1. Proper Nutrition Is Important to the Health and Well Being of Nursing Home Residents

3. Enough intake of essential nutrients to maintain good health

8. Nutrition Care Alerts Program Improving the Nutritional Health of Your Residents !

9. Designed to help maintain nutritional health of residents Designed to help facilities address four areas of resident care !

10. Four Common Nutrition Related Conditions Unintended weight loss Dehydration Pressure ulcers Complications of tube feeding

11. Physician Nursing Assistant Nurse Dietitian and Diet Technician Pharmacist

12. Unintended Weight Loss Needs help to eat or drink Eats less than half of meals/snacks Complains of mouth pain Has dentures that don’t fit Has a hard time chewing or swallowing !

13. Unintended Weight Loss Has trouble using utensils Is sad, has crying spells, or withdraws from others Is confused, wanders, or paces Has diabetes, COPD, cancer, HIV, or other chronic disease !

14. Unintended Weight Loss Report observations and warning signs to nurse Encourage resident to eat Honor resident’s food preferences Offer alternative foods, drinks Help resident who has trouble feeding him/herself

15. Unintended Weight Loss Don’t rush resident while he/she is eating Record meal/snack intake Provide oral care before meals Position resident for feeding as directed by nurse

16. Dehydration Drinks less than 6 cups of liquid daily Has dry mouth, cracked lips, sunken eyes, or urine is dark in color or has strong odor Needs help to drink Has trouble swallowing liquids Has vomiting, diarrhea or fever Is dizzy, easily confused, or tired !

17. Dehydration Report observations and warning signs to nurse Encourage intake of 2-4 ounces of water every time you see resident, unless directed otherwise Record fluid intake Offer ice chips frequently, if permissible

18. Dehydration Offer sips of liquid between bites of food at meals and snacks Make sure resident can lift pitcher and cup If resident cannot drink without help, offer appropriate assistance

19. Pressure Ulcers Is subject to -incontinence -heavy perspiration Needs help -moving arms,legs,or body -turning in bed -changing position when sitting !

20. Pressure Ulcers Has lost weight Eats less than half of meals and snacks served Is dehydrated Has discolored, torn, or swollen skin over bony areas !

21. Pressure Ulcers Report observations and warning signs to nurse Check and change linens as appropriate to keep resident dry Handle/move resident with care to avoid skin tears and scrapes Reposition resident frequently and properly

22. Pressure Ulcers Use “Unintended Weight Loss Action Steps” to improve calorie/protein intake Record meal/snack intake Use “Dehydration Action Steps” to improve fluid intake if resident is orally fed

23. Residents Who Are Tube Fed Has nausea, vomiting or diarrhea Has swollen stomach or stomach ache Has constipation or cramping !

24. Residents Who Are Tube Fed Has coughing, wheezing, wet breathing, or a feeling of something caught in the throat At the site where the feeding tube enters the body there is -pain, redness, heat or swelling -crusty or oozing fluid !

25. Residents Who Are Tube Fed Report observations and warning signs to nurse Maintain position of resident with head elevated 30 degrees or more, as tolerated, during feedings and for at least 30 minutes after feedings

26. Based on the Nutrition Care Alerts Adapted with permission by the Nutrition Screening Initiative, a project of the American Academy of Family Physicians, American Dietetic Association, and National Council on the Aging, Inc., and funded in part by a grant from Ross Products Division, Abbott Laboratories, Inc. These materials were developed by the National Policy and Resource Center on Nutrition and Aging at Florida International University through grants from the US Administration on Aging and US Health Care Financing Administration.