To those working on the front lines in nursing homes and skilled nursing facilities, it comes as no surprise to hear that CMS is directing state surveyors to be alert and investigate those residents experiencing a significant decline in their condition during the pandemic particularly those residents with weight loss and/or a decline in mobility. As we know, weight loss and changes in mobility can be a direct effect of increased social isolation resulting from the healthcare emergency. Essential quarantine and social distancing come with a high cost for our seniors who already experience higher incidences of loneliness and isolation. Healthcare professionals have the skills to address the wide range of challenges that increased isolation has introduced to our long-term care residents.
Decreased taste and smell and diminished appetite can lead to poor eating habits and weight loss, and unfortunately these are often devastating side effects that isolation and various illnesses generate. Weight loss can cause complications ranging from dehydration and increased confusion to increased risk of skin breakdown, all of which inadvertently lead to decreased ADL and functional mobility independence.
There are many ways appetite can be encouraged within your facilities, including the following:
- Offer small meals often including protein packed small meals/snacks several times a day.
- Trend meal intake and maximize snack or mealtimes reflective of better appetite. If you know that a resident traditionally eats more in the evening, use that time to offer favorite, protein-rich foods.
- Train and engage all staff in meal assistance including administrators and activities staff to assist with meal set up and feeding (opening cartons, cutting meat, self-feeding, encouragement).
- As infection control allows, offer the structure of eating at a table as opposed to alone in the room or in bed.
- Remove wrappings, boxes or covers and move food to an actual plate/bowl so that food looks homemade and appetizing.
- Fortify food with things like yogurt, cream, honey, butter, and/or oats to meals to increase caloric intake and boost energy.
- Always have snacks and beverages handy. Make eating a communal event as much as possible while following infection control precautions. Meals should be enjoyable and not rushed.
- Enlist family member support when able. Have them join the resident virtually for meals.
- Remember that food has to be eaten to count. Honor resident choice and encourage selection of favorite foods, even if it’s cereal for supper!
- Coordinate opportunities with therapy and activities to encourage exercise and activity to help stimulate a healthy appetite.
- Timing therapy sessions to assist patients in routine daily functions including getting dressed and out of bed for meals to improve alertness and mobility for safe intake of meals/snacks.
- Refer for speech or occupational therapy screening when safe chewing/swallowing or self-feeding or positioning are of concern.
Fun fact: Did you know that the scent of cinnamon, citrus, spearmint, and peppermint can all stimulate appetite and alertness?
As the public health emergency continues, we must continue to rise to our residents’ needs. It is crucial to be diligent about monitoring weight and enriching resident care plans with nutritional and physical activity interventions to prevent weight loss. The keys to successful resident outcomes during a pandemic are knowledge, communication, and collaboration. Reliant Rehabilitation is proud to partner with you, your staff, and your residents!