Nutrition + OT


The guest lecturer from today was very knowledgeable and enlightening. I did not have a strong background in nutrition nor did I realize the extreme importance of nutrition, especially in regards to the elderly and those that have been hospitalized. One takeaway from today's lecture was the importance of focusing on clients' quality of life over simply surviving. Especially in the acute care setting, if our goal is just to stabilize a patient and send them home, we have missed a huge part of our job! We should be focusing on making sure that the patients are able to get back to the things that are meaningful to them instead of having residual symptoms of being hospitalized including weakness and fatigue. Most if not all of these residual symptoms can be prevented with proper nutrition. One thing I did not know prior to this lecture was that patients leaving the hospital should be on an increased caloric intake and supplements at least 6 months following discharge including regular exercise to build back muscle mass that was lost while hospitalized. It could take upwards of 4,000 kcals of intake per day (with a strong emphasis on protein intake) over a period of months to get out of the hypermetabolic/hypercatabolic state and prevent further loss of muscle mass and muscle glycogen following hospitalization. Many of these malnurished patients are uneducated of the importance of proper nutrition which leads to many preventable complications. I liked the practical applications that she gave us regarding OT practice. For example, we can encourage our patients to bring their supplements (like Ensure) to therapy sessions in order to promote intake. In addition, we should be looking out for signs of malnutrition in practice and make referrals to dietitians when appropriate in order for our clients to receive the best care they can get and address any nutritional needs as soon as possible. In addition, we should encourage them to either follow up with a dietitian after they discharge or make sure the client has a thorough and comprehensive plan regarding nutrition for several months prior to discharge.  
One occupational therapy intervention that could be done incorporating nutrition includes doing a cooking task with an older adult client. Maybe the client has some motor deficits that is causing difficulty with cooking. The OT could not only address the motor deficits in the task but also educate the client on making sure that the meals they cook include ample protein because that will help them maintain their muscle mass and slow the progression of sarcopenia. 
Another intervention that could be done with OT in a group setting with clients that have some cognitive deficits include making a chart to put up in the home that serves as a reminder of their nutrient intake. For example, they could make a chart that has three boxes for each day, and every time the client drinks an Ensure, they can cross off one of the boxes. This could be a visual reminder to promote intake of enough calories (protein especially). The OT could also work with the group on creating a collage of various food items that are high in protein to keep in their home that also serves as a reminder of foods that they could make sure to buy at the grocery story and eat on a regular basis to maintain proper protein intake. 

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