A Case Study In Dementia Care

As Marjory MacLeod told us at the beginning of the week, the BDA Scotland Board were hosting a Scottish Parliamentary Reception on Wednesday June 10th to showcase the role of Dietitians and their work in the area of dementia. Last night that event took place, and it was a great success wth key partners displaying resources and examples of good practice to dietetic colleagues and MSPs from across Scotland.

One of those illustrating her work was Sheila Riddoch Lead Dietitian, Acute Services, NHS Sheila RiddochGrampian, and now she has taken the time to share her work further through our blog.

As Marjory said in her blog on Monday approximately 90,000 people are currently living with dementia in Scotland and Dietitians play a vital part in their care.

Eating and having a good meal is part of our everyday life and important to everybody, not least to people living with dementia. However dementia can greatly affect a person’s relationship with food and eating. Whilst the difficulties experienced vary from one individual to another the result is often weight loss and deteriorating health. Undernutrition is common among older people generally; and the consequences include increased frailty, skin fragility, falls, hospitalisation and increased mortality. In people with dementia, undernutrition is particularly common. It also tends to be progressive, with weight loss often preceding the onset of dementia and then increasing in pace across the disease course. However, whilst weight loss is a common problem for people with dementia, undernutrition can and should be avoided.

Sheila demonstrating the pictorial menus and illustrating colour contrast crockery and trays.
Sheila demonstrating the pictorial menus and illustrating colour contrast crockery and trays at the Scottish Parliament.

The cause of undernutrition in people with dementia is often multi-factorial involving the behavioural, emotional and physical changes which take place as dementia progresses. However one of the common problems which people with dementia encounter is a change in vision and a reduced understanding of what they are seeing. This led to research by a team at Boston University who showed that if we change what we do, and thereby allow people to see their food; they are much more likely to eat it. In context, what the team did was serve food to people with advanced Alzheimer ’s disease on standard white plates and then served the same food to the same client group on red plates. What they found was that people eating from the red plates consumed 25 percent more food than people eating from white plates. The simple reason for this improvement was that the contrast in colours between the food and the crockery allowed people to see their food more easily and subsequently they were more inclined to eat it.

With this research in mind NHS Grampian trialled the use of colour contrast crockery and coloured reusable drinking glasses in a local assessment unit for older people. When compared to the use of the traditional crockery and disposable white tumblers, positive feedback was received.

Since the provision of a good quality eating experience is an integral part of the therapeutic care provided in hospital and the results of the trial were so positive, a decision was taken to introduce the new crockery & tumblers to all hospital wards in NHS Grampian. This is seen to be a very positive move given the fact there is a high number of patients who could potentially benefit from high contrast crockery. This move also serves to ensure that there is a consistent approach across the Board and it supports equitable access whilst eliminating the ‘labelling’ of patients with individual needs.

Key Facts & Case StudiesFor more case study examples which illustrateNDRUK Resource how dietitians are working to improve nutritional care in dementia across Scotland click here.

For more practical information and advice aimed at carers of those with demenia click here.

Finally for more information on Dietitians and Dementia click here.

If you would like to share your case study examples, or your thoughts on the blog, please leave a comment below.

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