The availability and an assessment of the nutritionally-relevant information from 100 medical records of ambulatory residents in ten special care units (SCU) for Alzheimer's patients was determined. Eight facilities had estimated calorie and fluid needs and four estimated protein needs of residents. Over 40% of the residents were underweight and significant weight loss was reported for 20%. Values for hemoglobin, hematocrit, albumin and cholesterol were available on 61, 60, 36, and 25% of the patients, respectively. Hemoglobin, hematocrit and albumin were 8% lower and cholesterol was 24% higher than the levels associated with high death rates among institutionalized elderly. Many factors existed placing patients at high risk for malnutrition. Staff at all the facilities monitor the nutritional status of Alzheimer's patients to a variable extent.
Patients with Alzheimer 's disease (AD) are particularly vulnerable to many ofthe riskfactors ofmalnutrition. The delivery ofnutritional care to these patients is an essential component in reversing or averting the development of malnutrition in this population group. The attitudes of the staffinvolved in the care ofthese patients may greatly influence the quality ofcareprovided. Staffofspecial care units (SCU) for dementia patients and of adult day care programs (ADC) filled out a questionnaire designed to determine their attitudes towards the provision of nutritional care to AD patients. SCU staffscored significantly higher (p < .05) than ADC staffin only two ofthe
Staff training in special care units (SCU) and adult day care programs (ADC) is extremely important for the proper management of Alzheimer's disease (AD) patients, even though there are indications that current training programs may be inadequate. Staff of 11 SCUs and 12 ADCs completed questionnaires designed to characterize the nutrition-related training they received in order to identify areas where improved training could result in better nutritional care of clients with AD or other dementias. Staf of both settings reported in-services as the most commonly attended training activity followed by conferences. ADC staff attended significantly more college courses that included topics related to AD than SCU staff (p < .05). The most frequently reported topics included in training sessions were, encouraging Food Science and Human Nutrition, University of Missouri, Columbia, Missouri. Candace S. Holdt, PhD, RD, is Assistant Professor, Food Science and Human Nutrition, University of Missouri, Columbia, Missouri. food intake, responding to problem eating behaviors, and providing verbal cues to eating. The topics less frequently covered in training were managing overeating, sanitary feeding techniques and manipulation of food shapes, sizes and consistencies. Both groups reported that experience was their best preparation for work with AD clients. More studies are needed to determine what areas of training in the nutritional aspect of care are most effective, how to deliver training programs to impact the ability of staff to provide appropriate nutritional care to clients with AD, and how to measure the effectiveness of training.
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