Quality of Life for Older Adults Can be Enhanced by Less-Restrictive, More Individualized Diets
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CHICAGO – The American Dietetic Association has published its first position paper with companion practice paper. These papers, each titled The Nutritional Approach for Older Adults in Health Care Communities, call for an individualized approach to evaluating and addressing the needs of older adults living in health care communities to maintain their health and enhance their quality of life.
ADA’s updated position paper, published in the October issue of the Journal of the American Dietetic Association, represents ADA’s official stance on individualized nutrition approaches for older adults residing in health care communities:
It is the position of the American Dietetic Association that the quality of life and nutritional status of older adults residing in health care communities can be enhanced by individualization to less-restrictive diets. The American Dietetic Association advocates for registered dietitians to assess and evaluate the need for nutrition interventions tailored to each person’s medical condition, needs, desires and rights. Dietetic technicians, registered assist registered dietitians in the assessment and implementation of individualized nutrition care.
ADA’s position paper and companion practice paper were written by registered dietitians Becky Dorner, owner and president of Becky Dorner & Associates, Akron, Ohio; Elizabeth K. Friedrich, a nutrition and health promotion consultant in Salisbury, N.C.; and Mary Ellen Posthauer, president of M.E.P. Healthcare Dietary Services, Evansville, Ind.
Health care communities are defined as “living environments for persons with chronic conditions, functional limitations or need for supervision or assistance,” according to the authors. They include “assisted living facilities, group homes, short-term rehabilitation facilities, skilled nursing facilities and hospice facilities.”
According to the authors, care for those who live in these settings “must meet two goals: maintain health and preserve quality of life. These goals can compete when it comes to delivery of nutrition care. Food must meet nutrition needs but also enhance quality of life.”
By 2030, it is estimated that more than 72 million Americans totaling more than 19 percent of the population will be 65 or older – a 52 percent increase since 2007. In 2008, approximately 1.6 million Americans 65 and older lived in institutional settings – and more than 15 percent of those age 85 and older.
ADA’s position and practice paper recommend that registered dietitians and dietetic technicians, registered should be closely involved in developing individualized care plans that are “consistent with needs based on nutritional status, medical condition and personal preferences. RDs should assess nutritional status, determine a nutrition diagnosis, plan appropriate nutrition interventions and monitor and evaluate outcomes. Dietetic technicians, registered support RDs ... and may complete parts of the process as assigned by an RD. Collaboration between the patient, family and members of the health-care team will help achieve these goals.”
The papers also recommend registered dietitians and dietetic technicians, registered “should be actively involved in developing facility policies and procedures and educating staff, residents and family members on the benefits of a less-restrictive diet based on each individual’s needs.”
According to the authors: “Older adults residing in any health care community are more likely to need assistance with activities of daily living and have cognitive impairment due to Alzheimer’s disease or other dementias. Health care communities have embraced new philosophies that reflect major paradigm shifts in culture from institutional care to more personalized living in a home-like environment.
“Improving quality of life and quality of care, allowing choices in daily living and assisting individuals to make informed health care decisions are all major goals of culture change and person-centered care. Involving individuals in choices about food and dining such as food selections, dining locations and meal times can help them maintain a sense of dignity, control and autonomy.”
The American Dietetic Association is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy. Visit the American Dietetic Association at www.eatright.org.