There are several quality variables that can be assessed during a meal time visit at a facility. Meal time is not only for intake of foods and fluids. The mood and ambiance of the environment are factors that lead to an enhanced dining experience.
While visiting a patient on a memory care unit at meal time, the following was visualized. One of the residents was at a dining room table and a staff member appoached her from behind. The resident became very upset and stated she did not like to be approached from behind. She said she does not hear or see well and insisted that she be approached from the front so she can see. She gets frightened when she does not know someone is approaching her.
As I sat with my patient at her table, three other staff members appraoched this resident from behind. By the time the last staff member had demonstrated this behavior, the resident was so upset she asked to be removed form the dining room. She had not finished her meal. While I am not at the facilty every day, I have a high level of suspicion that this happens at most if not all meals. Whether there are sensory issues for this senior or not, she has made it clear what her wishes are. The staff need to comply with those wishes for her safety and well being.
The concern is that the nursing and professional staff are not communicating the needs of the residents to everyone involved on the team. The wait staff should be fully aware of the care plan needs of all of the residents. They should be trained in monitoring behavior and know interventions. They are the best eyes and ears for the professional team and their input is essential for early issue identification. They should be trained to report ineffective iinterventions to the professional team. Professional nursing staff should be in the dining area for every meal to observe intake, eating or swallowing difficulty and as a just in time trianing resource for the non medical wait staff.
Weight loss can be deadly for serniors. Most often they are not in prime nutrional health and a loss of weight usualy means loss of muscle mass. Loss of muscle mass leads to further disabiity due to loss of functional reserves that are already in short supply.