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Nutrition, Kitchen Safety & Preparing Meals for Elder Care Receivers

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Title: Nutrition, Kitchen Safety & Preparing Meals for Elder Care Receivers


1
Nutrition, Kitchen Safety Preparing Meals for
Elder Care Receivers
2
Learning Objectives Participants will be able to
  • Plan meals using Dietary Guidelines
  • Reorganize the kitchen for safety convenience
  • Shop for groceries for best nutrition, economy
    safety
  • Identify safe food handling practices
  • Know easy meal preparation techniques
  • Demonstrate techniques to make mealtimes more
    pleasant for Care Receivers

This information is provided to raise awareness.
Always check with health care providers when
planning for serving meals.
We value your opinion. Please ask your instructor
for an evaluation form at the close of this
session.
3
Planning Meals Using Dietary Guidelines
  • Tailor the Guidelines to the specific Care
    Receiver
  • Choosing appropriate Dietary Guidelines
  • Physicians/Dietitians guidelines, prescribed
    specifically for the Care Receiver
  • Guidelines from organizations for specific
    chronic diseases of the Care Receiver
  • http//www.goldencuisinestore.com/home.jsp?navSect
    ionhomepageTitleHome
  • www.alz.org
  • www.diabetes.org
  • www.stroke.org
  • www.americanheart.org
  • www.Parkinson.org

4
New Dietary Guidelines effective 2005
  • One size doesn't fit all USDA's new MyPyramid
    symbolizes a personalized approach to healthy
    eating and physical activity. The symbol has been
    designed to be simple. It has been developed to
    remind consumers to make healthy food choices and
    to be active every day.

United States Department of Agriculture
Guidelines for Americans www.cnpp.usda.gov or
call toll free (888) 779-7264 Visit
http//www.mypyramidtracker.gov for menu planning
and food tracker tools.    
5
Note Any Food Allergies, Food/drug Interactions
All Other Do Not Serve Foods
  • Common allergy-producing foods include eggs, milk
    products, peanuts, wheat products
  • Some foods reduce effectiveness of certain drugs
  • Care Receiver may complain that certain foods
    cause gastric discomfort

6
Determine Care Receivers Food Preferences
  • Avoid serving foods the person dislikes
  • Substitute others to provided needed nutrients
  • Adjust recipes for favorite foods to satisfy
    dietary guidelines

7
Plan Meals From Appropriate Dietary Guidelines
Care Receiver Preferences
  • Prepare meal planning form, one plan sheet/day
  • As you plan, remember that good nutrition can
    come from simple foods, simply prepared
  • Attach recipes (if any) for that day to the form
  • You may want to make copies of frequently used
    recipes attaching a copy is easier than moving
    the recipe from form to form
  • Plan for one to two weeks
  • Look on the time required to do this planning as
    an investment in future time-saving stress
    reduction

8
Meal Planning
  • Shopping
  • Prepare grocery list from meal plan form
    recipes
  • Become familiar with the specific grocery store
    you use ( food safety practices)
  • Prepare grocery shopping list in the order of the
    aisles as you will shop them
  • Meal Plans
  • File meal plans for use rotating re-use (plan
    once, use over over)
  • File plans in loose-leaf notebook
  • Use a sheet protector to display the
    plan-of-the-day to hold any recipes for the day
  • Mount meal plans on refrigerator door with magnets

9
Meal Times
Care Receiver may prefer (or may be prescribed)
to have several smaller meals, rather than the
traditional three squares
  • Breakfast, lunch dinner, plus mid-morning,
    mid-afternoon, bedtime snacks
  • Smaller, more frequent meals help keep blood
    sugar levels more constant
  • Mealtimes snack times can become daily events
    to be anticipated with pleasure

10
Adjusting Foods Served to Dietary Guidelines
Sodium/Salt
  • Whatever Dietary Guidelines are used to plan and
    serve the Care Receiver, adjustments are often
    required for optimum nutrition Some may include
  • Reducing sodium (salt)
  • Remove salt shaker from dining area
  • Use salt substitutes, lemon juice, herbs (as
    permitted)

