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Long Term Care Institute Resources
  1. Super Snack Menus
  2. How-To Guide for Interdisciplinary Resident Dining Program
  3. Hydration Program
  4. Food and Hydration Aide Staff Position (FHA)
  5. Nutrition Risk Assessment: Form, Guide, Strategies and Interventions
  6. Validated Method for Documenting Food and Fluid Intake at Meals
  7. Determining Stature via Knee Height
  8. Obtaining and Trending Accurate Body Weights
  9. Nutrition Care Alerts, Presentation
  10. Nutrition Care Alerts, Warning Signs and Action Steps Poster
  11. Nutrition Care Alerts, Warning Signs and Action Steps Pocket Cards
  12. Nutrition Screening Initiative: Nutrition Care Alerts
    a.
    for caregivers in Nursing Facilities
    b. for caregivers in Home Care
  13. Food Safety Posters
  14. Nutrition Care Alerts, Pamphlet for Caregivers


Approaches to Increase Food and Fluid Intake

Super Snack Menu

 

Description:
This is a nutrient-dense, one-week cycle snack menu for residents which offers a variety of good tasting, high-calorie/high-protein snack foods twice daily. (regular or reduced concentrated sugars, RCS)
This schedule is geared to decrease snack
fatigue and increase nutrient intake.

Format: PDF file requires a reader such as Acrobat Reader. Free Download of Acrobat Reader

Instructions: Download and save in your
"My Documents" file as a PDF file. Print
out these menus and reproduce for use by
your foodservice staff in preparing a snack
regimen for your residents.

Super Snack Menus available:

How-To Guide for Interdisciplinary Resident Dining Program

Description:
This is a 12-page guide with step-by-step instructions for developing and maintaining an effective dining program that assures adequate assistance at mealtime for every nursing home resident. Sample worksheets and training tips are included to help plan and organize a customized program.

Format: PDF file requires a reader such as Acrobat Reader. Free Download of Acrobat Reader

Instructions: Download and save in your
"My Documents" file as a PDF file and print.

Guide available:

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Hydration Program

Description:
This program includes helpful guidelines, tools and directions for the development and maintenance of an effective, comprehensive nursing home hydration system. Various components address tracking of fluid intake between meals, utilization of a hydration cart, and the use of a dehydration checklist.

Format:Microsoft Word files require Microsoft Office software.

Instructions:
Download and save in your "My Documents" file as a Word or Excel file. Modify printed materials as needed.

Materials available:

Food and Hydration Aide Staff Position (FHA)

 

Description:
The Food and Hydration Aide staff position (FHA) is central to the interdisciplinary team approach we designed to 1) increase food and fluid intake in long term care residents and 2) more accurately and efficiently identify nutrition and hydration problems. Conceived as a specially trained CNA that report findingsto both the Dietary and Nursing departments, the FHA "bridges the gap" between traditional Dietary and Nursing responsibilities.

In addition to assisting residents with food and fluid intake, the responsibilities of the FHA are integral to the following:
1) Validated method for documenting food and fluid intake at meals (FFED);
2) Hydration Program, including documentation of
between-meal fluid intake (BEV);
3) Determining stature via knee height; and
4) Obtaining and trending accurate body weights.

Format:Microsoft Word and Excel files required Microsoft Office software.

Instructions:
Download and save in your "My Documents" file as a Word or Excel file. Modify printed materials as needed.

Materials available:


Resident Assessment

Nutrition Risk
Assessment: Form, Guide,
Strategies and Interventions

Description:
These materials were developed by the
American Dietetic Association's (ADA) Long Term Care Task Force, Consulting Dietitians in Health Care Facilities (CDHCF) Practice Group of the ADA, and the Health Care Financing Administration. A detailed itemization of coded nutrition risk factors (e.g. number and stage of pressure ulcers, chewing and swallowing ability, disease state, etc.) allows for quick determination of nutrition risk level. The forms include a comprehensive list of suggestions and procedures to be followed in order to help decrease risk factors.

Format: Materials must be ordered.

Instructions: Download ordering information
and forms from the CDHCF web site.

