Nutritional Assessment

Since this tends to be a holiday issue, let's talk about another piece of the comprehensive assessment. Food and how it influences our well being.

When we do a nutritional assessment what we look for is whether or not someone is at nutritional risk.

We do this by looking at a person's health and by determining how any illnesses they might have are affecting their appetite. We look at how difficult it is for someone to eat because certain foods may upset their stomachs or because certain disease processes or medications may cause sore or sensitive spots in and around the mouth. Any issues like these can deter a person from eating and obviously, affect their health.

We look at whether or nor they are eating a balanced diet. If it is not balanced, we look for what those underlying reasons might be. Is it a lack of money to purchase more expensive fresh fruits and vegetables? Or is it an inability to get to the store to shop or prepare them once they are home?

What is their dental health like? Do their dentures fit properly? If not, are they causing mouth sores that make it difficult to eat? Are there natural teeth that are missing or that may need treatment, such as fillings, which make it uncomfortable to eat or may contribute to an unbalanced diet?

Is the reason financial? If a person is spending less than $25.00 to $30.00 per week on food, it is hard for them to get a balanced diet. Some people truly have less to spend on food, whereas, some may choose to spend less. This choice may stem from incorrect beliefs or ideas about saving money that can be dealt with through counseling.

Social contact can be a determining factor of how well someone eats. Studies show that seniors who have no one to eat with or cook for are more likely to eat less nutritious meals. This is one of the reasons behind congregate meal sites and the Meals on Wheels programs.

Multiple medicines can also have an impact on appetite. The more medicines one takes, the higher the chance that there will be side effects that influence the appetite. These could be things like changes in the taste of foods, drowsiness, weakness and nausea.

Involuntary weight loss or gain can also signal nutritional problems. It could also be a sign that there is something more serious going on. In cases like this our first course of action is to have the client check with their doctor and have a more thorough evaluation done.

The short evaluation below can you give an indication of whether or not you have some nutritional issues.

• Do you have an illness or condition that made you change the kind and/or amount of food you eat? If YES, score 2 points.
• Do you eat fewer than 2 meals per day? If YES, score 3 points.
• Do you have 3 or more alcoholic beverages almost every day? If YES, score 2 points.
• Do you eat few fruits and vegetables or milk products? If YES, score 2 points.
• Do you have tooth or mouth problems that make it hard for you to eat? If YES, score 2 points.
• Do you eat alone most of the time? If YES, score 1 point.
• Do you take 3 or more different drugs a day? If YES, score 1 point.
• Have you lost or gained 10 pounds in the last 6 months, without making any changes to your diet? If YES, score 2 points.
• Are you not always physically able to shop, cook and/or feed yourself? If YES, score 2 points.

Now let's see how you scored. If your score is between 0 -2, consider your risk low or no nutritional risk. Recheck your assessment again in six months.

If your score is between 3 - 5, consider yourself at moderate risk and look at how to address the issues that could be causing this.

If the score is 6 or greater, consider yourself at high nutritional risk. Seek appropriate help and definitely look for ways to correct the problem.

Other things to be very cautious of are excessive alcohol use and any smoking behaviors. These habits can impair judgment about food choices or dull the taste buds which makes food less appetizing. Also be aware of the effect exercise has on you, your appetite and your weight. Exercise will help regulate weight and encourage an appetite to increase.

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