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Nutrition and Hydration Programme Case Study with Care 4 U

Sharing the programme with the team at Care 4 U

Cares 4 U, an independent Home Care Agency in Rochdale were approached by Martin Hazlehurst, GM Nutrition and Hydration Programme Worker.

The agency has a client base of around 90 service users who are cared for by the team in the local community.

Martin explained about the GM Nutrition and Hydration programme and why it is being undertaken and its benefits to both service users and also the agency staff. He explained that the training could help prevent hospital admissions or even longer stays in respite or other care facilities. Therefore, enabling people to remain at home and healthier!

Staff received training

The training provided to the staff was extremely well received and gave valuable insight to the carers, who deal with the most vulnerable on a daily basis, and provided them with the awareness of what signs to look out for and how to use the Armband to physically check for being underweight.  Several of our service users were highlighted as needing some form of early intervention such as:

  • Introducing a Food Diary
  • Involving the family
  • GP referral
  • Dietitian involvement

Here are two stories of service users who have benefited as a result of this awareness training.

Kathy, age 89, living alone, living with dementia

Kathy lives alone and is living with dementia. She was receiving home care from Care 4 U, 3 times a day – morning, lunch and evening. At the morning call the carers attended to personal care and gave her breakfast. She didn’t always eat all her breakfast. When care staff went back at lunch Kathy would often say that she had already eaten. The family visited at tea time so the next call from Care 4 U was in the evening.

Following Nutrition and Hydration training, the evening carer noticed that Kathy’s pyjamas were very big on her and that she had lost weight. She tried out the Paperweight Armband which signposted that she may be at risk of undernutrition. The carers also highlighted that her drinks were often untouched from the previous visit.

When speaking to the family it became clear that Kathy was telling them that she wasn’t hungry at tea time, saying she had eaten already. Despite good care between the carers and the family no one had noticed that she was barely eating anything. The family believed it was normal for older people to lose weight so they hadn’t been concerned.

Working together, the family and carers put a food diary in place to keep track of what Kathy was eating and her visits were extended to give her company while she ate. They purchased weighing scales to monitor her weight. This improved steadily and after just a month Kathy was back in the healthy weight range.

Dorothy, age 87, living alone

Dorothy lives alone. She lost her husband over a year ago and was receiving home care from Care 4 U. Dorothy was of slight build and never seemed to have much of an appetite so it was accepted by care staff that it was ok if she didn’t eat very much.

Following the Nutrition and Hydration training Dorothy’s main carers tried the armband test on her. They also noticed her clothes were loose. The armband test showed she was underweight. Dorothy’s son had put her lack of appetite down to the loss of her husband and just “getting older.” Following the red-flag questions, a referral was made to the GP who visited Dorothy at home. The GP made a referral to the Dietitian who visited Dorothy and her son and set up a plan of action to improve Dorothy’s eating. This involved providing Fresubin drinks for a short period, putting a food diary in place to record exactly what she was eating each day and providing extra home care visits so the carers could prompt her to eat little and often.

Dorothy was weighed at the start and then monitored 4 weeks later. She was putting on weight and has not needed to be referred back to the GP. She has continued to improve and no further involvement from Dietitian has been required.  Dorothy continues to be cared for at home and the carers are more aware of the signs to look out for should she decline in the future.

**The names have been changed to protect the identity**