Appetite and weight tend to decrease slowly as older people who manage their own shopping, food preparation and eating reduce dietary intake without realising it. Family members and carers who see the person regularly may only begin noticing the weight loss after significant physical changes have occurred. While the causes of weight loss are complex, here are a few indicators that someone may need dietary intervention:
Unplanned weight loss in the last 3-6 months
Falling Body Mass Index (BMI)
Reduced nutritional intake
Low levels of nutrients noted during blood analysis
A history of alcohol misuse
Use of medicines including insulin, chemotherapy, antacids, or diuretics.
Dieticians specialise in improving and optimising nutrition by considering the needs and preferences of the individual. Early, practical intervention can help in maintaining general health, activity levels and independence for older people living in the community and in residential aged care.
About Empower
We Change Lives
Empower Healthcare is a national allied-health service provider and partner with Home Care package providers, NDIS plan managers & Aged Care organisations to deliver life changing allied health services. We offer a full-service platform from physiotherapy, occupational therapy, podiatry, dietetics to osteopathy, massage therapy and most recently, home nursing services and pride ourselves in the delivery of high-quality therapy solutions, value packed services and responsive ethos.
It is a very exciting time with Empower Healthcare building on the success of its Victorian operation and now expanding nationally into NSW & WA. With a growing team of 100+ clinicians, we provide over 1,500 treatments every day and service more than 100 healthcare organisations. Building on this strong foundation, we are well positioned and committed to delivering exceptional care.
Our therapists genuinely care about the people we work with and take the time to build strong relationships that holistically improve social, physical and mental wellbeing to live happier and healthier lives.
How To Get Clients Started With Our Home Care & NDIS Services
Simply click on the image below for our referral form.
Malnutrition is a common cause of loss of vitality and poor health outcomes in older people.
Reduced dietary intake of essential nutrients and calories often occurs as a result of a combination of conditions and factors that can make food preparation and eating difficult and unappealing for older adults. Getting to the bottom of why someone may be developing nutrient and calorie deficits and implementing strategies to improve diet and quality of life can take time and expertise.
A dietitian can assist in the management of at-risk older people living in the community and residential aged care settings by:
1. Screening to ascertain the BMI and nutritional intake of people experiencing unwanted weight loss.- Comprehensive assessments to determine the causes of malnutrition.
2. Implementing “Food First” strategies like eating small but frequent, high energy, high protein snacks and meals.
3. Implementing nutrition support for malnourished people who are unable to maintain body weight by food intake alone.
4. Developing practical and appropriate meal plans and schedules to improve daily nutritional intake.
5. Supporting people in the community to access meal and food services that meet their individual tastes, dietary needs, and abilities.
6. Improve the quality of life of ageing clients by increasing the energy they have available to participate in social and community activities.
Diet and food preferences are personal and often sensitive matters, dieticians work with individuals to create the best personalized and enjoyable solutions for people struggling to maintain adequate nutrient intake.
Empower’s dietetic services is available across all of our service channels, residential aged care, home care and NDIS. Please click on the relevant link below to learn more.
About Empower
We Change Lives
Empower Healthcare is a national allied-health service provider and partner with Home Care package providers, NDIS plan managers & Aged Care organisations to deliver life changing allied health services. We offer a full-service platform from physiotherapy, occupational therapy, podiatry, dietetics to osteopathy, massage therapy and most recently, home nursing services and pride ourselves in the delivery of high-quality therapy solutions, value packed services and responsive ethos.
It is a very exciting time with Empower Healthcare building on the success of its Victorian operation and now expanding nationally into NSW & WA. With a growing team of 100+ clinicians, we provide over 1,500 treatments every day and service more than 100 healthcare organisations. Building on this strong foundation, we are well positioned and committed to delivering exceptional care.
Our therapists genuinely care about the people we work with and take the time to build strong relationships that holistically improve social, physical and mental wellbeing to live happier and healthier lives.
How To Get Clients Started With Our Home Care & NDIS Services
Simply click on the image below for our referral form.
