HSC 214 Help Individuals To Eat And Drink

1. HSC 214Help Individuals To Eat And Drink

2. Elements Of Competence • Make preparations to support individuals to eat and drink • Support individuals to get ready to eat and drink • Help individuals consume food

3. Scope Here is a guide to the areas you will cover in this unit.For this unit you need to prepare for, support and help people to consume food and drink. • Food and drink can include snacks, meals, hot drinks and cold drinks. • Key people include the patient, their family and friends, other carers, and other members of the multidisciplinary team e.G. The dietician.

4. Scope • Preparations including using protective clothing, or obtaining specialist equipment for the patient. • Risks that could include the incorrect storage of food, infection and contamination, patients eating food and drink they are not able to and unexpected reactions to food and drink.

5. Scope • Taking appropriate action could include reporting to the nurse in charge if the patient is not eating properly and referral to specialised nurses or the dietician. • Types of nutrition which will include, individualised diets, high fibre diets, low fat diets, soft food diets, clear fluid diets, and dietary supplement drinks.

6. Aims By the end of this session you will be able to • Prepare the patient to eat and drink • Know how to support patients to get ready to eat and drink • Know how to assist the patient to eat and drink

7. Objectives By the end of the session you will. • Be aware of the importance of appropriate selection of, preparation and monitoring of food and drink consumption. • Be able to assist and support the patient to consume food and drink according to their individual needs.

8. Objectives • Be aware of factors that effect nutritional needs and eating habits. • Be able to list the constituents of a well balanced diet. • Be aware of the signs and symptoms of adverse reactions to food.

9. Links to Other Units • Core values – including respecting the right of the patient and cultural choices. • Health and safety- including the storing and preparation of food. First aid including chocking and adverse food reactions. • Communication – including confidentiality, record keeping and speaking to your patient and the care team.

10. Food Hygiene When preparing and serving food to patients it is important to ensure that food poisoning is prevented. The highest standard must be maintained. The food safety regulations 1995 deals with the safe preparation of food for human consumption.It is concerned with. • Food premises and storage. • Food handlers. • Food safety assessments. • Training.

11. Food Hygiene Everyone involved in any aspect of food preparation or handling must undergo training on induction to their workplace. If you are preparing, serving or assisting a patient to eat or drink you must tie your hair back. Hands should be washed to prevent the spread of bacteria by using an antibacterial hand wash not gel before the preparation of food and when assisting the patient to eat.

12. Food Hygiene The way food is stored is important, raw and cooked meat should be stored at the bottom of the refrigerator. Cooked foods should be covered and served immediately. The refrigerator should be cleaned daily and it’s temperature checked and recorded daily.

13. Dietary Requirements All human beings require essential nutrients in order to survive. They are classified into five major groups. • Proteins. • Carbohydrates. • Fats. • Vitamins. • Minerals.

14. Proteins – found in fish, meat, eggs, milk, cheese, nuts, cereals, tofu and beans. Proteins promote growth and are essential for the replacement and renewal of body cells. They are essential for everyone and they must be eaten each day as the body is not able to store protein. Food Groups

15. Food Groups Carbohydrates Found in potatoes and root vegetables e.g. yams, sweet potato, and in bread, flour, rice, cereals and pasta. Also all products which are sugar-related. Carbohydrates are also known as starches are used to provide energy and heat by the body. They are essential to provide an energy source for the body, but if they are eaten to excess they will be stored as fat.

16. Food Groups Fats – Found in butter, margarine, cooking oil, dripping (animal fat), meat, fat, cream, milk, cheese, egg yolks. Fats are a very concentrated source of heat and energy.If they are eaten to excess they will be stored by the body in the adipose layer just beneath the skin.

17. Food Groups Vitamins and Minerals Vitamin A- Found in liver and fish oils, milk, butter, eggs and cheese and can be made by the body from carotene which is found in carrots, tomatoes and green vegetables. Protects from infection and contributes to growth. A lack of vitamin A can cause eye problems.

