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Nutrition & Diet: Issues for People who have Learning Disabilities

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Introduction

Nutrition & Diet: Issues for People who have Learning Disabilities A Learning Contract Steven Perks Group T September 1999 Advanced Diploma in Clinical Nursing Tutor: Andy Philpott The aim of this learning contract is to enhance my knowledge on the importance of a well balanced, varied and healthy diet among the people with whom I work. I will look at addressing what constitutes a good diet, which nutrients are important to us in terms of promoting health and wellbeing and specific issues, which may be associated with people who have learning disabilities. I will then hopefully come to some conclusions about the importance of promoting and supplying a healthy diet to the people with whom we work. I will conclude with an evaluation of the learning contract. The nutritional status of people is seen as of particular importance in the field of nursing, not only in the physical sense of health, but as LeMay (1996) stresses also the influence it has on the persons psychological and social wellbeing. Bond (1997) emphasises the fact that significant expertise is needed to assess problems associated with eating and in the provision of appropriate interventions. Sarah Mullally, England's Chief Nursing Officer said recently: 'Every nurse is responsible for ensuring that people receive dietary care appropriate to their needs' (Dinsdale 2000). To begin lets look at what is needed to provide a good diet. ...read more.

Middle

At the other end of the scale there are some people with learning disabilities who may be at risk of weight loss, or who may have difficulty in gaining weight. Lee and Nieman (1996) comment that factors leading to malnutrition include, inadequate nutrient intake, nutrient mal-absorption, increased nutrient requirements and inadequate emotional and social nurturing, all of which can be applied to people with learning disabilities living in long-stay environments. Dorset NHS Trust (1999) list the following reasons as to why some clients may become underweight, hyperactivity, behavioural problems such as meal refusal/refusal of certain foods, dysphagia, inappropriate feeding utensils, positioning at mealtimes, depression, and medical problems such as poor dentition. Dysphagia is a problem experienced by some people who are learning disabled, especially if there is associated cerebral palsy or a history of strokes. Weller (1997) defines dysphagia as difficulty in swallowing. The nurse's goal in feeding an individual with dysphagia is to maintain or improve nutritional status and to ensure safety during mealtimes (Copeman 1999). Food for individuals with dysphagia needs to be pureed or mashed; this can cause its own problems as Herbert (1996) states adding liquid to foods will reduce nutritional value by 50%, pureed food also looks unappetising and could lead to meal refusal. Therefore meals should be made to look as appetising as possible, thickened using Thickn'Easy, and made as nourishing as possible with the addition of calorie supplements such as Maxijul or Polycal. ...read more.

Conclusion

ARROWSMITH, H. DAVIDSON, A. and ROLLINS, H. (eds.)(2000) Adult Nutritional Support: A Practical Guide for Nurses. Longman Higher Education. COPEMAN, J. (1999) Nutritional Care for Older People: A guide to Good Practice. London: Age Concern. DAHL, M., THOMMESEN, M., RASMUSSEN, M. and SELBERG, T. (1996) 'Feeding and Nutritional Characteristics in Children with Moderate or Severe Cerebral Palsy'. Cited in ALDRIDGE, J., PULLEN, J. and WHELAN, C. (2000) A Survey of the Nutritional Status of Adults and Children Using the Learning Disability Services of a Health Trust. Journal of Learning Disabilities. Jun. 4(2), pp.141-152. DEPARTMENT OF HEALTH (1995) The Health of the Nation. A Strategy for People with Learning Disabilities. London: HMSO. DINANI, S. and CARPENTER, S. (1990) Down's Syndrome and Thyroid Disorder. Journal of Mental Deficiency Research. 34, pp.387-392. DINSDALE, P. (2000) Food for Thought. Nursing Standard. 14(19), p.12. DORSET NHS TRUST (1999) Nutrition Facts for Learning Disabilities. Nutrition and Dietetic Services. HERBERT, M. (1996) Coping with Children's Feeding Problems and Bedtime. British Psychological Society. LEE, R. D. and NIEMAN, D. C. (1996) Nutritional Assessment. 2nd Edition. Boston: McGraw-Hill. LEMAY, A. (1996) Nutrition. Cited in CLAY, M. (2001) Nutritious, Enjoyable Food in Nursing Homes. Nursing Standard. 15(19), pp.47-53. PERRY, M. (1996) Treating Obesity in People with Learning Disabilities. Nursing Times. 28Aug. 92(35), pp.36-38. ROPER, N. LOGAN, W.W. and TIERNEY, A. J. (1990) The Elements of Nursing Based on a Model of Living. 3rd ed. Edinburgh: Churchill Livingstone. SULLIVAN, A. and TUCKER, R. (1999) Meeting the Nutritional Needs of People with Mental Health Problems. Nursing Standard. 13(47), pp.48-53. WELLER (2000) Bailliere's Nurses Dictionary. 23rd ed. Mosby ...read more.

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