11
Adjusting Foods Served to Dietary Guidelines -
Sugar
  • Reducing sugar
  • At least 18 different names for sugar that may
    appear on labeling brown sugar, corn sweetener,
    corn syrup, dextrose, fructose, fruit juice
    concentrate, glucose, high-fructose corn syrup,
    honey, invert sugar, lactose, malt syrup,
    maltose, molasses, raw sugar, sucrose, syrup,
    table sugar
  • If any of these ingredients appear first or
    second on label or if there are several in the
    list the sugar content is deemed high
  • Non-sugar sweeteners (if prescribed or allowed)
  • Some sweeteners can cause unpleasant, even
    dangerous side effects
  • All sweeteners are different, i.e., Aspartame
    Read the labels

12
Adjusting Foods Served to Dietary Guidelines
Calories Other
  • Use both product labels and a reliable calorie
    counter to record calories on meal plans
  • Be aware of serving sizes
  • Be aware that some Care Receivers may need more
    calories, not fewer
  • Adjust other ingredients and nutrients as
    prescribed by the doctor or dietician

13
Reorganizing the Kitchen For Safety Convenience
14
Physical Hazards - Assess the Kitchen
  • Tripping/falling hazards
  • Slippery or cracked flooring
  • Loose tiles
  • Throw rugs
  • Extension cords
  • Clutter
  • Electrical/fire hazards
  • Frayed electrical cords
  • Overloaded plugs
  • Natural gas leaks

After assessing, make any needed corrections and
repairs
15
Physical Hazards Assess the Kitchen
  • Fire Extinguisher
  • Should be charged and operational
  • Stress If there is smoke or fire GET OUT!
    (Plan and practice exit strategies)
  • Smoke Alarm/Carbon Monoxide Alarm
  • Batteries working (change them at least when
    changing clocks to/from Daylight Savings Time)
  • Again stress GET OUT!

16
Assess the Abilities of Care Receivers
  • Every Care Receiver is unique, with individual
    strengths and weaknesses
  • Caregivers need to assess the functional
    abilities of Care Receivers to identify the best
    possible care
  • Consult professionals, as needed

17
Assess for Kitchen Safety
  • Assess physical abilities and limitations
  • How much can s/he safely lift?
  • How far can s/he comfortably reach?
  • How much bending can s/he tolerate?
  • Assess cognitive/memory abilities
  • Can s/he understand, remember and follow safety
    precautions?

18
Hazardous Materials in the Kitchen
  • The kitchen does contain hazardous materials
  • To help keep the kitchen a safe place,
  • Ask, What is the worst that could happen if this
    product were used inappropriately?
  • Then develop strategies to avoid this possible
    outcome
  • Read labels on all non-food products especially
    cleaning products
  • Store all hazardous products in a separate
    cabinet away from foods Provide a lock for this
    cabinet if necessary for safety
  • Post Poison Control Telephone Number
    1-800-222-1222

19
Sharing the Kitchen with the Care Receiver - Care
Receiver Independence is a Prime Goal for
Caregivers
  • Since Care Receiver and Caregiver may share the
    kitchen space, duties, equipment and food,
    reduce conflicts by
  • Making all changes tactfully and with the Care
    Receivers participation
  • Making adaptations for mobility equipment such as
    wheelchairs walkers
  • Use this collaboration as an opportunity to
    chunk the junk
  • De-clutter cabinets, shelves, drawers, pantries
  • Since this may be a major job, take it one shelf
    or drawer at a time
  • Encourage Care Receiver to give away unneeded
    items to family or friends, give to a charity, or
    to have a garage sale

20
Arranging the Kitchen
  • Place items within easy reach of the Care
    Receiver
  • The Caregiver adapts to the kitchen as laid out
    for the Care Receiver
  • When the Care Receiver no longer comes into the
    kitchen as a participant, it can then be arranged
    for the convenience of the Caregiver
  • Arrange equipment food packages by type
  • Face all food packages with labels forward for
    easy identification
  • Label cabinets, shelves, and drawers, using
    address labels and bold markers

A place for everything and everything in its
place equals a stress reducer for the
Caregiver(s), especially if there are two or
more Caregivers
21
Grocery Shopping for Nutrition, Economy
Safety After meals are planned, grocery shopping
is the next step in providing good nutritional
care
22
Nutrition
  • Choose fresh fruits vegetables as often as
    possible
  • Less-than-perfect-appearance does not necessarily
    mean less nutrition and those items may often
    be purchased for lower cost
  • Supplement fresh produce with canned and/or frozen

