While the holidays are filled with fun and cheer for many worldwide, the emphasis on sampling delicious food during this time of year can bring about frustration, sadness, and depression for others. Many of our residents have diet modifications, whether due to following a cardiac (low salt) diet or the inability to safely swallow regular food textures and/or drink thin liquids. When this is the case, knowing resident rights concerning diet modiﬁcations can help SNF communities navigate the season safely while following food preferences and choices made by our residents.
When concerns related to diet are identiﬁed, diets are often modified. Although modiﬁcations to a resident’s diet are done with the resident’s best interests in mind due to medical or other reasons, we sometimes forget to consider the downside of diet modiﬁcations.
Some of the risks that can be attributed to diet modiﬁcations include the following:
- Weight loss
- Skin breakdown
- PEG site infection
- Loss of function
The American Speech-Language-Hearing Association (ASHA) and the Pioneer Network/Rothschild Foundation have established a Food and Dining Clinical Standards Task Force to address residents’ rights regarding diet modiﬁcation. This task force has created a care planning tool for reaching a mutual decision regarding how the IDT will accommodate dietary choices to maximize residents’ well-being.
Skilled nursing communities should adopt a policy regarding the utilization of the care planning tool before putting this tool into practice. Including this tool in SNF policies will provide the components needed to outline each discipline’s piece of the process and serve as a written policy & procedure for state surveyors to reference at survey time.
The intention behind the tool is for SNFs to honor resident choices while at the same time incorporating clinical judgment and upholding resident rights.
Below outlines the CMS Critical Element Pathways, which support diet and nutrition philosophies:
- CMS 20053 – Dining
- CMS 20075 – Nutrition
- CMS 20080 – Rehab and Restorative
- CMS 20092 – Hydration
- CMS 20093 – Tube Feeding
With proper utilization of the Rothchild Person-Centered Care Planning Tool, Speech and Language Pathologists (Speech Therapists) can help residents, families, and SNF communities navigate the process of understanding how to meet both clinical best practices and regulations associated with safety, food preference, and choices.
Let’s do all we can to make this holiday season as joyful as possible by ensuring our patients’ well-being is considered in all spheres — physical, mental, emotional, and social. Always be mindful of the risks associated with food restrictions or diet modiﬁcations.