I have spent the majority of my clinical rotation at a long-term care facility in Maryland. I never could have imagined what a unique opportunity this would be. As a wellness intern, I was thrilled to be in an environment that embraced the full spectrum of life and activities, but I was also apprehensive, never having worked with seniors. It took less than a week for me to truly feel at home with the residents. One moment, a resident is shrieking with joy after winning Bingo, and another moment a resident is clinging to my hand as she wrestles with dementia. I can’t put a finger on the exact moment, but I fell in love with long term care. Below are a few things I have learned during my rotation:
- Whether it’s ice cream and candy bars or spinach and broccoli, the most important focus is getting residents to eat. Many of their appetites have significantly diminished, so finding calorie-dense foods that they will tolerate is the name of the game.
- Interviewing residents can be like putting together a puzzle with missing pieces. Sometimes you have to do a lot of digging in charts and paper records to figure out what is really going on with someone. Many of them are poor historians.
- Protein is your best friend. As long as kidney function is stable, the residents are at constant risk for pressure ulcers and falls. They need plenty of protein to prevent further muscle wasting and to heal any skin tears or wounds.
- Long-term care is all about quality of life. Whether it is a particular diet order or their daily dose of medicine, the resident has the right to override it. If they should be on a cardiac diet or a nectar thick liquid diet, they can choose to be on pleasure feeds. As long as they can make decisions, they do make decisions. It is our job as dietitians to help our patients live their lives to the fullest.