Food and Dining
       Core components of quality of life and 
         quality of care in long term care
    The Academy of Nutrition and 
    Dietetics tells us…
     Under-nutrition affects the quality and 
      length of life
     The prevalence of protein energy nutrition 
      for residents ranges from 23% to 85%
     Malnutrition is associated with poor 
      outcomes
     Residents with evidence of malnutrition on  
      restricted diets might have restriction that 
      discouraged food intake 
                                          Factors Affecting Nutritional Status
        • Food intake typically declines even in healthy older adults. This is often 
           referred to as the “anorexia of aging”
        • Decreased appetite can be due to:
               Decrease in levels of hormones that control satiety and food intake. 
               Depression
               Multiple medications (Polypharmacy, drug–nutrient interactions, or                                                 side 
        effects: anorexia, nausea, vomiting)
                           Sensory loss that affects ability to see, smell, and taste food
                           Oral or dental changes affecting chewing/swallowing ability-most 
                    significant problem affecting nutritional intake therefore status
                    Chronic diseases including:
                    cerebrovascular accidents, Parkinson’s disease, cancer, diabetes, and 
                    dementia
                    All contribute to changes in appetite, metabolism, and energy needs
      Consequences of  Undernutrition 
   
    increased morbidly & mortality 
   
    loss of strength
   
    depression 
   
    lethargy
   
    immune dysfunction 
   
    pressure ulcers
   
    delayed recovery from illness 
   
    increased chance of hospital admission 
   
    poor wound healing
   
    Unintended weight loss
      MDS 3.0 and Section K States:
     Food and dining requirements are core 
      components of quality of life and quality of 
      care in nursing homes.  Research also tells 
      us that:
      ◦50 – 75% of residents leave 25% of their food 
       uneaten
      ◦60 – 80% of residents have physician or dietitian 
       order to receive supplements
      ◦25% of residents experienced weight loss when 
       research staff conducted standardized weighing 
       procedures over time