Weight Loss Prevention
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USE MORE RESTRICTIVE CRITERIA TO TARGET RESIDENTS
As a last resort, if your facility is severely understaffed, you can use more restrictive criteria to target the mealtime or snack interventions to only those residents at highest risk for weight loss. Such residents either eat less than 50% of most meals or have a history of weight loss or both.
Check results from the Step 1 assessment to identify residents with intake levels under 50% and then check medical records to see which residents show a history of weight loss. Our research and that of other investigators suggests that residents with low intake levels (i.e., who eat less than 75% of most meals) but who have a healthy Body Mass Index value (>20) and no recent weight loss may not, in fact, need intervention. These findings, however, are preliminary, and this targeting approach, unfortunately, means that some residents will likely receive sub-optimal feeding assistance. Many of them, however, may at least maintain their weight, even if they don't gain pounds. Despite its serious drawbacks, this targeting approach is preferable, ethically and clinically, to providing sub-optimal assistance to all residents.
Cost-Saving Tip:
Because nursing homes offer few snacks and beverages to residents between meals (2), most facilities will have to dole out more to buy foods and beverages for our between-meal snack intervention. They may be able to offset the cost, however, by offering snacks instead of oral nutritional supplements. Our research shows that residents prefer a variety of food and fluid choices, which suggests they would prefer snacks to supplements (2). Moreover, residents consumed more calories from between-meal snacks than from supplements (2). Their average daily intake increased 380 calories per day as a result of the snack intervention, compared to 94 calories per day as a result of supplements. This finding suggests that the snacks were more palatable to residents.
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