No one wants to deal with an enquiry from the Aged Care Quality and Safety Commission. Neither do you want the heightened stress from a choking incident possibly damaging the credibility of your facility. And what if an investigation determines the incident as a premature and preventable fatality? Transitioning to the International Dysphagia Diet Standardisation Initiative (IDDSI) global framework could be one of many strategies that protects the reputation of your organisation by reducing these risks and increasing the safety and well being of your consumers.
Part 2 of the IDDSI blog series explains how the IDDSI framework trumps the current Australian Standards and how we can help you and your staff either begin or complete accomplishment of the transition process.
The size of the problem
As dysphagia often happens at the same time as other health conditions, it is difficult to be certain of the prevalence rate. However, and alarmingly, research indicates that 50-75% of nursing home residents have a prevalence of dysphagia (1).
And as you may be aware, many of these instances can be avoided if dysphagia is treated timely and appropriately.
What is more worrying, is that if dysphagia is not treated appropriately by staff, then besides choking, associated health complications include pneumonia, chest infections, dehydration, malnutrition and weight loss.
Often dysphagia residents exhibit sociated declined health, so staff will have difficulty in administering medication and this can result in hospital admissions. In the worst cases, dysphagia can result in death.
When Professor Joe Ibrahim, Head of Health Law and Ageing Research Unit at the Department of Forensic Medicine at Monash analysed nursing home deaths within a 15-year period, he found over 3,000 deaths were considered premature and preventable (2).
“The study showed that choking was the second highest incidence that caused premature deaths in nursing homes.”
Don’t leave your residents to chance and become a statistic.
Why does the IDDSI Framework Trump the Australian Standards
While we have had voluntary national terminology in Australia that addresses food textures and thickened fluids for people with swallowing problems since 2007, the (IDDSI) Committee created global standardisations based on comprehensive evidence-based best practice. From recorded experiences, the recommendations accommodate a greater spectrum of severity, so there is far more accuracy in serving food textures and drink thicknesses appropriate for individual conditions.
Additionally, these standards have been introduced to reduce the variation in care. While staff are transient across geographic locations, a global standardisation aids in a universal understanding and approach that minimises risk.
There are three major changes between the existing Australian terminology to the IDDSI framework, such as 1. a new numbering system 2. colour code changes denoting the thickness of drinks, and 3. the removal of bread and sandwiches from the new IDDSI Level 6 Soft & Bite-Sized category.
By transitioning to the IDDSI standards, you and your staff can have peace of mind, knowing another advisory and protection level has been added, with these standards supported by peak bodies such as Speech Pathology Australia, Dietitians Association of Australia and the Institute of Hospitality in HealthCare. As all relevant health professionals are educated and trained to adopt the standards, further benefits yielded will include improved communication and collaboration.
Australia is joining more than 20 other countries including New Zealand, the US, Canada, and several European nations in implementing it.
The best way to implement this framework is through an AWARE-PREPARE & ADOPT strategy.
And this is where I can be of help to you.
I have created a FREE informative presentation for your staff involved in care and catering that addresses the first stage of Awareness.
Dietitians are experts in food and nutrition. They assist people with optimising their diet and nutrition to improve one’s health and quality of life, and to prevent and treat a range of chronic health conditions. Dietitians can also help patients manage nutrition at different stages of life, nutrient deficiencies, and food intolerances and allergies. Dietitians have sound university training accredited by the Dietitians Association of Australia (DAA), and undertake continuous professional development that complies with the DAA guidelines for best practice.
Dietitians perform thorough nutrition assessments and monitoring, taking into account various factors including a patient’s medical, clinical and diet history, individual nutritional requirements and their health goals. This information helps accurately diagnose nutrition issues and forms a treatment plan that ensures patients receive quality evidenced-based care and achieve the best health outcomes.
Since 1 May 2019, many hospitals, health care professionals, aged care organisations, disability providers, community groups and industry have been transitioning from the Australian Standardised Terminology to the global International Dysphagia Diet Standardisation Initiative ( IDDSI ) standards.
Today I would like to raise with you the importance of implementing the IDDSI framework and recommendations so that clinical care managers, food service team and nursing staff of residential aged care facilities are empowered to collaborate and create a positive impact in their facility.