23
Read Food Labels
  • Size of serving (NOTE serving size noted on
    labels may differ from serving size noted in
    Dietary Guidelines use Dietary Guidelines
    information)
  • Nutrients contained (for a quick comparison, use
    the of RDA information)
  • Sell-by date (to avoid buying outdated or almost
    outdated foods)
  • Avoid buying empty calories (junk food)
  • Even if the Care Receiver needs extra calories,
    those provided should contribute to good
    nutrition
  • Special treats may add to quality of life, so
    when care is taken to satisfy Dietary Guidelines,
    they may become a part of the plan

24
Grocery Shopping For Economy - Most households
have food budgets
  • Careful planning shopping can help stretch the
    food dollars available
  • Shop from the list
  • Use the food dollars for the foods actually
    needed
  • Avoid shopping when hungry hungry shoppers are
    prey to impulse buying
  • Use a calculator to track total cost of items in
    the basket while shopping
  • Avoid Total shock at the check-out stand
  • Shop during less crowded times for a more
    pleasant experience

25
Grocery Shopping For Economy, 2
  • Shop for one or two weeks worth of groceries in
    a single trip. Fewer trips to the store fewer
    opportunities to over-buy.
  • Use Coupons Wisely
  • Only use for nutritious foods on your meal plan
  • Be alert for combinations of store specials
    coupons for extra savings
  • Choose to cook more from scratch foods
  • Initial time spent may be longer, but savings can
    be great
  • Use shelf labels to compare price-per-unit for
    best buys
  • Quality of lower priced items is often comparable
    to higher priced ones

26
Grocery Shopping For Safety
Being aware of safety concerns while grocery
shopping, especially when Care Receivers are
shopping with them, can help Caregivers provide
better care
  • Physical Safety help Care Receivers avoid
  • Wet floors, mops and buckets
  • Produce and other merchandise on floor
  • Wrinkled floor mats
  • Unstable displays and stacked merchandise
  • On-floor advertising decals (which may be
    perceived as 3-dimensional and cause falls)
  • Carts with protruding merchandise
  • Thoughtless shoppers running children

NEVER, EVER, LEAVE CARE RECEIVER ALONE IN THE
CAR!
27
Food Safety
  • Shop in an order that will keep food at safe
    temperatures
  • Packaged and canned goods
  • Produce
  • Frozen foods
  • Dairy and eggs
  • Meats, poultry, fish
  • To avoid long waits at check-out, avoid shopping
    when store is crowded
  • Take food directly home after shopping and put it
    away immediately to keep it safe to eat

28
Safe Food Handling Practices
  • Many Care Receivers have weakened immune systems
    are vulnerable to food-borne illnesses
  • Prevention Avoid infections by following safe
    food handling practices to avoid infections
  • Put away all refrigerated and frozen foods as
    soon as possible meats, poultry, fish, dairy
    products
  • Use a thermometer to check temperature inside
    refrigerator
  • Temperatures from 40 degrees F to 140 degrees F
    are in the DANGER ZONE for bacterial growth
  • Refrigerate all leftovers promptly
  • A two-hour limit is often suggested, but shorter
    times are safer times

29
Effective Infection Control Hand Washing
  • Wash hands frequently in warm, soapy water for at
    least 20 seconds each time
  • Singing Happy Birthday (silently if you wish!)
    is suggested as a good timer for hand washing
  • Frequently disinfect countertops, cutting boards
    and all other surfaces that come into contact
    with food
  • Wash surfaces and allow to air dry
  • Use a solution of 1 ounce of bleach to 1 gallon
    of water, Hypochlorite Solution
  • -US Department of Health Human Service,
  • Centers for Disease Control Prevention
    guidelines

30
Preparing Food
  • Avoid cross-contaminating other foods when
    preparing meats, poultry, fish and eggs
  • Example Do not use cutting board for chopping
    vegetables after it has been used for cutting
    meat disinfect thoroughly first