18. Food Groups Vitamin B group – Found in cereals, liver, yeast, and nuts. This is a large group of complex vitamins, all of which are essential for maintaining a good skin. It mat be that a lack of vitamin B is responsible for some diseases of the nervous system.

19. Food Groups Vitamin C – Found in citrus fruits, strawberries, potatoes, and some green vegetables. Vitamin C cannot be stored so it must be taken each day. A lack of vitamin C can cause scurvy, a disease which affects the gums and causes bleeding- an extremely serious condition. People who have a lack of vitamin C are also more likely to be affected by viral infections and coughs and colds.

20. Food Groups Vitamin D- Found in eggs and fish oils, and is made by the body when the skin is exposed to sunlight. Vitamin allows calcium to be absorbed to strengthen and develop the bones and teeth. A severe shortage of vitamin D will lead to rickets, a deforming disease of the bones, seen in children.

21. Food Groups Vitamin E – Found in wheat germ, cereals, liver,egg yolks and milk. This helps prevent cell damage and degeneration.

22. Food Groups Minerals- Calcium, iron, and sodium are found in eggs, cocoa, liver, baked beans, cheese and milk. Iron is important for the formation of red blood cells, and a lack of iron can lead to anaemia.Calcium is used for the development of bones. Sodium is important for maintaining the fluid balance of the body and an excess of sodium can be a contributory cause of oedema (fluid retention).

23. A healthy diet is essential to maintain a healthy heart. Sensible eating habits recommended by the medical research council to reduce the risk of heart disease and type 2 diabetes. A four year study funded by the food standards agency has given £2.7m to look at the impact of changes in dietary fat and carbohydrates on known factors for these diseases. A Balanced Diet

24. Eat five portions of fruit and vegetables a day. Use organic and free range produce whenever possible. Decrease your intake of junk and processed foods. Consume fresh foods and whole grains every day. Limit your intake of tea, caffeine and alcohol. Drink plenty of good quality water. Limit your intake of saturated fats (found in red meat, cheese and cream etc) but ensure sufficient intake of essential fatty acids ( found in fish, nuts and seeds). Have only moderate intake of sugars. Limit your salt intake. Avoid preservatives and colourings when possible. A Balanced Diet

25. Dietary Requirements See handout number 1

26. Hydration For survival all human beings require at least 2 litres of water within twenty-four hours. In easy terms to tell your patients, that’s eight glasses of water at least a day. Dehydration can lead to the internal systems of the body shutting down and death.

27. Helping Patients To Eat And Drink When assisting your patients it is very important to find out what the patient’s individual needs are. On assessment you should be asking the patient if they have any special diet or if they allergic to any foods. The unit where you work has an obligation to provide food that respects the needs of all clients including cultural needs.

28. Cultural Needs And Choice It is important to give patients in your care choice in the food that they eat. This will make your patient feel more comfortable and meal times more enjoyable. In a hospital environment your patients do not have the opportunity to have their food around a table most patients will have their food at the bed side which may make your patient feel uncomfortable.

29. Cultural Needs And Choice Cooked food should be offered both in the type of food, the way it is cooked and the quantity of food that is provided. You also need to consider religious requirements and personal preferences that people have in respect of their food.

30. Vegetarians do not eat meat or meat based products. Vegans are vegetarians who also do not eat dairy products, eggs, or any animal related foods. Muslims do not eat pork or meat from carnivorous animals and will only eat meat killed in a particular way (halal). Alcohol is forbidden. Jewish people do not eat pork or meat and milk together. Meat must have killed and prepared in a particular way (kosher) Hindus do not eat beef, and many are vegetarian. Alcohol is forbidden. Sikhs do not eat beef and do not drink alcohol. Rastafarians are mainly vegetarian, although those who do eat meat cannot eat pork. Cultural Needs

31. Assisting The Patient When patients are confined to bed you need to consider their position before they eat. If the patient needs to be moved in order to eat their meal, you should offer any assistance necessary, but otherwise encourage the person to be as independent as possible. If you need to assist your patients to use the toilet before the meal do so, in a quiet and dignified manner.

