When people receive any type of care or support (particularly long term care) an assessment should be made about their nutrition and hydration. This should include food allergies, likes and dislikes and the support they need to eat and drink.
It is important to work in person-centred ways and to provide food which is suitable and that meets each individual’s needs.
Personal belief
Certain religions forbid some foods, and some recognise some days for fasting. It is important that you respect this.
Some individuals choose not to eat certain foods, so it is important that you know what this means. For instance, those who are vegans do not eat dairy foods as well as not eating meat.
Health conditions
It is important to know if there are any foods a person should not have because of health conditions.
For example:
People with raised blood cholesterol levels may be advised not to have too much saturated fat such as butter, fried items and pastry
People with diabetes may be encouraged to avoid too much sugar found in sweets, chocolate, sugared breakfast cereals, cakes and puddings and encouraged to eat fewer of these or smaller portions
Those who have high blood pressure may be advised to limit salt
Anyone who is obese should be encouraged to limit sugary and fatty foods
Food allergies
Difficulties eating or drinking without help
Some individuals might experience difficulties in eating or drinking without help.
This may be due to:
Forgetting to eat (perhaps due to dementia)
Side-effects of medication which may affect appetite or cause sickness e.g. some people on certain medications for depression should not have cheese
Poorly fitting false teeth e.g. can they eat normally or do they need soft food?
Physical illness such as a stroke which may have affected the individual's muscles around their mouth for chewing or hand for lifting drinks
Depression which may cause poor appetite
A visual impairment which may affect the way a person sees their food to eat it
Having arthritis in the hands which means they may need help with cutting up food or opening packs like yogurts
It is important that individuals are treated with dignity and respect. They should have plenty of time to eat, not be rushed. They should also be supported to eat and drink independently and be able to choose whether they would like to use any equipment offered to help them.
What equipment is available to support people in eating and drinking independently?
Select the image for some examples.
Technology such as clocks or reminder messages to tell someone when it is time to eat or drink
Cutlery with shaped and padded handles that can help with gripping
Two-handled mugs to help people with poor grip, tremors or weak wrists
Cups with lids to reduce the risk of spillage
One-way straws that help people to drink without the need to lift cups and glasses, even if muscle weakness has reduced their ability to suck
Non-slip mats which stop plates from moving around while people are cutting food
Plates and bowls with high sides to prevent food falling off the edges or insulated bowls which keep the food hot if the individual eats slowly
If you have concerns that an individual is not eating or drinking enough despite being encouraged and supported, you should discuss your concerns with your manager who may seek advice from a specialist such as a dietician or a nutritionist. They will ensure that additional support can be provided.
What may this additional support include?
Choose one or more options, then click the pencil.
Closer monitoring of nutrition and fluid intake
Talking to the person to identify any barriers to eating and drinking
Emphasising that good nutrition and hydration are important
Discussing the problem with the person’s carer or family member
Consulting with other workers such as doctors, therapists or dentists
Feeding and/or hydrating by force
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Additional support can include:
Closer monitoring of nutrition and fluid intake
Talking to the person to identify any barriers to eating and drinking
Emphasising that good nutrition and hydration are important
Discussing the problem with the person’s carer or family member Consulting with other workers such as doctors, therapists or dentists
Provision for nutrition and hydration must be carried out in a person-centred way. Efforts must be made to meet each individual’s needs and choices.
Their care plan is an essential part of recording and delivering this.
Select each tab for some essential guidance.
Supporting an individual to stay hydrated
Individuals should have access to fluid at all times, unless it is restricted for medical reasons
They should be encouraged to drink throughout the day and not wait until they feel thirsty, as feelings of thirst are an early sign of dehydration
To make sure that individuals are drinking enough you need to offer drinks and encourage and support them to drink as set out in their care plan
Drinks need to be refreshed regularly and placed within easy reach for those with restricted movement or mobility
If you are at all concerned about an individual’s fluid intake, make sure you report these concerns to either a senior member of staff, the individual’s carer or their family
Supporting an individual to stay nourished
Food provided should be in accordance with an individual’s care plan, and the care plan must ensure that cultural preferences, needs related to health conditions, and allergen advice is followed
Food safety principles need to be applied when storing, preparing and handling food
If the care plan states that the person needs encouragement or help and support with eating, this needs to be provided
Food needs to be served at the right temperature and within easy reach
If an individual needs specific utensils to eat independently, these need to be available too
As with concerns about fluid intake, any worries about an individual’s food or nutrition should be shared with a senior member of staff, the individual’s carer or their family