Affects of nutrients & identify types of diet

Physical Factors

can interfere with the nutritional status of residents such as fatigue, medications, illnesses, pain, or medical conditions. Residents that have poorly fitting dentures, have missing, broken, or loose teeth, or have sores or infections in the mouth are at risk for inadequate nutritional intake. Residents who have lost or gained weight or are dehydrated may experience a change in the way their dentures fit.

sensory changes

occur when people age and can interfere with the desire to eat. As people age, they may experience a diminished sense of smell and taste that can make eating less pleasurable. Residents with decreased vision may need assistance during mealtime including adaptive equipment and using the clock method to describe where food is located on their plate (mashed potatoes at 12:00, milk at 1:00, carrots at 6:00, etc.).

promote socialization

and should be a pleasant experience for residents. To achieve this goal, the environment should be free of unpleasant odors or excessive noise. If any conflict is noted between residents in the dining area, this should be reported to the nurse so a better seating arrangement can be made. The NA should be mindful that emotional factors such as loneliness or depression can negatively affect a resident's desire to eat. It is important to sit with residents who need assistance and keep conversations resident focused.

Regular diet

typically has no restrictions and residents eat what they desire.

Clear liquid diet

is sometimes temporarily used for residents who have vomiting or diarrhea. Clear liquids are clear (see through) and include gelatin, broth, clear soda, or juice. These liquids consist of mostly water and carbohydrates for energy and do not irritate the stomach or intestines. For residents with dysphagia, the liquids can be thickened to prevent aspiration.

Full liquid diet

may be given to a resident recovering from an illness and may be used for longer periods of time than a clear liquid diet. It may also be used for those who have digestive disorders, difficulty chewing, or who are advancing from a clear liquid diet. Full liquids are not see through and are liquid at room temperature.

Examples include sherbet, eggnog, milk, plain ice cream, yogurt, strained vegetables, and strained cereals.

Soft diet

may include variations such as a pureed diet which is blended to a smooth consistency or a mechanical soft diet where food is finely chopped. A soft diet is prepared for individuals having difficulty swallowing, chewing, or digesting food or for residents who have had a stroke (CVA).

Therapeutic diets

are ordered for special medical conditions. A registered dietician plans and manages special diets. There may be restricted portions, foods, or ingredients.

Diabetic diet:

Ordered for diabetic residents and for individuals on a reduced calorie diet for weight loss. Foods that are high in sugar are to be avoided such as honey, syrup, soda, jams, cakes, cookies, or candies. Sugar free substitutes such as Splenda or NutraSweet may be included. Carbohydrates are restricted in this diet because they break down into simple sugars in the blood stream. Diabetics must be closely observed for signs of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia). If any of the following symptoms are observed, report it to the nurse immediately. Many diabetics know when their blood sugar is too high or low, so always listen to those residents and report their concerns to the nurse.

Hyperglycemia symptoms

• Polydipsia ( excessive thirst)

• Polyphagia ( excessive hunger)

• Polyuria (excessive urination)

• Blurred vision

Hypoglycemia symptoms

• Confusion

• Tremors

• Diaphoresis (profuse sweating or feeling cold and clammy

• Anxiety

• Headaches

• Hunger

• Fatigue

• Weakness

Low sodium (low salt) diet:

Ordered for those with congestive heart failure, hypertension, blood vessel, or kidney disease. Foods that are high in sodium are restricted such as bacon, ham, lunch meats, canned soup, chips, and other processed foods. Adding salt to meals is to be avoided but a substitute such as Mrs. Dash can replace the saltshaker or packets to add flavor to foods.

Bland diet:

Ordered for residents with digestive disorders or can be used temporarily for residents with diarrhea. Spicy foods are avoided, and bland foods are encouraged.
One example of a bland diet is the BRAT diet that includes bananas, rice, apple sauce, and toast.

Low fat/low cholesterol diet

Ordered for those with diseases of the heart, liver, or gallbladder. Some foods to be avoided include fried foods, trans fats, saturated fats, margarine, butter, mayonnaise, salad dressings, and skin on poultry. Fat-free or low-fat substitutes are available.

Low calorie diet

Ordered for residents who need to lose weight and promotes better eating habits. Protein, fat, and carbohydrate intake are balanced to meet nutritional needs and weight loss goals.

Examples of therapeutic diet?

1. Diabetic diet

2. Low sodium (low salt) diet

3. Bland diet

4. Low fat/ low cholesterol diet

5. Low calorie diet