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Contents

Index. Page 2Learning outcomes. Page 3Alignment to Qualifications and Credit Framework (QCF). Page 3Links to Care Quality Commission (CQC) outcomes. Page 3

Unit One. Pages 4 - 6Prevention of malnutrition in vulnerable adults.Unit One Questions. Page 7

Unit Two. Pages 8 - 12Signs and symptoms of malnutrition and dehydration.Unit Two Questions. Page 13

Unit Three. Pages 14 - 16Assessing nutritional requirements.Unit Three Questions. Page 17

Unit Four. Pages 18 - 24Screening.Unit Four Questions. Page 25

Unit Five. Pages 26 - 29The environment for eating and drinking.Unit Five Questions. Page 30

Unit Six. Pages 31 - 33The eating experience.Unit Six Questions. Page 34

Unit Seven. Pages 35 - 37Providing for special dietary requirements.Unit Seven Questions. Page 38

References and further reading. Page 39

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The ‘Malnutrition Universal Screening Tool’ (‘MUST’) is reproduced here with the kind permission of BAPEN (British Association for Parenteral and Enteral Nutrition). For further information on ‘MUST’ see www.bapen.org.uk.

Learning outcomes.

• To provide an overview of good nutrition and hydration.• Identify the elements of a balanced diet.• Identify the causes and consequences of malnutrition and dehydration.• Be able to identify and assess the potential of malnutrition using the Malnutrition Universal

Screen Tool (MUST).• Be aware of the ways to prevent or treat malnutrition / dehydration.• Know when to refer to specialist support – G.P. etc.

Alignment to Qualifications and Credit Framework (QCF).

Covers knowledge elements of units HSC2014. FSN201 FSN301.

Links to Care Quality Commission (CQC) outcomes.

Outcome 4: Care and welfare of people who use services. Outcome 5: Meeting nutritional needs.

N.B:Weareawarethatofficialpracticeistousetheterms“serviceusers”or“peopleusingthisservice”todescribethosereceivingcare.Weprefertheterm“client”anduseitthroughoutourtrainingpackage.

Key:

worksheet important

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Unit One

Prevention of malnutrition in vulnerable adults.

This manual is intended to support carers to recognise, treat and prevent malnutrition and dehydration in elderly clients. On completion of this course carers will have knowledge and understanding as described in the learning outcomes on page 3.

A balanced diet.

Nutrition and hydration are very important for everybody. Access to basic food and drink is a fundamental right. Good nutrition and hydration can have a positive effect on people’s health and wellbeing and are an important part of successful aging.

Dehydrationcanbedefinedashavinganinsufficientquantityofwaterinthebodyinordertocontrol and regulate the body’s normal physical functions.

What is a normal diet?

Foodandfluidsareanecessityforlife,withoutthemwewouldnotsurvive.Theyareessentialfor growth, energy, health and repair and for protection against illness.

According to Field & Smith (2008) nutrition is a process whereby food is taken into the body and broken down, allowing for production of energy necessary for the maintenance and function of all living cells.

Adequate nutrition is necessary to provide energy for all vital functions, provide for the building and maintenance of body tissues, and to regulate body processes such as temperature control.

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A balanced nutritional diet includes the three major food groups:

• Carbohydrates: potatoes, cereals, bread, pasta, rice.• Protein:meat,fish,cheese,eggs.• Fats:

Saturated fats - dairy products, milk chocolate. Polyunsaturatedfats-foundinfresh,frozenorcannedoilyfish;vegetableoils. Monounsaturated fats – olive oil, avocadoes.

Plus:

• Dietary Fibre.• Vitamins and minerals.• Fluids.• Fruit and Vegetables.

Anexcess,deficiencyor imbalanceofanyof theseessential componentscan lead topoornutritional status and in some cases malnutrition.

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Daily recommended calorie sources:Carbohydrates - 47-50% minimumProtein - 15% maximumFats - 33-35% maximumAlcohol - 0-5%

Fluid (Water).

Althoughnotconsideredasaspecificnutrient,waterisanessentialcomponentofourdietandmakesup50to70percentofanadult’stotalbodyweight.Withoutfluidsurvivalislimitedtoaround 3 to 5 days.

Water is vital for normal body growth and maintenance. It is also involved in a number of processes, for example temperature control, kidney function, and removal of waste products.

Water is lost from the body through:

• Urine, faeces.• Sweat.• Respiration.

Water is obtained from three main sources:

• Normal drinking.• Through diet, particularly fruit, vegetables.• As a by-product of chemical reactions within the body.

Mosthealthyadultsrequirebetweenoneandoneandahalflitresoffluidaday,thisneedstobe increased if they are physically active or during periods of hot weather. Older people may require up to 2 litres.

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Of the three major food groups which should you eat most of?3.

Unit One Questions

Why do we need to eat?1.

How long can a person survive without water?2.

Why do you think fruit and vegetables are an important part of a balanced diet?5.

Whyisitimportanttohaveextrafluidsinhotweather?4.