Do health shakes need MD order?

[Loveness14]

Hello Everyone,

I work in Assisted living & Memory Care. Some of my residents like to drink health shakes between meals. Do I need a MD order? Should it be PRN? And how would I request it...as a nutritional supplement? I am thinking that will imply they are not eating enough.

Please let me know your thoughts, or how you word the order, (if needed), at your facilities.

Thank you in advance.

[ktwlpn, LPN]

I work in LTC and we need an order for everything-I don't know the first thing about assisted living, sorry I can't help you.

[Mn nurse 22]

Is your facility providing the health shakes? Do the assisted living residents have orders for medication administration? How independent are they?

i would think that an independent resident who took their own meds and only needed minimal assistance with ADLs probably doesn't need an order for a health shake.

A memory care resident if you are providing medication administration and assisting them to drink their health shake might need an order.

i don't know the regulations about that, especially for your state, just what I always thought through if I was deciding to seek MD orders.

Wouldnt hurt to check nutrition label ad make sure it is balanced nutrition and not contraindicated with their other meds.

[mander]

I live in New York. I worked as a care aide on the memory care unit and as a medication aide on the 'enriched' side where everyone was pretty independent. Health shakes were always considered a medication and we had to watch people drink them. On the memory care side the nurse was technically supposed to stand there and watch the resident drink them. They always needed an order. Now, some of the residents took their own meds on the enriched side and we would give them a box of shakes or put in in their refrigerator for them. Or they just went and bought their own.

I would assume that they really shouldn't be drinking them unless they weren't eating enough... can't they cause weight gain? Then again, they can do what they want so I guess you wouldn't be able to refuse it to them. Sounds to me like you would get a PRN order and let the resident keep the shakes in their rooms? I think it depends on what is allowed at your facility or not. I wasn't working there as a nurse so this is just from my observations/experiences as an aide.

[Sam J.]

Few things in an ALF in many states require a doctor order. In fact, in many states ALF requirements focus only on the financials- such as how deposits must be handled, eviction protocols, and that certain staff can't be hired (for listed barrier crimes)- look up your state's regulations, you might be suprised at how brief they are, more so compared to a SNF's. ALF residents aren't normally considered 'patients', so the rules are fast and loose. ALFs are the biggest rip-off in the American health care spectrum. The fact that the people there want healthshakes tells me the food is lousy- and great food is commonly the best marketing/selling point of many ALFs. And I betcha those people are going to be charged a hefty surcharge for those shakes, even if they don't eat the meals that are offered. Other than telling the owners of the ALF that the food may be lousy, I'd suggest consulting your policy manual (if there even is one)- I bet it will only address how to bill the occupants for those shakes.