To spread the word about the importance of
measuring food temperature, the USDA has created
a campaign centered around "Thermy"
31
Safe Food Handling
  • Damp towels, sponges and dish
    cloths are breeding grounds for bacteria
  • Use paper towels or freshly disinfected-and-dried
    towels each time
  • Cook eggs, meats and other dishes to safe
    temperatures
  • Use meat thermometer and chart showing safe
    temperatures for doneness of various foods
  • Observe freshness dates on food packaging

32
REMEMBER WHEN IN DOUBT, THROW IT OUT!
  • Sickness can be caused by food that still looks,
    smells and tastes OK and even a tiny taste
    can cause illness
  • Once a food has become contaminated with
    bacteria, it may not be possible to make it safe
    to eat by any means

33
Easy Meal Preparation
  • After all the preliminary work is done (planning
    meals from appropriate Dietary Guidelines,
    shopping for groceries, being certain that the
    kitchen is safe) its finally time to prepare
    meals for the Care Receiver in ways that are
    easy on the Caregiver
  • Remember good nutrition can come from simple
    food, simply prepared
  • Easy-on-the-Caregiver Techniques
  • Plan ahead
  • Use very simple recipes
  • Cook once, serve several times

34
Easy-on-the-Caregiver Techniques For Preparing
Meals Examples
  • Example 2 COOK IN QUANTITY freeze in portions
    to serve over time
  • beans (or beans and rice)
  • Stew
  • Soup
  • Pasta and sauce
  • Roast beef
  • Baked turkey
  • Example 1 -- BAKED CHICKEN served as
  • Entrée
  • Sliced in sandwiches
  • Chopped and served as chicken salad
  • Leftovers and bones simmered with vegetables
    rice to make soup

35
Easy-on-the-Caregiver Techniques
  • Assemble meals and snacks for the entire day put
    on trays refrigerate (as needed)
  • Use store-heat-and-serve containers
  • Assemble meals from what is available
  • It is not necessary to cook every meal!
  • Be adventurous and creative in combinations of
    foods

36
Making Meal Preparation Easier for the Caregiver
  • Use prepared foods sometimes from a Deli or
    Restaurant
  • When cooking for the rest of the family, prepare
    and set aside an extra serving for the Care
    Receiver
  • Delegate tasks to
  • The Care Receiver (tailor the tasks to his/her
    capacities and interests)
  • Family
  • Friends

37
Making Meal Preparation Easier for the Caregiver
  • Play a CD of favorite music to make kitchen tasks
    more fun
  • If Care Receiver is present, choose some
    favorites of theirs, too
  • When friends ask what they can do ask them to
    bring a meal now and then!
  • Consider using Meals on Wheels for temporary
    Caregiver respite

38
Making Mealtime Pleasant For the Care Receiver
  • Mealtimes are not just about food
  • They provide the opportunity for socialization
  • They mark the times of the day
  • They can be a meaningful, enjoyable activity to
    be anticipated with pleasure
  • For the Care Receiver
  • As needs change, mealtimes can become
    uncomfortable, frustrating and unpleasant
  • Caregivers can help avoid this by making
    thoughtful and appropriate changes

39
Making Mealtime Pleasant For the Care Receiver
Food
  • Serve favorites often by adapting recipes to
    Dietary Guidelines
  • There may be a detectable difference, but often
    the Care Receiver will still enjoy the food
  • Provide choices to provide the Care Receiver with
    a sense of control
  • Adjust food consistency, texture and morsel size
    to the Care Receivers ability

40
Making Mealtime Pleasant For the Care Receiver -
Chewing Swallowing
  • Serving some pureed foods may help Care Receiver
    become accustomed to them in case they are
    limited to that form of food later
  • Assemble meals that appeal to several senses
  • Aroma and contrasting colors, even foods of
    different temperatures, make dining more pleasant

41
Making Mealtime Pleasant For the Care Receiver -
Serving Sizes
  • Avoid servings that seem too large to the Care
    Receiver
  • Being presented with large servings can be
    discouraging to Care Receivers
  • For many Care Receivers, having smaller, more
    frequent meals can provide needed nutrients more
    pleasantly for them

