Approaches to Increase Food and Fluid Intake
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Super
Snack Menu 
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Description:
This is a nutrient-dense, one-week cycle snack menu for
residents which offers a variety of good tasting, high-calorie/high-protein
snack foods twice daily. (regular or reduced concentrated
sugars, RCS)
This schedule is geared to decrease snack
fatigue and increase nutrient intake.
Format:
PDF file requires a reader such as Acrobat Reader. Free
Download of Acrobat Reader
Instructions:
Download and save in your
"My Documents" file as a PDF file. Print
out these menus and reproduce for use by
your foodservice staff in preparing a snack
regimen for your residents.
 Super
Snack Menus available:
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How-To
Guide for Interdisciplinary Resident Dining Program
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Description:
This
is a 12-page guide with step-by-step instructions for developing
and maintaining an effective dining program that assures
adequate assistance at mealtime for every nursing home resident.
Sample worksheets and training tips are included to help
plan and organize a customized program.
Format:
PDF file requires a reader such as Acrobat Reader. Free
Download of Acrobat Reader
Instructions:
Download and save in your
"My Documents" file as a PDF file and print.
Guide
available:
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Hydration
Program
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Description:
This program includes helpful guidelines, tools and directions
for the development and maintenance of an effective, comprehensive
nursing home hydration system. Various components address
tracking of fluid intake between meals, utilization of a
hydration cart, and the use of a dehydration checklist.
Format:Microsoft
Word files require Microsoft Office software.
Instructions:
Download and save in your "My Documents" file
as a Word or Excel file. Modify printed materials as needed.
Materials
available:
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Food
and Hydration Aide Staff Position (FHA)
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Description:
The Food and Hydration Aide staff position (FHA) is central
to the interdisciplinary team approach we designed to 1)
increase food and fluid intake in long term care residents
and 2) more accurately and efficiently identify nutrition
and hydration problems. Conceived as a specially trained
CNA that report findingsto both the Dietary and Nursing
departments, the FHA "bridges the gap" between
traditional Dietary and Nursing responsibilities.
In addition to assisting residents with food and fluid intake,
the responsibilities of the FHA are integral to the following:
1)
Validated method for documenting food and fluid intake at
meals (FFED);
2) Hydration Program, including documentation of between-meal
fluid intake (BEV);
3) Determining stature via knee height; and
4)
Obtaining and trending accurate body weights.
Format:Microsoft
Word and Excel files required Microsoft Office software.
Instructions:
Download and save in your "My Documents" file
as a Word or Excel file. Modify printed materials as needed.
Materials
available:
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Resident
Assessment
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Nutrition
Risk
Assessment: Form, Guide,
Strategies and Interventions
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Description:
These materials were developed by the
American Dietetic Association's (ADA) Long Term Care Task
Force, Consulting Dietitians in Health Care Facilities (CDHCF)
Practice Group of the ADA, and the Health Care Financing
Administration. A detailed itemization of coded nutrition
risk factors (e.g. number and stage of pressure ulcers,
chewing and swallowing ability, disease state, etc.) allows
for quick determination of nutrition risk level. The forms
include a comprehensive list of suggestions and procedures
to be followed in order to help decrease risk factors.
Format:
Materials must be ordered.
Instructions:
Download ordering information
and forms from the CDHCF
web site.
Materials
available:
(http://www.cdhcf.org/products/p5014.html)
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Validated
Method for Documenting Food and Fluid Intake at Meals
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Description:
This method for estimating food and fluid
intake at meals was developed specifically for, and validated
in, the routine nursing home environment. Resulting meal
intake estimates may be recorded in the medical record via
a facility's existing recording system or via the specially
developed FOOD AND FLUID INTAKE TRACKING form.
The advantages of this system are the increased accuracy
of food intake estimates and the availability of separate
fluid intake estimates for meals.
Format:Microsoft
Word files require Microsoft Word software.