32. Assisting The Patient Patients who need protective napkins should be given them before they eat. Sometimes it will be necessary to protect clothing and for comfort and cleanliness to protect a person’s neck, and chest if they do have some difficulties in eating. It is far better to offer some kind of protection and allow patients the dignity and independence of feeding themselves than to feed them simply because they make a mess

33. Some patients will experience difficulties in eating and drinking because of their condition, their level of confusion or their level of understanding.There could also be difficulties in someone eating and drinking properly because of environmental or emotional factors, or if they are embarrassed. Check if the patient needs any aids for eating and drinking see handout number 2 Assisting The Patient

34. Aids for Eating And Drinking See handout number 2

35. The patient may have a physical disability and they may be unable to move their arms. They may be unable to grip a knife or fork. They may be unable to cut up their food. A visually impaired may be unable to see the food and to know what they are eating. They could have a serious disorder where a patient is having problems in eating food The patient could be confused and forget they were eating or not be able to concentrate. The patient may have badly fitted dentures which could be resolved easily. The patients medication could have made them loose their appetite or made them nauseous The patient may have problems swallowing. You May Need to Assist Your Patient Because

36. Feeding Your Patient To prepare your patient you need to ensure you wash your hands. Without rushing your patient offer condiments and sips of their drink between mouthfuls. Support your patient in a dignified manner.Help the patient to clean themselves during and after eating. If the patient has poor eyesight describe what id on the plate. Always sit with the patient when assisting them to eat. Take this opportunity to talk to your patient.

37. Monitoring Patients It is essential to monitor the amount the patient eats and drinks, this may be recorded on a fluid balance chart / food chart or verbally to the nurse in charge. Monitoring of the patients diet may enable early detection of dehydration and malnutrition. If the patient has Diabetes their diet could be monitored to stabilise blood sugars.

38. Diabetes Mellitus Diabetes is the abnormal production of insulin within the pancreas resulting in a disorder of the metabolism of carbohydrates, fat and protein. A strict monitoring of the patient’s carbohydrates and proteins has to be maintained, with strict monitoring of patients blood sugars. Insulin therapy may need to be supplemented. A prescription diet must be followed, the patient will be supported by the Diabetic nurse, Dietician and Consultant.

39. Mental Health Problems Dementia- The patient may forget to eat or drink. The patient could refuse food or if they still live at home not be able to prepare the food. Depression- The patient may have a loss of appetite, or not be motivated to prepare food. Eating Disorders- A psychological problem including the loss of appetite and weight loss and needs to be reported and investigated.

40. Vomiting- A reflex action, the expulsion of the stomach contents. Dehydration- Fluid imbalance. Electrolyte disturbance I.e salts the body needs like potassium, sodium and chloride. Dyspepsia- Indigestion, pain after eating, heartburn or water brash. Dysphasia- Difficulty in swallowing. Aphasia- Inability to swallow at all due to a Tumour, Nerve Damage, or the patient may have a PEG tube. Anorexia- Loss of appetite. Jaundice- Yellow discolouration of the skin and mucus membranes. Important Terminology

41. Caused by foreign body getting lodged in the windpipe Food Boiled sweets Pen top Coins Aims Remove obstruction as soon as possible Summon medical help urgently if obstruction cannot be removed Symptoms Red at first – turning grey Unable to speak Clutching at throat Panic Choking

42. Allergic Reaction If a patient has an allergic reaction to a certain food the signs are • Flushed or swollen face, neck or mouth. • Coughing or choking • Vomiting • Sweating and muscle cramps. • Rash or other skin reaction.

43. Allergic Reaction • Tell the doctor or nurse in charge exactly what the patient had eaten. • Keep any left over food in case it is needed for analysis. • Record clearly in the person’s notes or case file that they are allergic to the particular food.