Materials available:

(http://www.cdhcf.org/products/p5014.html)

Validated Method for Documenting Food and Fluid Intake at Meals

 

Description:
This method for estimating food and fluid intake at meals was developed specifically for, and validated in, the routine nursing home environment. Resulting meal intake estimates may be recorded in the medical record via a facility's existing recording system or via the specially developed FOOD AND FLUID INTAKE TRACKING form.

The advantages of this system are the increased accuracy of food intake estimates and the availability of separate fluid intake estimates for meals.

Format:Microsoft Word files require Microsoft Word software.

Instructions:
Download and save in your "My Documents" file as a Word or Excel file. Modify printed materials as needed.

Materials available:

Determining Stature via Knee Height

 

 

 

Description:
A number of common disabilities and disease processes make it difficult to accurately measure standing height in most nursing home residents. It is logical to choose an alternate method for measuring stature that can be applied to a majority of residents. Knee height, in combination with the use of standard formulas, is an appropriate choice.

Knee height can be measured accurately and efficiently if this responsibility is assigned to a few well-trained staff who perform these measures on a daily basis (e.g., FHA Staff Position). The RD or DTR can calculate stature from the knee height measure. An alternative method can be used for bi-lateral amputees or contracted residents.

Format:Microsoft Word files require Microsoft Word software.

Instructions:
Download and save in your "My Documents" file as a Word file. Modify as needed.

Materials available:

Obtaining and Trending Accurate Body Weights

 

Description:
An accurate body weight obtained at frequent intervals is one of the most reliable, inexpensive and non-invasive ways to identify when a resident is not obtaining adequate nutrition and/or hydration. Included here are simple methods to obtain and trend accurate body weight measures so that residents in need of intervention can be identified in a timely fashion.
This method has 5 elements:
1) simple method to assure accuracy of scales;
2) assignment of responsibility for body weights to a
 few well-trained staff who perform these measures on a daily basis (e.g., FHA Staff Position);
3) simple step-by-step approach to obtaining accurate
weights;
4) weight trending form (12-month) for the medical
record; and
5) pre-programmed Excel spreadsheet for ongoing
calculation of significant weight changes.

Format:Microsoft Word and Excel files require Microsoft Office software.

Instructions:
Download and save in your "My Documents" file as a Word or Excel file, modify rpintedmaterials as needed. "Do not disable macros in Excel Weight Change Spreadsheet".

Materials available:


Educational Tools for Staff

Nutrition Care Alerts,
Presentation

Description:
These in-service presentations, based on the Nutrition Screening Initiative's Nutrition Care Alerts, focus on the importance of nutrition, the problems that lead to malnutrition,
dehydration, and pressure ulcers, and steps staff can take to prevent or correct these problems. Presentations are available for professionals (advanced version) such as nurses and administrators and for non-professionals (basic version) such as nursing aides and foodservice staff.

Format: Microsoft PowerPoint file requires
Microsoft PowerPoint software.
Free PowerPoint Reader available

Instructions: Download and save in your "My Documents" file as a PowerPoint presentation. Use in nutrition care related in-services with all staff in your facility.

Presentations available:

Nutrition Care Alerts,
Warning Signs and
Action Steps Poster

Description:
These colorful, highly visible posters, based on the Nutrition Care Alerts, lists the warning signs of involuntary weight loss and dehydration along with their respective action steps staff can
take to prevent or correct these problems. A blank space remains at the bottom left hand side of the poster so that each facility can add their own program logo.

Format: Microsoft PowerPoint file requires Microsoft PowerPoint software.
Free PowerPoint Reader available

Instructions: Download and save in your "My Documents" file as Nutrition Care Alerts Poster. Insert your facility logo in the blank space at the bottom of the poster. Modify as desired. Print posters in color or black-and-white. Enlarge to desired size.

Posters available:

Nutrition Care Alerts, Warning Signs and Action Steps Pocket Cards

Description:
This set of pocket-sized cards can easily be
carried by nurses and nursing aides and act
as an individualized reminder of the Nutrition Care Alerts. Each card in the set has the warning signs for one of the nutrition themes (unintentional weight loss, dehydration, pressure ulcer, and complications from tube feedings) on one side, and the action steps to be taken on the other.

Format: Microsoft PowerPoint file requires
Microsoft PowerPoint software.