Instructions:
Download and save in your "My Documents" file
as a Word or Excel file. Modify printed materials as needed.
Materials
available:
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Determining
Stature via Knee Height
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Description:
A number of common disabilities and disease
processes make it difficult to accurately measure standing
height in most nursing home residents. It is logical to
choose an alternate method for measuring stature that can
be applied to a majority of residents. Knee height, in combination
with the use of standard formulas, is an appropriate choice.
Knee height can be measured accurately and efficiently if
this responsibility is assigned to a few well-trained staff
who perform these measures on a daily basis (e.g., FHA Staff
Position). The RD or DTR can calculate stature from the
knee height measure. An alternative method can be used for
bi-lateral amputees or contracted residents.
Format:Microsoft
Word files require Microsoft Word software.
Instructions:
Download and save in your "My Documents" file
as a Word file. Modify as needed.
Materials
available:
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Obtaining
and Trending Accurate Body Weights
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Description:
An accurate body weight obtained at frequent intervals is
one of the most reliable, inexpensive and non-invasive ways
to identify when a resident is not obtaining adequate nutrition
and/or hydration. Included here are simple methods to obtain
and trend accurate body weight measures so that residents
in need of intervention can be identified in a timely fashion.
This method has 5 elements:
1)
simple method to assure accuracy of scales;
2) assignment of responsibility for body weights to a few
well-trained staff who perform these measures on a daily
basis (e.g., FHA Staff Position);
3) simple step-by-step approach to obtaining accurate weights;
4) weight trending form (12-month) for the medical record;
and
5) pre-programmed Excel spreadsheet for ongoing calculation
of significant weight changes.
Format:Microsoft
Word and Excel files require Microsoft Office software.
Instructions:
Download and save in your "My Documents" file
as a Word or Excel file, modify rpintedmaterials as needed.
"Do not disable macros in Excel Weight Change Spreadsheet".
Materials
available:
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Educational Tools for Staff
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Nutrition
Care Alerts,
Presentation
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Description:
These in-service presentations, based on the Nutrition
Screening Initiative's Nutrition Care Alerts,
focus on the importance of nutrition, the problems that
lead to malnutrition, dehydration,
and pressure ulcers, and steps staff can take to prevent
or correct these problems. Presentations are available
for professionals (advanced version)
such as nurses and administrators and for non-professionals
(basic version) such as nursing aides and foodservice
staff.
Format:
Microsoft PowerPoint file requires
Microsoft PowerPoint software.
Free PowerPoint Reader available
Instructions:
Download and save in your "My Documents" file
as a PowerPoint presentation. Use in nutrition care related
in-services with all staff in your facility.
Presentations
available:
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Nutrition
Care Alerts,
Warning Signs and
Action Steps Poster
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Description:
These colorful, highly visible posters, based on the Nutrition
Care Alerts, lists the warning signs of involuntary
weight loss and dehydration along with their respective
action steps staff can
take to prevent or correct these problems. A blank space
remains at the bottom left hand side of the poster so that
each facility can add their own program logo.
Format:
Microsoft PowerPoint file requires Microsoft PowerPoint
software.
Free
PowerPoint Reader available
Instructions:
Download and save in your "My Documents" file
as Nutrition Care Alerts Poster. Insert your
facility logo in the blank space at the bottom of the poster.
Modify as desired. Print posters in color or black-and-white.
Enlarge to desired size.
Posters
available:
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Nutrition
Care Alerts, Warning Signs and Action Steps Pocket Cards
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Description:
This set of pocket-sized cards can easily be
carried by nurses and nursing aides and act
as an individualized reminder of the Nutrition Care
Alerts. Each card in the set has the warning signs
for one of the nutrition themes (unintentional weight loss,
dehydration, pressure ulcer, and complications from tube
feedings) on one side, and the action steps to be taken
on the other.
Format:
Microsoft PowerPoint file requires
Microsoft PowerPoint software.
