Ask what is served if the resident does not like either item on the menu. Check the menus. Each day should include a minimum of six ounces of meat, fish, poultry, eggs, cheese or other high protein food, sixteen ounces of milk, four servings of fruits or vegetables, and four servings of bread, or bread substitute such as spaghetti, or cereal. If you have questions about the food groups, ask the Registered Dietitian to explain them and show you that the menus include the foods and adequate size servings to meet the minimum standard. If he/she likes big meals, inquire as to the availability of large portions.

Inquire as to the times the meals are served. Ask questions. If the night meal is too early, is it possible to eat at a later time? The Food Service Supervisor can provide answers.

Ask the Food Service Supervisor how the food is prepared. Try to find out if most of the entrees are prepared or cooked by staff at the facility or are most of them convenience foods straight from the freezer! We do recognize that there are some good convenience foods, but others don't belong in the nursing home.

Check what foods and beverages are offered between meals. You can take a look in the nourishment kitchens on the units to see what's there. Chances are, the foods there, are the foods served between meals.

Sanitation? Ask to tour the kitchen areas, or at least peek through the door. Ask yourself is the kitchen clean, neat and tidy; does the dietary staff appear clean and neat. Now, be a little reasonable, we're not expecting total cleanliness, they are working, but you shouldn't see yesterdays food on the floor. You get the drift.

If your family member has a disease, or condition that requires a therapeutic diet, we strongly recommend that you discuss the information with the Registered Dietitian. He/she should inform you of the therapeutic diets available in the facility. Recent trends have included liberalizing therapeutic diets for residents in nursing homes, and "Apples" and "Oranges" agrees with the trend. We have, and continue to recommend, based on the resident's nutritional status, the most liberal diet the resident can tolerate without compromising his/her health. In most cases, the doctor will agree and change the diet to the one recommended. It is important to us that the residents eat their meals, and if a more liberal diet makes the difference, why not?

What to look for and What You Should Expect from the Dietary Services

May we suggest you observe a meal or two and take notes-was the tray attractive, the food prepared properly, the menu followed, and most importantly would you eat the meal?

You should expect the Dietary Department to serve meals and snacks which are nutritious, palatable, adequate in portion sizes, and include foods you enjoy.

Our Best to You in Your Search for a long-term Care Facility. Bye for now. See you next time on the Net.

'Til then---HAPPY EATING!

Apples and Oranges

The American Heritage® Dictionary of the English Language, Third Edition copyright © 1992 by Houghton Mifflin Company. Electronic version licensed from InfoSoft International, Inc. All rights reserved.


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