Community Dietitians NHS Grampian
Who are we?
The Community Dietitians in NHS Grampian are based at:
| Area |
Base |
Contact details |
|
Aberdeen City |
The City Hospital |
Links Resource Centre
|
|
Aberdeenshire |
Aberdeen Health and Care Village |
50 Frederick Street gram.communitydietetics@nhs.scot
|
|
Moray |
The Glassgreen Centre |
The Glassgreen Centre
Thornhill Drive Elgin, Moray |
What do we do?
We provide a clinical service to people in clinics, hospitals, their own homes and care homes. We also offer education and training on a wide variety of nutritional topics,
undertake health promotion activities within the community and produce dietary resources and leaflets.
Contacting us
Care home staff can contact us directly at any time with queries or information on the numbers or email addressed above.
Referring
If you wish to refer a resident in Aberdeen or Aberdeenshire please use the referral forms at the following link care home referral forms. For Moray please use the Referral Form for Moray.
Resident’s should be referred according to the MUST screening guidance.
If you are unsure as to whether a referral is necessary you can contact us for advice.
Dietary Information for care home residents
The nutritional care older people in long term care has been highlighted as an important area for continued improvement. The focus on nutrition is not just about what a person eats and what is available, but is also about the environment and social interactions around the mealtime experience.
Good nutritional care, adequate hydration and enjoyable mealtimes can dramatically improve the general health and well-being of older people, as well as increasing their resistance to disease and their recovery from any illness, trauma or surgery.
The national guidance states that meals are varied and nutritious. They reflect food preferences and any special dietary needs. They are well prepared and cooked and attractively presented. They also state that the nutritional status of residents will be regularly assessed and reviewed.
In order to do this care home staff at all levels require access to up-date, evidenced based advice.
The Community Dietitians in Grampian have produced a number of resources for care home staff to help ensure they have up-date information.
Diet Resource Pack
The diet resource pack provides information on the most common nutritional problems as well as a range of therapeutic diets. This pack can be used by care, nursing and catering staff.
There is also a menu planning guide for care homes.
Nutrition Screening
Nutritional screening is an essential part in assessing a person’s nutritional status. The National Care Standards recommend that all care home resident?s are screened for risk of malnutrition.
The ‘MUST’ screening tool is a validated screening tool which is used nationally and implemented in NHS in care homes and hospitals. There is a specific MUST screening tool for care homes in Grampian.
It is recommended that this version of the tool is used as it reflects local actions, resources to be used and when to refer to the dietitian.
This screening tool is not foolproof. If you are in doubt about the nutritional status of a patient you can contact your local community dietitian for advice. It may not be appropriate to use it in some circumstances such as end of life.
Poor Appetite / Poor food intake
There are a number of reasons a resident may lose their appetite and eat less food.
Poor dietary intake and weight loss can be caused by illness, side effects of medication, anxiety, depression, pain, nausea, chronic arthritis, old age, dementia, bereavement or even unfamiliar meals and surroundings. All of which can result in poor appetite.
Poor appetite can lead to malnutrition, which in turn leads to delayed wound healing, increased risk of pressure sores and respiratory infections, weakness, reduced mobility and depression. This can result in longer recovery times (and therefore hospital stay) and also increased mortality risk.
The action you take will depend upon the MUST score, however for all patients with significant weight loss the first step is to fortify the diet with foods rich in energy and protein.
The booklet Food Fortification : A Guide to Adding Extra Nourishment (link) provides detailed information on fortifying meals and providing high energy snacks and drinks.
Dementia
Generally people with early dementia should be encouraged to follow a healthy well balanced diet however as dementia progresses people may experience various nutritional
problems.
The diet resource pack provides information on dementia. Further practical information can be found in the booklet: Dementia Care Support with eating and drinking: A practical
guide for carers Dementia guide support with eating and drinking
Dysphagia
Resident’s may develop dysphagia for a number of reasons such as stroke, Motor Neurone Disease, Huntington’s Chorea, Multiple Sclerosis, Parkinson’s. oesophageal strictures,
head & neck surgery or radiotherapy.
If you have concerns about a patient’s ability to swallow, ask the GP to refer them to the Speech and Language Therapy (SLT) department for a swallowing assessment. The SLT
will recommend whether the texture of the food and fluid needs to be modified and which the type of modification is required. The Community Dietitian can advise on nutritional
aspects of the diet required.
It is not advisable to start a resident on a modified texture diet unless they have a confirmed swallowing problem as these diets can be unappetising and lead to weight loss.
Further guidance on managing dysphagia can be found in the diet resource pack. The NHS Grampian guidelines also provide information on texture classification of solids and
liquids and guidelines for the use of thickeners
Tube Feeding
If you have any residents who are fed via an enteral feeding tube they will be reviewed regularly by a dietitian. Usually this will be the community dietitian who covers your care home but occasionally they may be reviewed by a hospital dietitian.
Training for Care Homes
The Community Dietetic Department provide training for care home staff on a range of nutritional topics.
Training on MUST screening and Food Fortification is provided at regular intervals throughout he year.
If you require training on any particular nutritional topic please contact your community dietitians to discuss this.