Weight Loss Prevention
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OPTION B: PHOTOGRAPH MEAL TRAYS
Assign a staff person to photograph each resident's tray both before and after each meal during the assessment period, then compare the photos to estimate intake levels.
This also need not be a daily assessment for all residents, but rather a periodic evaluation conducted as part of an MDS assessment or reassessment of each resident to identify those at risk of weight loss.
The staff person should:
- Label each tray with the resident's name or other identifying information, the date, and the meal period before taking each photo.
- Take the before and after photographs during meals on two days (a total of six meals) within the same week.
- One staff member can usually take before and after photos for approximately six to eight residents during any one mealtime period. If all staff work together, photos can be taken for a much larger group of residents by one staff member: before photos can be taken of a group of trays before leaving the kitchen and after photos can be taken as the trays are picked up at the end of the meal.
- Take each photograph from the same angle, at the same distance. We photographed meal trays at approximately a 45 degree angle from two feet away. Photographs should be taken such that the volume of foods and fluids remaining in containers on the tray are visible.
- Ensure that photos are developed or printed. Alternatively, photos taken with a digital camera can be downloaded to a computer that is available to multiple staff members, including licensed nurses and dietary personnel.
When the photos are available for viewing, a supervisory staff person (or persons) should:
- Compare the before and after photos for each meal to estimate the resident's food and fluid intake.
- Use our Mealtime Observational Protocol to conduct these estimates.
Advantages:
The photos can be evaluated by multiple professionals to ensure reliable estimates. They allow comparisons to be conducted in a less hurried manner and after hectic mealtimes. They also provide simultaneous, visual evidence of food volumes both before and after meals, so staff need not rely on their memories to estimate intake levels. Photos can also be used to inform the kitchen staff of residents' food and fluid preferences and as tools for teaching nurse aides to accurately estimate consumption levels.
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