Assisting with Nutrition and Hydration in - …

1 Assisting with Nutrition and Hydration in Long-Term Care By Hartman Publishing Inc. Managing Editor Susan Alvare Proofreader Suzanne Wegner Cover and Interior Designer Kirsten Browne Illustrators Thaddeus Castillo/Robert Christopher Page Layout Thaddeus Castillo Photography Art Clifton/Dick Ruddy/Susanita Marcos Sales/Marketing Gailynn Garberding/Debbie Rinker/Yvonne Gillam Customer Service Joey Tulino/Yvonne Gillam Copyright Information 2004 Hartman Publishing, Inc. 8529 Indian School Road, NE. Albuquerque, NM 87112. (505) 291-1274. web: e-mail: All rights reserved.

2 No part of this book may be reproduced, in any form or by any means, without permission in writing from the publisher . ISBN 1-888343-73-7. Notice to Readers Though the guidelines and procedures contained in this text are based on consultations with healthcare professionals, they should not be considered absolute recommendations. The instructor and readers should follow em- ployer, local, state, and federal guidelines concerning healthcare practices. These guidelines change, and it is the reader's responsibility to be aware of these changes and of the policies and procedures of her or his employer.

3 The publisher, author, editors, and reviewers cannot accept any responsibil- ity for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the contents of the book. The publisher does not warrant or guarantee any of the products described herein nor perform any analysis in connection with any of the product information contained herein. Gender Usage This textbook utilizes the pronouns he, his, she, and hers interchangeably to denote healthcare team members and clients.

4 Acknowledgments A special thanks for our insightful and always available reviewers: Jean P. Stanhagen, RN, BSN. Bethel Park, PA. Jeanne Miles, RN. Haven, KS. Sharon L. Hopper, RN, SDC. CNA Instructor Oneida, NY. Kathy J. Archer, BS, RN. Nursing Assistant Program Specialist The Community College of Baltimore County Baltimore, MD. Margaret Pearson CEO/Program Director P&A Nursing Philadelphia, PA. Anne Snyder COO/Educational Director P&A Nursing Philadelphia, PA. Mattie Scott, RN. Galesburg, IL. Table of Contents 1 2. Explain verbal and nonverbal communication.

5 15. The Dining Assistant 1 3. Identify barriers to 1. Explain the need for dining communication ..16. assistants ..1 4. List ways to make communication 2. Describe the role of the dining accurate and complete ..18. assistant ..2 5. Explain how to develop effective 3. Explain why promoting independence interpersonal relationships ..19. is important ..4 6. List guidelines for 4. Identify the residents you will be communicating with residents Assisting ..4 with special needs ..21. 7. Describe appropriate responses to 2 resident behavior ..25. Residents' Rights 6 8.

6 Explain how communication affects nutritional status ..27. 1. Explain Residents' Rights ..6. 9. Identify signs and symptoms of 2. List examples of behavior supporting swallowing problems and explain and promoting Residents' Rights ..7 how to communicate concerns ..28. 3. Define the terms abuse and neglect and list signs of abuse and neglect ..8. 4. Infection Control 31. 4. Discuss the ombudsman's role ..10. 1. Define terms related to infection 5. Explain HIPAA and list ways to control and explain the chain of protect residents' confidentiality ..10 infection.

7 31. 6. Explain The Patient Self- 2. Explain why the elderly are at a higher Determination Act (PSDA) ..13 risk for infection ..33. 3 3. Identify when to wash hands ..33. 4. Identify when to wear gloves ..35. Communication and 5. Define bloodborne pathogens and Interpersonal Skills 15 explain OSHA's Bloodborne 1. Define communication ..15 Pathogen Standard ..36. 6. Explain Standard Precautions and 2. Describe how to make dining Transmission-Based Precautions .36 enjoyable for residents ..54. 7. Explain signs, symptoms, and causes 3. Explain how to serve meal trays.

8 55. of foodborne illness ..38. 4. Demonstrate how to assist a resident 8. Identify why the elderly are at higher with eating and drinking ..57. risk for foodborne illness ..38. 5. Demonstrate how to feed residents 9. Describe ways to prevent the spread who have special needs ..59. of infection ..38. 5 7. Safety and Emergency Care 64. Proper Nutrition and 1. Describe how the dining assistant Hydration 42 can promote safety ..64. 1. Describe the importance of good 2. Explain the dining assistant's role in Nutrition ..42 emergencies ..65. 2. Identify nutritional problems of the 3.

9 Demonstrate knowledge of first aid elderly or ill ..42 procedures ..65. 3. List the six basic nutrients and explain the USDA Food Guide Pyramid ..43. 8. Assisting Residents with 4. Explain the role of the dietary department ..45. Dementia 75. 1. Define dementia and recognize its 5. Describe factors that influence food causes ..75. preferences ..46. 2. Describe Alzheimer's disease and 6. Describe how to prevent dehydration identify its stages ..75. and identify symptoms that must be reported ..46 3. List strategies for better communication with Alzheimer's 7. List ways to identify and prevent residents.

10 77. unintended weight loss ..47. 4. List common difficult behaviors 8. Explain special diets ..48. related to Alzheimer's disease ..78. 9. Explain thickened liquids and 5. List and describe interventions for identify three basic thickened problems with eating ..80. consistencies ..51. 6. Describe creative therapies for 6 residents with Alzheimer's disease ..81. Feeding Techniques 54. 1. Explain the swallowing process ..54. 9. Observing and Reporting Changes in Residents 85. 1. Explain why changes are important to report ..85. 2. Describe how to report factual observations.