Setting the Scene – The Size of the Problem
Did you also know that Dysphagia affects 50 to 75% of residents in aged care facilities?
The International Dysphagia Diet Standardisation Committee recognised the need to create a ‘common language’ for dysphagia diets, to describe food textures and drink thickness to reduce the risk of incidence choking.
The incidence of choking on food is a whopping seven times greater for people over the age of 65 years presenting with frailty or acute illness. confusion amongst health and care workers combined with miscommunication regarding diet textures and drink consistencies, has resulted in increased choking deaths across Australia.
Due to these alarming statistics revealed today, The NSW Ombudsman’s report into Reviewable deaths of people with Disability in Residential Care, recommended that to reduce preventable deaths there must be improvement in identification and management of swallowing and choking risks and better communication about food textures that are safe for people with dysphagia to eat.
Prevention is the Key
Many instances of choking can be avoided if dysphagia is treated timely and appropriately.
What is more worrying, is that if dysphagia is not treated appropriately by staff, then besides choking, associated health complications include pneumonia, chest infections, dehydration, malnutrition and weight loss.
And with dysphagia residents exhibiting sociated declined health, staff will have difficulty in administering medication and this can result in hospital admissions. In the worst cases, dysphagia can result in death.
No one wants to deal with an enquiry from the Aged Care Quality and Safety Commission including the heightened stress arising from the possibility of a facility facing a credibility risk, especially if the investigation determines the incident as a premature and preventable fatality.
When Professor Joe Ibrahim, Head of Health Law and Ageing Research Unit at the Department of Forensic Medicine at Monash analysed nursing home deaths within a 15 year period, he found over 3,000 deaths were considered premature and preventable.
The study showed that choking was the second highest incidence that caused premature deaths in nursing homes.
What’s the Difference?
There are three major changes between the existing Australian terminology to the IDDSI framework, such as:
A new numbering system
Colour code changes denoting the thickness of drinks, and
The removal of bread and sandwiches from the new IDDSI Level 6 Soft & Bite-Sized category.
Why Implement IDDSI Standards and Framework?
While we have had voluntary national terminology in Australia that addresses food textures and thickened fluids for people with swallowing problems since 2007, the IDDSI Committee has created global standardisations based on comprehensive evidence-based best practice. Several years of pilot trials can now provide greater assurance that meals and drinks are prepared appropriately and according to the severity of dysphagia.
These standards have been introduced to reduce the variation in care. While staff are transient across geographic locations, a global standardisation aids in a universal understanding and approach that minimises risk.
Moreover, staff can have peace of mind knowing peak bodies such as Speech Pathology Australia, Dietitians Association of Australia and the Institute of Hospitality in HealthCare support these standards and add another protection level when dealing with dysphagia consumers.
As all relevant health professionals become educated and trained to adopt the IDSSI standards, further benefits yielded will include improved communication and collaboration.
Australia has now joined more than 20 other countries including New Zealand, the US, Canada, and several European nations in implementing IDDSI.
The best way to implement this framework is through an AWARE, PREPARE & ADOPT strategy.
Author,
Shirley Webber, Dietitian
Is Your Team Aware of IDDSI?
I have been helping several facilities introduce the IDDSI framework and I can help your facility too.
I have created a FREE educational presentation for your staff involved in care and catering that address the first stage of Awareness.
Ideal for catering managers, food service assistants, cooks, chefs, clinical managers and nursing staff in residential aged care settings.
What they will learn:
What is IDDSI and why it’s needed
Explanation of the changes from existing to new standards
The IDDSI Framework including detailed descriptions of each food and fluid texture
Practical demonstration of apply the IDDSI Flow & Food test, and adjusting consistency
Implementation, resources and tools to aid adoption and implementation
The practicalities of applying the IDDSI Framework
Following the presentation:
Your senior management team walk away with a fresh perspective and transition readiness to start the mapping the preparation and handling process of foods and liquids in your facility.
Care staff confidently categorise and test foods by important food characteristics such as moistness, stickiness, hardness and toughness including particle size for minced foods.
Watch this video to learn more about the workshop.
