Geriatric nurses, can you help? - page 2
I'm needing some nutritional resources for a patient who has a FTT (failure to thrive) dx. Doesn't want a Peg, but will eat certain foods with a very good appetite. One is ice cream. I recall... Read More
Oct 31, '05We use 2calHN which is a very high calorie drink and comes in many flavors. We've used Remeron with good results on some people. Megace is in the same category as many chemotherapeutic agents and very expensive. Never seen that work. Never have seen Marinol work either.
We use Magic Cups, super cereal, supermashed potatoes. Promod protein powder works to help heal wounds but is pretty nasty tasting.
I had one patient. She maintained her weight on nothing but ice cream and milk. She would refuse to eat anything else, so we'd give her ice cream shakes at breakfast, lunch and dinner and a cup of ice cream anytime we could get it into her. She died peacefully at the age of 98.
Oct 31, '05Promod protein powder works to help heal wounds but is pretty nasty tasting.
You might try mixing the Promod into about 100 mls of Ensure or Glucerna instead of water.
Oct 31, '05Quote from Angie O'Plasty, RNCall Sysco, it looks like that is who they get it from, your dietary dept likely already buys from them, they are about the largest restaurant / food services supplier in the US.I'm a little confused. The website seems to be a UofW purchasing contract from a local vendor.
Not sure how I'm supposed to use the information. Could you explain, please?
Here is the link to their contact info
Nov 2, '05This is probably more than you're asking for but here goes . . .
As with most problems, start at the beginning. WHY is this gentleman not eating? Look at his diagnoses and labs and see if they indicate a physiological problem (cancer/malabsorbtion). Does he have dysphagia and physically can't get the food down? What meds is he taking, could he be Digoxin toxic? Is he taking so many meds they're killing his appetite? Crushing meds is good for that. Does he have a zinc deficiency that's causing a smell/taste disturbance? What condition are his teeth and gums? Does he have chronic pain or constipation that's preventing him from wanting to eat?
Once you rule out the physical problems, start on the emotional ones as previously stated. Depression will stop people from eating. Is he end-stage dementia and doesn't know how to eat anymore? Psych can help with that.
I hesitate to throw more and more meds at people without considering all the above. In geriatrics, I consider all symptoms to be medication side effects until proven otherwise. I've never had any success with Marinol or Megace, either.
Okay, now take a look at his meal offerings--is he overwhelmed by the amount of food on the tray? Does he hate the sight of puree/mech soft? Is he overstimulated by the crowd and noise of the dining room? As people age, they tend to lose their taste, what remains is their taste for sweets.
Try all the suggestions made by the previous posters (I made notes to try on my unit, thanks!). Try drizzling maple syrup over meat, add ice cream whenever feasible to drinks. A big hit in my place are Creamsicle Floats--orange soda and ice cream around 3 pm.
Keep trying and remember to document your efforts in the chart, esp. the careplan to show you're doing all you can. Hopefully, something will work and in 6 months you can post your success story for us.
Nov 2, '05:kiss Hope I can help a bit. I oversee the restorative dining program at my facility. Has this resident been seen by speech(for swallowing difficulties) the dietician? Antidepressants are good but make sure you have a dx for depression, which is what it really is for. Does the resident need adaptive equipment? Plate guard, scoop bowl, adaptive utensils? They have a good appetite you mentioned, but for what? Can family/friends bring in favorites? If you don't have a restorative dining program you can refer them to, try an unrushed atmosphere in a smaller dining area. Feel free to email me and let me know how things go.
Nov 2, '05All great ideas. The biggest thing to remember is to get the most cal/ nutrients in the smallest amout of food. A lot of elderly don't have appetites....who would if you weren't up and moving, along with all the other smells of a nursing home.
We found that one of our residents weren't eating because they were nauseated from the faint smell coming from a room mates foley cath. Just something to think about too.
Nov 2, '05Got the answer for Magic Cup.
Go to www.4webmed.com, Desserts and Snacks then click on High protein/High calorie ice cream...TaDah...Magic Cup. Sells for $1.39 each.
I remember magic cups...long time ago though. Works good. I think it's more of a malt.
Nov 3, '05Wow.....1.39 each. Now I know why we have to have an order for this. Our dietary mangager used to refuse to give them to us for residents unless they had an order.:angryfire :angryfire Cheap @%!*&
Jan 10, '08The web site is www.hormelhealthlabs.com The ice cream comes in Wild Berry, Orange, Chocolate, and Vanilla. Vanilla is also available in a Sugar-Free version. Magic Cups are gluten-free.
Jan 11, '08Sounds like everyone has covered it, but we use Magic Cup too. Also ensure, promod protein powder ( I mix it with ice cream and make a "shake"). As for drugs we use megace, marinol and mirtzapine.
Jan 11, '08
Jul 23, '08we use magic cups in our ltcf. everone likes them;good extra nutient Really a cross b/t ice cream & pudding!