Weight Loss Prevention
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REGARDING BOTH OPTIONS…
Can you assess residents who eat meals in their rooms using either option A or B? Yes. The most practical way to do this is to assess at one time all residents on one hallway or in one unit who are eating in their rooms. Trays should be checked or photographed before the nurse aide enters the resident's room and again when the aide exits the room. We recommend that the staff person conducting the assessments stay in the hallway throughout the meal period. This allows the person to keep watch on all the rooms simultaneously.
A Time-Saving Tip:
This works for both options: Concentrate first on assessing those residents who are not identified on MDS item K4c as having low intake levels or who are not identified as poor eaters (i.e., eats less than 75% of most meals) in their medical chart. Percentages vary widely among nursing homes, but on average about half of all residents are identified as poor eaters on the MDS. In our experience, nursing home staff make few, if any, "false positive" assessments on this MDS item--or in the medical record. That means, if a resident is identified as under eating on the MDS or in his or her medical chart, then chances are very good that the assessment is accurate. You should then focus first on assessing potentially unidentified poor eaters.
Double-Duty Assessments:
With either assessment option, the supervisor's estimates of food and fluid intake can be compared to estimates made by nurse aides and feeding assistants for the same residents and mealtimes to check the accuracy of these latter estimates. Any aides and assistants who consistently report inaccurate estimates can receive additional training in conducting intake calculations (see our Guidelines for Estimating Food and Fluid Consumption). If you took before and after photos of meal trays, these can be used as training tools.
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