Inservice Long Term Care
- 1. ! ! Diet’s Explained A helpful guide to understanding differences among diets ! Maria Di Nello Nov. 2013 DIET MANUAL: BY MARIA DI NELLO !1
- 2. Low Sodium Cardiac Who is put on a cardiac diet? People with underlying heart conditions would best be suited for a cardiac diet. This refers to people with high blood pressure, hypertension, heart disease, and other heart concerns. This can also be used as a prevention diet to any type of cardiovascular disease. What is a cardiac diet? A cardiac diet is one that is lower in cholesterol, fats, and sodium. It also recommends a high consumption of whole grains, fruits, vegetables, and low fat protein sources. Main Differences from Regular Diet on Spreadsheet ! • • • • LS saltine crackers vs. regular crackers Plain pork with LS gravy vs. 3oz pork sandwich Decaf only drinks vs. any beverage of choice Herb seasoning packet vs. salt packet Fats and Sodium The person needs to watch their sodium levels and should not have more than 2g (1 tsp) of salt a day. Too much salt can cause an increase in blood pressure, putting extra stress on the heart. To limit saturated fats, you should primarily be avoiding fats that are solid at room temperature and egg yolks. Cholesterol is a fat that is commonly found in eggs, red meat, and shellKish. Adults are recommended to have less than 300mg of cholesterol in one day, someone on the heart healthy diet should have about 200mg. DIET MANUAL: BY MARIA DI NELLO !2
- 3. ! Regular Diet ! Who is put on a regular diet? This diet is given to residents who do not need any diet modification. They are considered healthy enough to have no nutrition concerns. It provides balanced nutrition in an aesthetically pleasing manor. This is the most liberal diet offered to residents. ! ! • • • • Main Differences on Spreadsheet No fluid restrictions No condiment restrictions (sugar, salt) No fruit and vegetable restrictions No bread and dessert restrictions DIET MANUAL: BY MARIA DI NELLO ! ! !3
- 4. ! Mechanical Soft Who is put on a mechanical soft diet? The mechanical soft diet is assigned to the resident who has difKiculty chewing or swelling the items found on a regular diet. This is the most liberal mechanically altered diet. ! What are foods like? Foods on this diet are soft. Whole and cooked meats should be grounds and vegetables should be cooked to a fork maskable texture. Everything should be able to be chewed easily and should be moist enough to stay cohesive. ! ! Differences from Regular diet? ! ! ! • Garden vegetable soup is pureed • Saltine crackers, condiments, and seasoning remain the same • Collard greens and banana pudding are pureed • BBQ pork sandwich has pureed BBQ pork on a soft bun • Sweet potato fries are mashed sweet potatoes DIET MANUAL: BY MARIA DI NELLO !4
- 5. ! Pureed Diet Who is put on pureed free diets? This diet is typically for residents requiring modification of food texture related to the inability to chew and swallow. This is the most mechanically altered diet and if for the residents who cannot tolerate the dyphagia mechanically altered and mechanical soft diet. What are the main differences from a regular diet? • Garden vegetable soup is pureed • No crackers • The BBQ pork sandwich has pureed pork with pureed bread • Sweet potato fries become scooped mashed potatoes • Collard greens become pureed collard greens • Banana pudding is purred banana pudding • All seasoning and condiment packages remain the same ! What foods are avoided on this diet? On this diets all foods must be pureed, smooth and cohesive with no mixed textures. Everything is pudding like and nothing that requires the need to chew is allowed. To enhance the appearance of this diet there are company’s that mold the pureed food into the foods they should look, meaning purred carrots would appear in the shape of carrots on the plate. ! DIET MANUAL: BY MARIA DI NELLO !5
- 6. Carb Controlled ! Who is put on carb controlled diets? This diet is given to residents with diabetes. It gives consistent meal patterns and portions of carbohydrates to help maintain blood sugar levels and manage weight. It is important for these residents to monitor their carbohydrate intake in order to prevent vision and nerve damage. These residents get 3 meals and a snack every day. ! Main Differences from Regular Diet: • • • • No crackers with soup 4oz spoodle of pears instead of banana pudding Sugar substitute packet for coffee No regular soda drinks, diet only ! What kinds of foods have carbohydrates? Foods that have carbohydrates are starches (breads, cereals, grains, rice, and pasta), dried peas, beans and lentils, fruits, vegetables (potatoes, corn, peas, winter squash), milk, yogurt, and sweets. ! DIET MANUAL: BY MARIA DI NELLO ! !6
