Dietitians in Dementia
This week is Dietitians Week (8-12 June 2015) which is led by the British Dietetic Association (BDA) and was established as part of Trust a Dietitian, which highlights the work of the dietetic profession in the UK. The world’s first Dietitians Week took place last year: 9-13 June 2014, demonstrating and promoting the great variety of roles within the profession and the significant impact dietitians have on public health.
Dietitians Talking about Dementia at Scottish Parliament
This year the BDA Scotland Board hosted a Scottish Parliamentary Reception on Wednesday June 10th to showcase the role of Dietitians and their work in the area of dementia. They invited all 128 MSP’s along with an external list of interested parties and all Scottish Dietitians. This area of work was chosen as dietitians play a vital part when working with people with dementia. Dietitians can:
- Help you with diet and nutrition-related problems
- Provide you advice on appropriate food choices, the importance of hydration and eating environments
- Help to reduce the stress and distress that can be associated with eating when someone is living with dementia and
- Provide you with advice and support to family and professional carers who are involved in food provision.
Dietitians: Agents of Change in Dementia
At the event the three publications that dieticians have supported, the Alzheimer Scotland AHP leaflet and the carers resource were all shared at the reception. The links are at the end of this blog. In addition to this, one of the many projects dietitians are developing was shared, below is the example by Sheila Riddoch
“A Good Meal: Important to everybody”
Eating and having a good meal is part of our everyday life and important to everybody, not least to people living with dementia. However dementia can greatly affect a person’s relationship with food and eating. Whilst the difficulties experienced vary from one individual to another the result is often weight loss and deteriorating health. Under nutrition is common among older people generally; and the consequences include increased frailty, skin fragility, falls, hospitalisation and increased mortality. In people with dementia, under nutrition is particularly common. It also tends to be progressive, with weight loss often preceding the onset of dementia and then increasing in pace across the disease course. However, whilst weight loss is a common problem for people with dementia, under nutrition can and should be avoided.
Eating & Drinking: what does the research tell us
The cause of under nutrition in people living with dementia is often multi-factorial involving the behavioural, emotional and physical changes which take place as dementia progresses. However one of the common problems which people living with dementia encounter is a change in vision and a reduced understanding of what they are seeing. This led to research by a team at Boston University who showed that if we change what we do, and thereby allow people to see their food; they are much more likely to eat it. In context, what the team did was serve food to people with advanced Alzheimer’s disease on standard white plates and then served the same food to the same client group on red plates. What they found was that people eating from the red plates consumed 25 percent more food than people eating from white plates. The simple reason for this improvement was that the contrast in colours between the food and the crockery allowed people to see their food more easily and subsequently they were more inclined to eat it.
Implementing the Evidence: changing the crockery & tumblers
With this research in mind NHS Grampian trialled the use of colour contrast crockery and coloured reusable drinking glasses in a local assessment unit for older people. When compared to the use of the traditional crockery and disposable white tumblers, positive feedback was received. Since the provision of a good quality eating experience is an integral part of the therapeutic care provided in hospital and the results of the trial were so positive, a decision was taken to introduce the new crockery & tumblers to all hospital wards in NHS Grampian. This is seen to be a very positive move given the fact there is a high number of people who could potentially benefit from high contrast crockery. This move also serves to ensure that there is a consistent approach across the Board and it supports equitable access whilst eliminating the ‘labelling’ of people with individual needs.
On reflection, we have shared one example of how making a small change can have a large impact, it would be great to hear of other examples.
Further information on the publications:
Allied Health Professionals Dementia Champions: Agents of Change
Allied Health Professionals Delivering Post-Diagnostic Support: Living Well with Dementia
Allied Health Professionals Delivering Integrated Care: Living Well with Community Support
Alzheimer Scotland AHP leaflet
Eating Well with Dementia – a guide for carers. A guide for carers of people with Dementia, to support eating and drinking for nourishment and well being.
Lead Dietitian, Acute Services, NHS Grampian
Sheila has worked in the NHS as a dietitian for over 30 years and been responsible for delivering a clinical service within a range of hospital services including Adult Acute Specialties; Continuing Care; Community Hospitals & Mental Health. Specialist areas of practice have been Care of the Elderly, Post Acute Rehabilitation and she has a special interest in Nutritional Support. For the past few years she has had a Lead role in supporting the delivery of good Nutritional Care throughout all hospitals in NHS Grampian, a role she undertakes as part of a core team including NHS Grampian Nurse Consultant in Nutritional Care & Head of Catering Services.