The client who I chose to do a mini nutritional assessment on is an 84-year-old male Caucasian male with a late stage of dementia. He is my grandfather and lives in my house with my family and I. He has been living with us for at least five years up to this point. This person is not at risk for malnutrition and is not malnourished. The MNA shows that he is actually in a normal range for his nutritional status. As you can see from the form attached, he is pretty much all within good ranges for each concept in regards to his nutrition. He has no pressure ulcers, he can feed himself, and with him living her with us we are constantly taking care of him and making sure he is getting enough of the needed nutrients and is safe and moving around frequently. He is in good spirits, just needs a little extra help sometimes.
Care Plan: Short-term Goals
- First short term goal would be to limit his sugar intake in the mornings. He has been seen consuming too much coffee cake/desserts/pie in the morning with his coffee while reading the paper.
- He is often uninterested in drinking water, so I think it would help him if he were to incorporate more glasses of water in his day/diet.
Care Plan: Long-term Goal
- One long-term goal that would be crucial for this person would be what will his future nutrition going to look like? Right now, with him being here constantly around a family member, he is getting his medications on time with water and food, he is getting at least 3 square meals a day, and he is getting good healthy meals during the day with snacks intermittently. At some point, he will require the need for professional help either in an assisted living center or a nursing home. It is a concern that he will not be given the proper amount of attention or adequate nutrition when in a place like that. So, a long-term goal for him in regards to his nutrition, would be to make sure that if he ever changes locations, he is monitored and helped very frequently in this area.
For right now, this patient does not need to be educated on how to feed himself and on how to eat/chew/swallow. He is sufficient in that area. He needs to be educated on why it is important to eat three meals a day and why it is important to drink enough water. The problem with him though is that with his dementia he forgets to do so, but if he has the help of our family he will continue to have adequate nutrition levels as he does now. Again, if he were to change locations, the staff would need to make sure he is being taken care of as we take care of him here. If this happens, I have no doubt he will meet these goals listed above and he will be able to successfully maintain optimum nutrition. He should be sure to stay away from beer, processed meats and cheeses, microwavable popcorn, and white foods specifically since these foods are not good for dementia patients (Mole, 2018).
As stated earlier, right now this patient is not at nutritional risk. However, in a few weeks it would make sense to check again his levels and make sure he is still within proper range. When doing so, we can check to see if he is more hydrated, has clear urine, and this would help indicate that he has been drinking more water. Also, we can try to take away the coffee cakes in the morning to reduce the sugar intake. Giving him once slice and putting it away would be helpful and this could be a part of his education, as well as a part of the follow-up care. Lastly, follow-up care would involve checking with a professional to see if his nutrition is still normal if he switched locations. If he was still living with my family in a few weeks, we would check at his next doctor’s appointment to see if we are making sure we are doing a good job to keep his nutritional levels where they need to be.
The person that I interviewed is a 69 year old male. He is relatively active and does not show much if any signs of cognitive decline. His total MNA assessment score was 20, which puts him at risk for malnutrition. The main factors placing him at a risk for malnutrition are a moderate decrease in food intake leading to a loss of 4.5 lbs in the past 3 months. The patient does not have adequate intake of legumes or vegetables in his diet either.
Short Term Goals
Increase his intake of legumes, fruits and vegetables to at least 2 servings per day. Especially his intake of vegetables as he has expressed that he does not eat very much vegetables at all.
Increase his overall food intake including well rounded, nutritious meals.
Long Term Goal
Gain back the 4.5 pounds that were lost due to decreases in food intake over the next 3 months.
Research has showed a direct link between the intake of fruits and vegetables to a reduced risk of mortality among older adults (Nicklett & Kadell, 2013). The patient should increase his intake of green, leafy vegetables as this will give him vitamin K which promotes blood clotting and reduce bone fragility. Increasing the patients intake of legumes will also be helpful to supply him with good energy for his daily activities as they are filled with carbohydrates. Increasing his legume intake will also provide him with his daily fiber which will help with digestion. The patient should continue being active as this will keep his mind sharp and promote healthy cognitive function.
Follow Up Care
In 3 months, revisit the patient to see if he has accomplished his long term goal in gaining back the 4.5 pounds that he had lost from decreased food intake. Also, assess his diet and ensure that he is taking at least 2 servings of fruits and vegetables per day.
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