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This event consisted of the following:
- Key note speaker was Lorraine Norris, North Bristol NHS Trust, S Glos Community Health Services: Dignity and Nutrition for Older People
- Anita Gulati spoke on Food Matters: story of championing change of food cultures for adults with LD in residential care.
- Round table discussion: Scenarios (see below the scenarios given)
- What are the implications for dignity in care? (15 mins discussion on tables and then 10 mins plenary)
- Care of the Elderly, role of nutrition given by Jet O Neill
- Talking wall discussion: What role do we play in keeping our service users healthy through good food? What can we do differently? How do our personal attitudes towards food and well being affect our care giving?
Examples of scenarios
Elderly care: A
Gwyn is a feisty immaculately dressed tiny lady in her late 70’s weighing just over 8 stone. She had led an interesting and varied life living in Africa as a child and then coming to the UK in the swinging ‘60s having won a scholarship to train as a nurse. She met and married a doctor and continued to live an interesting life raising 4 children including a daughter with learning disabilities. In her late 40’s she was admitted to hospital as an emergency and was found to have cancer of the womb. This changed her whole attitude towards diet and she became a self taught expert on the role of healthy eating in well being. After chemotherapy she developed an allergic reaction to wheat and so dropped wheat and gluten from her diet altogether.
In her 70’s Gwyn experienced terrible emotional trauma resulting in significant weight loss, depression and attempted suicide. She was admitted to hospital and was then diagnosed as having dementia. During her long stay in hospital she did not feel like eating and was uninspired by the limited offer of wheat free choices which seemed to be mainly salad. Her family brought in dried fruit and nuts to supplement her diet. As a result of her vulnerability and complex needs she was admitted to a dementia secure unit. Her diet continued to be unimpressive despite the reputation of the care service for quality care. However, the service had a kitchen area where residents were encouraged to cook and eventually as Gwyn recovered from her depression she became interested in preparing her own food again. Slowly she began to regain weight.
However, unhappy with her lack of access to the outside world Gwyn asked to be moved from the unit and chose a residential care home. Here there was no access to the kitchen on health and safety grounds. In addition, partial to a glass of wine or two before her evening meal, Gwyn was annoyed to find the staff insistent on serving her wine with the meal. On her second day Gwyn was despondent to find her evening meal consisted mainly of mushrooms in a thin soup. Unimpressed and feeling as if she was at boarding school, which she experienced as a young girl, Gwyn had recovered enough of her feisty self to say “ but I am paying for this!”.
Adults with learning disabilities: B
Peter was placed in residential care for adults with learning disabilities some 7 years ago. Peter was very self conscious and shy when he arrived and slowly over time Peter’s waistline began to expand alongside his confidence and soon he was buying trousers and T shirts that were 4 sizes larger than when he first arrived. The staff were aware that this was not good for Peter’s health, and he was taking to sitting in front of the RV instead of choosing to go out to drama club. Peter was adamant that it was his choice to choose burgers and chips and other unhealthy foods in preference to healthier options. Peter also had a bit of a temper on him and staff admitted that with the stress of making sure all 12 residents ate an evening meal – it was easier to give into Peter’s expectations.
The manager was keen to get her team and residents involved in the Food Matters Project helped support a food tasting party which included residents from a neighbouring care home. All the residents were involved in preparing healthy snacks – such as guacamole and toasted sunflower seeds, and helping to plan, shop and cook a meal. A bread making machine was bought by the house and everyone enjoyed the smell of home cooked bread and adding in chosen extras such as seeds and raisins for variety. It was fun and exciting and everyone was enthusing about the new foods. Peter simply joined in and the staff were amazed to see how quickly he took to trying new foods.
Three months later Peter had lost half a stone, and was enthusiastic about helping to plan the week’s menu for the household, choosing nice recipes (which happened to be healthy) from colourful recipe books. And the manager was delighted, not just for Peter’s weight loss, and his calmer outlook, but because she was making significant savings on her food budget as a result of cooking from real fresh produce rather than buying in processed and ready made meals. She observed that “perhaps Peter had got addicted to the additives and salt in the processed foods he was eating previously”. She also saw that encouraging and supporting choice for adults with learning disabilities has to be balanced with duty of care.