- 7. 2gm Sodium Who is put on this diet? Residents typically put on this diet may have cardiovascular disorders like congestive heart failure, hypertension, or high blood pressure. If someone has chronic renal failure, edema (Kluid retention), or cirrhosis with ascites. The goal of this diet is to reduce water retention, help with blood pressure control, and to prevent being thirsty in those with Kluid retention. Foods avoided on this diet Bacon, lunch meat, ham, commercially prepared cheese, bread and crackers with salted tops, chips, crackers, pretzels, canned foods, instant hot cereals, pickles, olives, canned vegetables, salted nuts, gatorade, soups, teriyaki sauce, soy sauce, ketchup, salt and seasoning salt. Main differences compared to regular diet? • • • • ! ! LS Vegetable soup is the same No crackers vs saltine crackers BBQ pork sandwich —> 3oz plain pork sandwich with LS gravy Sweet potato fries, collard greens, banana pudding are the same • • All condiments are the same Salt packet —> Herb seasoning DIET MANUAL: BY MARIA DI NELLO !7
- 8. Dysphagia Mechanically Altered ! Who is put on these diets? This diet is typically given to residents who are transitioning from a pureed diet texture to solid foods. These foods are soft and moist and meats are ground or minced. This diet is given to those that have difficulty swallowing or chewing. Typically swallow evaluations are done in order to determine whether or not someone needs this diet. ! Main differences compared to a Regular Diet? • • • • • • • Vegetable soup—> pureed soup Saltine crackers —> no crackers BBQ pork sandwich —> ground BBQ pork, gravy, pureed bread Sweet potato fries —> mashed potatoes Collard greens —> chopped collard greens Banana pudding —> pureed banana pudding Same condiments ! Ground Meat Diet This diet would be for someone who cannot tolerate an entire portion of meat and need the meat to be ground in order to have an easier time consuming their meat. DIET MANUAL: BY MARIA DI NELLO !8
- 9. High Protein Renal Who is put on this diet? This is a diet that is given to patients with ESRD who are on dialysis. When someone is on dialysis, they have increased nutrient needs. Hemodialysis is done to clean the blood and Kilters/ removes waste, extra Kluid, and balances electrolytes (sodium, potassium, bicarbonate, chloride, calcium, magnesium, and phosphate). When someone has kidney failure, the kidneys are unable to perform these functions so hemodialysis is used instead. What does the diet consist of ? These patients need extra protein and calories since the dialysis treatment removes protein and calories from the body. It is recommended to get this extra protein from high quality sources like lean meats, poultry, Kish, and egg whites. Main differences compared to a Regular diet ! • • • • • • • No soups—>small salad No crackers —> diet dressing No bread —> Plain meat with LS gravy No french fries—> Instant mashed potatoes No collard greens —> green beans No banana pudding —> Canned pears No salt packet—> Herb Packet What foods should be limited? It is recommend to avoid foods high in sodium, phosphorus, and potassium. Fluid intake may also be monitored. DIET MANUAL: BY MARIA DI NELLO !9
- 10. Thickened Liquids Who is put on this diet? These kinds of diets are prescribed differently for all residents that are on dysphagia diets. The different consistencies are thin, nectar, honey and pudding thick. What does the diet consist of ? Thickened liquids are any liquid to which a thickening agent is added to create a thicker consistency. The preferred standard of Sodexo is to purchase pre-‐thickened liquids. Certain foods are considered thin liquids and should be avoided if thin liquids are restricted. Any food that becomes a liquid at room temperature or body temperature should be avoided including all hot and cold beverages, regular milk on cereal, frozen malts, and milk shakes. Main differences compared to a Regular diet: Nectar Thick: Only allowed liquids that have been thickened to a consistency that coats and drips off a spoon, similar to unset gelatin Honey Thick: Liquids are thickened to a honey consistency. The liquids flow off the spoon like a ribbon, just like actual honey Pudding Thick: Liquids have been thickened to a pudding consistency. They remain in a spoon in a soft mass. Examples of Thickened Liquids? Examples include frozen yogurt, egg nog, nutritional supplements, ice cream, sherbet, gelatin or jello, soups. DIET MANUAL: BY MARIA DI NELLO !10