42
Place Settings
  • Use solid-color plates and bowls that provide
    visual contrast with the food
  • Patterned china can be frustrating for those with
    low vision is it food or part of the
    decoration?
  • Use easily grasped or adaptive utensils, cups and
    glasses suited to needs
  • The size and shape of the handles of flatware may
    be hard to hold adjust to needs
  • Some cups may be too heavy or have handles too
    small for comfort adjust to needs
  • Glasses with waists, or stemware, may be easier
    to hold and lift without spilling contents

Assess all the place setting items frequently
adapt as needed
43
Physical Comfort
  • Adjust chair height, table height, chair-to-table
    relationship as needed
  • Having the tabletop at elbow height is usually
    comfortable
  • Provide cushions, pillows, footstools as needed
  • Support of the back makes mealtime more
    comfortable and relaxing
  • Some shorter Care Receivers may need a footstool
    to avoid pain and reduced blood flow to the legs
  • Brighter light is often welcome
  • For most people, brighter is more cheerful for
    those with reduced vision, it is essential

44
Social Comfort
  • Include Care Receiver in family meals whenever
    possible
  • But also realize that if s/he feels uncomfortable
    because of changing needs at the table, s/he may
    prefer to dine alone, joining the family, perhaps
    for just a beverage
  • Provide shirt savers or dress savers at every
    meal if spills are frequent
  • Do not refer to these as bibs even though the
    Care Receiver may
  • Provide them in styles and colors that blend with
    the Care Receivers clothes

45
Social Comfort
  • Adjust to his/her needs
  • Take care of spills with tact have a towel
    nearby but out of sight
  • Allow enough time for the Care Receiver to eat at
    his/her own individual pace
  • This may become increasingly slower, but exhibit
    (and try to be sincere!) patience

46
If the Care Receiver Dines Alone
  • Family photos on or near the dining table can
    provide a sense of comfort
  • If possible, see that the photos are large enough
    to be easily seen by the Care Receiver
  • A pleasant video or a favorite television show
    may provide some company
  • Providing a system easily used by the Care
    Receiver may be challenging
  • A window view with a bird- or squirrel-feeder
    right outside can provide mealtime entertainment

47
Letting Go
  • Realize that as the end of life nears, systems of
    the body begin to shut down
  • Coaxing a Care Receiver who is in this stage to
    eat and drink only causes them greater discomfort
  • Follow the physicians guidelines, and when this
    time comes, find the strength to let go
  • Seek other meaningful ways to provide care and
    comfort for the Care Receiver and solace for
    yourself

48
Resources For Caregivers
  • Call
  • 2-1-1 throughout Texas. Provides information and
    access to health and human service information
    for all ages
  • 1-800-252-9240 to find local Texas Area Agency on
    Aging
  • 1-800-677-1116 - Elder Care Locator to find help
    throughout the United States
  • Online
  • Family Caregivers Online www.familycaregiversonlin
    e.net
  • Online education, resources, links, frequently
    asked questions
  • Benefits Check-up www.benefitscheckup.org for an
    online way to determine benefits for which
    someone qualifies.
  • To schedule a caregiver presentation for your
    church, business, library, civic group, or other
    location, call your local area agency on aging or
    send an email from www.familycaregiversonline.net

49
(No Transcript)
50
What Assistance is Available Through the Area
Agency on Aging (AAA)?
  • Services for persons age 60 and older
  • Benefits counseling
  • Ombudsman - advocacy for those who live in
    nursing homes and assisted living facilities
  • Home delivered meals
  • Congregate meals
  • Light housekeeping
  • Caregiver Services
  • Information and referral
  • Caregiver education and training
  • Caregiver respite
  • Caregiver support coordination
  • Case management
  • Transportation assistance

51
  • Adapted from materials by Jeanne Crane, Caregiver
    and Advocate by Zanda Hilger.
  • Updated 2009 by Zanda Hilger and Betty Purkey.
  • Permission is granted to duplicate any and all
    parts of this program to use in education
    programs supporting family members caring for
    elders
  • This program is one module of a comprehensive
    caregiver education program provided by the area
    agency on aging
  • Go to www.familycaregiversonline.net for more
    information about this and
  • other training programs,
  • internet links,
  • frequently asked caregiver questions,
  • legal forms,
  • phone numbers,
  • and more
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