Free PowerPoint Reader available
Instructions:
1. Download the file.
2. Print out every two slides back-and front on one
sheet of paper. Slide one (1) should be the front of the
first page and slide two (2) should be the back of the first
page, slide three (3) should be the front of the second
page and slide four (4) should be the back of the second
page, and so on until you have a total five pages including
the cover page. For longer-lasting cards or a more formal
look, use heavy-bond paper or cardboard (if your printer
can handle it). You may also want to use colored paper.
3. If you want to produce many packets for a large
number of staff members, copy the slides-back-and-front-now.
Each set of slides will produce six (6) pocket card sets.
4. Assemble the five pages so that the slides are
in the same order as they appear in the file. The cover
page with the title "Nutrition Care Alerts" should
be on top and "Warning Signs!" should be the front
and "Action Steps" should be the back of each
subsequent page. The individual categories should be in
the following order: Unintended Weight Loss, Dehydration,
Pressure
Ulcers, and Tube Feedings.
5. Once assembled in this order, cut the entire package
once down the center and twice across (preferably using
a paper cutter) to form six (6) small, individual packets.
6. These packets can now be held together in the
top left corner with whatever seems most convenient or appropriate
to you. You may staple the packet together, or for a more
formal appearance, a rivet or a small ring can be used.
Distribute the cards among your CNAs, nurses, and other
staff members or individuals involved in the care of residents.
Pocket
cards available:
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Warning
Signs and Action Steps for Caregivers in
Nursing Facilities
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Description:
This is a one-page (back and front) handout
listing the warning signs that may potentially result in
involuntary weight loss, dehydration, pressure ulcers, and
complication from tube feedings. The warning signs are accompanied
by action steps that staff and family members may take to
help correct and prevent these
problems.
Format:
PDF file requires a reader such as
Acrobat Reader. Free
Download of Acrobat
Reader
Instructions:
Download and save in your
"My Documents" file as a PDF file or order in
bulk. For Download, print this handout in black-and-white
or in color and reproduce for distribution in your facility.
Handout
Available:
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Warning
Signs and Action Steps for Caregivers in Home Care
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Description:
This is a one-page (back and front) handout listing the
warning
signs that may potentially result in involuntary weight
loss, dehydration, pressure ulcers, and complication from
tube feedings. The warning signs are accompanied by action
steps that caregivers may take to help correct and prevent
these problems.
Format:
PDF file requires a reader such as Acrobat Reader. Free
Download of Acrobat
Reader
Instructions:
Download and save in your
"My Documents" file as a PDF file or order in
bulk. For Download, print this handout in black-and-white
or in color and reproduce for distribution to caregivers
of residents being discharged from the LTC facility to residential
facilities or home.
Handout
Available:
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| Food
Safety Posters
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Description:
These colorful posters developed by the United States Department
of Agriculture (USDA) contain basic food safety information
on the importance of personal hygiene, proper cleaning of
utensils, and safe food temperatures.
Format:
PDF file requires a reader such as Acrobat Reader. Free
Download of Acrobat Reader
Instructions:
Download and save in your "My Documents" file
as a PDF file. Print out these posters and display in appropriate
food handling areas in your facility.
Posters
available:
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Residents/Families/Care Givers: |
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Nutrition
Care Alerts,
Pamphlet for Caregivers
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Description:
This is a colorful, tri-fold pamphlet containing basic information
(based on the Nutrition Care Alerts) on nutrition and hydration
care to educate family members and caregivers of the importance
of nutrition care.
Format:
Microsoft PowerPoint file requires
Microsoft PowerPoint software.
Free
PowerPoint Reader available
Instructions:
Download and print out this
pamphlet in black-and-white or in color.
Reproduce back to back. The pamphlet should have two folds
with one side of the page opening to the right, the other
to the left. Distribute to family members or caregivers
of residents.
Pamphlets
available:
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