“Rabbit stew anyone?”

The role of a dietetic student in a care home

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The North Highland health and social care partnership supports a strong and integrated model of care for adults, including care homes. I was appointed as the nutrition and dietetic advisor for care homes in 2014 and took the lead in championing this work, along with Emma Pasieka (the Board’s dietetic placement co-ordinator), Urray House care home (part of the Parklands care group) and Dr Myra MacKenzie from Robert Gordon’s University. AHP practice education lead, Kerrie MacLean, advised and supported the group’s work using her experience of other AHP’s placements and in linking closely with NHS Education Scotland.

We developed a pioneering, first UK experience, of placing a student dietitian in a care home setting in The Highlands. In the course of the placement, the dietetic student and activities co-ordinator engaged with a group of residents with dementia and 2 of their relatives in remembering favourite meals from childhood, mainly from the wartime. Their memories and discussion then helped care home staff and the cook design a World War II themed lunch menu. It included scotch broth, rabbit stew and clootie dumpling.

Photo kindly provided by Urray House care home (part of The Parklands care group)

Photo kindly provided by Urray House care home (part of The Parklands care group)

The themed lunch was open to all residents and their relatives and we also had interest from the local press. Some of the comments from the day are recorded below from residents, relatives and staff, which sum up the event:

“Clootie dumpling was the best part”

“We always got clootie dumpling at birthdays and if you were lucky, you got a silver threepence”

“I was brought up on rabbits; they were tastier before the war”

“The food here is excellent and the chef has a real interest in food and nutrition: it’s great that she was able to prepare this meal for residents” 

“I think the whole idea was great. My mother was telling me about when she was little when her mother used to go to the butcher and get a rabbit for a shilling. She’d then sell the rabbit skin to a man that came round the houses; there’s no way she’d have remembered that without this themed lunch bringing back those memories”

“Having a focused discussion around food memories is a great way of engaging

with residents who have dementia and their families, giving them a voice in choosing their favourite menus and following up with a themed meal, where staff dress up to serve the food. Everyone can participate have fun and enjoy the memory.”

The work of the student dietetic placement demonstrated a successful innovative, multi-agency approach to placing a student dietitian in a care home setting, facilitating active conversations with people living with dementia. It worked particularly well with the people who can at times appear quiet or withdrawn. We were also delighted that our work was recognised at last year’s Scottish Dementia Awards as a runner up in “the most innovative partnership” category.

Dietitian Students in Care at Home Settings

We have built on the success of our work in the care home setting with our dietetic students and have been continuing to develop a model of practice placements in “care at home” settings. In NHS Highland alone 19,000 people receive care at home and the provision of adequate nutrition and hydration can be a challenge within this setting. Student dietitians rarely have the opportunity to experience the reasons for this, or the opportunity to present solutions.

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As a result, in 2015 NHS Education Scotland, the Care Inspectorate, NHS Highland, Robert Gordon University and Highland Home Carers agreed to go one step further than care home placements, and test another new model of training student dietitians; this time in the context of ‘care at home’ settings. You can find out more about this work in my blog post here https://ahpscot.wordpress.com/2016/01/11/care-at-home-pre-registration-training/. I believe that we are offering a great learning opportunity for our dietetic students while also supporting the needs of individuals and their families, in a very proactive, person-centred placement model.

Our experiences of implementing and evaluating a dietetic social care placement model has just been selected to be presented in a poster session at the International Congress of Dietetic Associations in Granada, Spain in 2016.

Reflections

Thank you for taking the time to read my blog post.

Food forms such a strong part of our social and personal memories and reminiscing about events can offer a fascinating insight to family & friendships, social history and opens conversations up with groups of people from all walks of life. So can I leave with this…..

“Think back to your memories of your 10th birthday party, what food & drinks were offered to all your friends & guests?”

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Evelyn Newman RD, NHS Highland, Nutrition and Dietetic Advisor: care homes, evelyn.newman@nhs.net

@evelynnewman17

Evelyn’s role as nutrition and dietetics advisor: care homes, is unique in the UK. She works within NHS Highland’s integrated adult social care team, working at a strategic advisory level, supporting the 73 care homes in the North of Highland. The role is very varied offering: many forms of training; tailored nutrition/hydration advice for care home managers; up to date food, fluid and nutrition policy and resource development and information.

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