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Caithness General Hospital
Queen Elizabeth Assessment & Rehabilitation Unit
The Dietetic Department
Many people whilst in hospital may find they have been referred to a dietitian. The reasons why people are referred can be many and varied but the ultimate goal remains the same. That is to optimise the nutritional status of patients whilst maintaining quality of life. Dietitians are often associated with providing advice to people who may overeat. In fact, a lot of our work in hospitals is involved with ensuring people eat enough, especially when appetites are poor or diets may be restricted.
On admission to the Queen Elizabeth Assessment and Rehabilitation Unit, when possible, patients are screened with a “Nutritional Risk Tool” by nursing staff. If a patient is deemed to be at risk of poor nutrition from the screen, they will then be referred to the dietitian. Patients may also be referred directly from hospital staff such as doctors, nurses, speech therapists, physiotherapists etc, who feel dietetic input would be helpful. It is also possible for patients to request to see a dietitian.
When a patient is referred, a full nutritional assessment will be carried out. Data collected may include heights and weights, eating ability (eg well fitting dentures, ability to feed self), blood test results, medications and information on medical condition. An interview with the patient is carried out whenever possible to ascertain the patient’s views on dietary intervention and to allow any barriers to achieving good nutritional intake to be identified.
Any intervention depends entirely on the individual case. Here are just a few examples of more common intervention on the Queen Elizabeth Assessment and Rehabilitation Unit:
· We can act as a source of information, helping people to understand the role diet can play with certain conditions, for example diabetes or multiple sclerosis. Perhaps more importantly, we can show how that translates to food on your table. There are usually leaflets available to provide further information from the Dietetic Department.
· We can help to identify problems people may have with eating and give advice to overcome them with dietary tips and assistance with menu planning. For example if there is difficulty chewing, the person may need soft, easy-to-eat meals to be arranged.
· If diets are restricted in any way because of poor appetite, difficulty with eating or special diet, we can identify any nutrient needs that are not being met and suggest ways to supplement intake if necessary. This can sometimes involve the use of special nutritional supplements such as Ensue Plus milky drinks with added vitamins and minerals, or other nutritional supplements.
· We can arrange appropriate texture of foods if there are problems with swallowing, which will provide adequate nutrition.
· If a patient cannot take any diet by mouth, we can arrange special methods of feeding through a tube into the stomach (called a nasogastric tube or PEG tube)
Remember that good nutrition can help speed the road to recovery, meaning discharge from hospital may be earlier and is therefore of great importance. The dietitian is trained to give individualised advice to help ensure intake is adequate for everyone. So if you have special diet needs that you need help with or if you feel you are losing weight, do not be afraid to ask to see a dietitian.