Question

The nurse in the long-term care facility cares for a 70-year-old man with severe (late-stage) dementia who is undernourished and has problems chewing and swallowing. What should the nurse include in the plan of care for this patient?

Answer 1

The nurse should include soft and easily chewable foods, nutritional supplements, collaboration with a speech therapist, a calm environment during mealtimes, regular weight monitoring, and involvement of the patient's family or caregiver in the plan of care.

Step-by-step explanation:

In the plan of care for the 70-year-old man with severe dementia who is undernourished and has problems chewing and swallowing, the nurse should include the following:

• Provide soft and easily chewable foods that are high in calories and nutrients, such as mashed vegetables, yogurt, and pureed meats.
• Consider nutritional supplements or fortified drinks to ensure the patient is receiving adequate nutrition.
• Collaborate with a speech therapist to assess the patient's swallow function and recommend appropriate modifications, such as thickening liquids or pureeing foods, to prevent aspiration.
• Maintain a calm and quiet environment during mealtimes to reduce distractions and promote focus.
• Monitor the patient's weight regularly to evaluate the effectiveness of the nutritional interventions.
• Consider involving the patient's family or caregiver in the meal preparation and feeding process to provide social support and encourage eating.

Special attention should be paid to the method of feeding to ensure safety and prevent aspiration, such as offering pureed or soft foods and assisting with feeding. The nurse should collaborate with a dietitian, speech therapist, and other multidisciplinary team members to manage the patient's nutritional status. Moreover, monitoring for signs of dysphagia (difficulty swallowing) and implementing appropriate oral care routines are also key components of the care plan.