520 CHAPTER 11 QUESTION


1. Someone notices that Mr. H. is having trouble grasping his utensils, and coordination seems to be declining. Which member of the IDT should Mr. H. be referred to?


2. What are some ways to develop a person-centered care plans for clients?


ANSWER


Refer to the Occupational Therapist, Registered (OTR) who specializes in evaluating fine motor skills and recommends assistive eating devices and techniques to help clients feed themselves.


• Focus on the client as the center of control, and supports each client in making his or her own choices.


• Make an effort to understand:


(1) what each resident is communicating, verbally and nonverbally


(2) identify what is important to each resident with regard to daily routines and preferred activities


(3) have an understanding of the resident’s life before coming to reside in the nursing home.


• Identify any cultural preferences and dietary preferences, sleep/natural wakening routine and meal timing preferences”


3.. Write a goal statement for Mr. Bravard, who is having more difficulty feeding himself and has been eating an average of about 50% of his meals in the past 30 days. He has also lost 2 pounds this week.


4. Write a goal statement for Mr. Bravard, who is having more difficulty feeding himself and has been eating an average of about 50% of his meals in the past 30 days. He has also lost 2 pounds this week.


• Mr. Bravard will consume an average of >75% of his meals daily over the next 90 days to prevent weight loss.


• Mr. Bravard will be assisted for all meals and snacks daily over the next 90 days to improve meal intake and prevent weight loss.


(1) Re-evaluate the care plan and revise


(2) Interview client to evaluate whether interventions in original care plan are appropriate and accepted by the client


(3) Determine if new goals are needed for client and confirm those goals are acceptable to the client


(4) Notify the family of new goals/interventions and reasons


(5) Adjust the care plan to include new goal and/or interventions


(6) Notify the IDT and NDTR and/or RDN of care plan changes and reason.


(7) Notify provider if new orders are required. (8) Continue to follow-up on interventions and goals.


(9) Write a short note indicating why care plan goals/ interventions were changes, what they were changed to, and who was notified.


SUPPLEMENTAL MATERIAL


Nutrition Fundamentals and Medical Nutrition Therapy


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