Free PowerPoint Reader available

Instructions:
1. Download the file.
2. Print out every two slides back-and front on one sheet of paper. Slide one (1) should be the front of the first page and slide two (2) should be the back of the first page, slide three (3) should be the front of the second page and slide four (4) should be the back of the second page, and so on until you have a total five pages including the cover page. For longer-lasting cards or a more formal look, use heavy-bond paper or cardboard (if your printer can handle it). You may also want to use colored paper.
3. If you want to produce many packets for a large number of staff members, copy the slides-back-and-front-now. Each set of slides will produce six (6) pocket card sets.
4. Assemble the five pages so that the slides are in the same order as they appear in the file. The cover page with the title "Nutrition Care Alerts" should be on top and "Warning Signs!" should be the front and "Action Steps" should be the back of each subsequent page. The individual categories should be in the following order: Unintended Weight Loss, Dehydration, Pressure
Ulcers, and Tube Feedings.
5. Once assembled in this order, cut the entire package once down the center and twice across (preferably using a paper cutter) to form six (6) small, individual packets.
6. These packets can now be held together in the top left corner with whatever seems most convenient or appropriate to you. You may staple the packet together, or for a more formal appearance, a rivet or a small ring can be used.

Distribute the cards among your CNAs, nurses, and other staff members or individuals involved in the care of residents.

Pocket cards available:

Warning Signs and Action Steps for Caregivers in
Nursing Facilities

Description:
This is a one-page (back and front) handout
listing the warning signs that may potentially result in involuntary weight loss, dehydration, pressure ulcers, and complication from tube feedings. The warning signs are accompanied by action steps that staff and family members may take to help correct and prevent these
problems.

Format: PDF file requires a reader such as
Acrobat Reader. Free Download of Acrobat
Reader

Instructions: Download and save in your
"My Documents" file as a PDF file or order in bulk. For Download, print this handout in black-and-white or in color and reproduce for distribution in your facility.

Handout Available:

Warning Signs and Action Steps for Caregivers in Home Care

Description:
This is a one-page (back and front) handout listing the
warning signs that may potentially result in involuntary weight loss, dehydration, pressure ulcers, and complication from tube feedings. The warning signs are accompanied by action steps that caregivers may take to help correct and prevent these problems.

Format: PDF file requires a reader such as Acrobat Reader. Free Download of Acrobat
Reader

Instructions: Download and save in your
"My Documents" file as a PDF file or order in bulk. For Download, print this handout in black-and-white or in color and reproduce for distribution to caregivers of residents being discharged from the LTC facility to residential facilities or home.

Handout Available:

Food Safety Posters



Description:
These colorful posters developed by the United States Department of Agriculture (USDA) contain basic food safety information on the importance of personal hygiene, proper cleaning of utensils, and safe food temperatures.

Format: PDF file requires a reader such as Acrobat Reader. Free Download of Acrobat Reader

Instructions: Download and save in your "My Documents" file as a PDF file. Print out these posters and display in appropriate food handling areas in your facility.

Posters available:

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For Residents/Families/Care Givers:

Nutrition Care Alerts,
Pamphlet for Caregivers

Description:
This is a colorful, tri-fold pamphlet containing basic information (based on the Nutrition Care Alerts) on nutrition and hydration care to educate family members and caregivers of the importance of nutrition care.

Format: Microsoft PowerPoint file requires
Microsoft PowerPoint software.
Free PowerPoint Reader available

Instructions: Download and print out this
pamphlet in black-and-white or in color.
Reproduce back to back. The pamphlet should have two folds with one side of the page opening to the right, the other to the left. Distribute to family members or caregivers of residents.

Pamphlets available:

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National Resource Center on Nutrition, Physical Activity & Aging
| Florida International University, OE 200, Miami, FL 33199
Phone: 305-348-1517 | Fax: 305-348-1518 | E-mail:
nutritionandaging@fiu.edu

This website is supported, in part, by a grant from the Administration on Aging, Department of Health and Human
Services (DHHS). Grantees undertaking projects under government sponsorship are encouraged to express freely their
findings and conclusions. Points of view or opinions do not, therefore, reflect official DHHS policy.