In-service: Person-Centered Care

Yesterday, I gave an in-service presentation to the entire staff at the Rosewood Center regarding resident care. The presentation focused on “person-centered dining” and how it’s concepts should be implemented by all staff members.

Person-centered care places the resident at the center of the care process instead of placing tasks, duties, schedules and regimens before the resident. Staff members have hectic work schedules that involve more than solely tending to residents and may unintentionally place things ahead of them but keeping the resident the #1 priority is the primary focus of person-centered care. This type of care focuses on the preferences and values of the resident and places great emphasis on individual needs, tastes, and lifestyles. At long term care facilities, there is a diverse population of individuals, each of them unique in their own way; they all have different needs based on their conditions and they all used to live different lifestyles at an earlier age. By recognizing that each individual has different preferences, their needs can be met and patient satisfaction will be upheld. Person-centered care is all about resident choices and preferences concerning everything, including food. Food may be one of the most important facets of long-term care because food nourishes and heals the body. Residents can receive medication and rest, but if their bodies are suffering from malnutrition or dehydration, the healing process will be impaired. Also, residents in long-term care experience a dramatic life change, which can severely impact their mentality; they may feel like they do not have much control over anything in their life anymore, however, food is one thing residents still have control over. Food means many things to many people but a common image is “home” so meal time is the perfect opportunity to promote the sense of family within the facility.

My presentation touched on ways to optimize resident satisfaction regarding dining services. The facility has policies and procedures in place but it is always good to refresh employees on this information as it is crucial to the success of the Center.

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Carrot Sticks Wrap-Up

Last week’s lesson brought an end to this summer’s Carrot Sticks program and my Child/Adolescent rotation. Since early June, we (another intern and I) have had Carrot Sticks every week (for a total of 10 weeks) on Tuesday mornings/afternoons at the Shack Neighborhood House. The program consisted of three 45 minute classes for children k-2; it was designed to educate children about proper nutrition and the importance of a healthy diet. Each class included a lesson, activity, and snack. We wanted to create educational content that was interesting to children and decided on a program “theme”, focusing each lesson around different food cultures. We decided to use European countries, with each lesson highlighting a different country for a total of 10 different countries including:

  • Lesson 1: Italy
  • Lesson 2: France
  • Lesson 3: Ireland
  • Lesson 4: Spain
  • Lesson 5: Germany
  • Lesson 6: Portugal
  • Lesson 7: Hungary
  • Lesson 8: United Kingdom
  • Lesson 9: Czech Republic
  • Lesson 10: Austria

The lesson for each class focused around each country’s food guide pyramid and our MyPlate. Each week, the children deciphered the differences and similarities between the two. Each lesson introduced the children to 5 different food staples from the country and each of the 5 foods was from 5 separate food groups. I wanted the lessons to be as interactive as possible to help the children learn as best (and to have as much fun) as they could. Therefore, each lesson was similar to the game of pin the tail on the donkey; children got to come up and pin pictures of the country’s 5 food staples to where they belonged on both our MyPlate and the country’s food guide pyramid. I believe this ended up being a very successful way to introduce children to new foods, by showing them pictures of what the food looks like and what food group it belongs in. The children enjoyed being an active part of the lesson, which kept their most of their focus throughout the entire lesson. In addition, our lessons also included educating the children on specific nutrients. Because of the age range of the population, we focused on different nutrients every 2 weeks. We believed that introducing a nutrient in one lesson and then reiterating it in the next lesson would help the children retain valuable information. The featured nutrients were as follows:

  • Lesson 1 and 2: Calcium
  • Lesson 3 and 4: Fiber
  • Lesson 5 and 6: Iron
  • Lesson 7 and 8: Vitamin E
  • Lesson 9 and 10: Potassium

Each week also featured snack time, which was often the children’s favorite part of the class. Some of the snacks included fruit and yogurt parfaits, veggie pizzas, smoothies, and even guacamole! We made sure that each snack was made with healthful ingredients and incorporated creative ways to introduce the children to new foods. For example: one lesson included veggie pizzas that were made into faces. We learned that making food fun for children is an effective way of getting them to try new things. Also, as we spent more time with the children and they began to like us more; therefore, they were more willing to try our snacks, even if they thought they looked “gross.” My favorite snack out of the entire summer was when I brought homemade guacamole on celery sticks. Almost every kid said that the snack looked nasty and that they knew they didn’t like it….but they were willing to try it. Once they tried it, almost EVERY one of them liked it and was asking for seconds!

Overall, I am sad that this summer’s Carrot Sticks has come to an end. After 10 weeks, it was easy to grow attached to the little ones, running around pretending to be nutrition ninjas. I love working with kids, as they can teach you as much about life as you can teach them. I believe they learned valuable nutrition information from our program this summer, like how to shop smart, cook healthy, and eat right (our nutrition ninja chant)! I am glad they received this type of education at this age because I believe that teaching nutrition to children early and often is the key to developing healthy eating habits for life.

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WIC Clinic

Last week was the final week of my rotations at the WIC clinic. I have been given amazing opportunities to work with pregnant and post-partum women as well as infants and children up to the age of five. Clinic locations for my rotation were in both Marion and Taylor County. I have also been rotating at the Mon County WIC, where I have attended breastfeeding class, provided nutrition education to clients, and am creating an online module for supermarket tours. On clinic days, I have been working side by side with WIC nutritionists to present current nutrition education and practice effective counseling skills involving VENA (Valued Enhanced Nutrition Assessment) principles to facilitate behavior change. Also, I have been able to:

  • Provide nutrition education and counseling services in a collaborative environment considering patient needs and resources for pregnant, post-partum, and breastfeeding women as well as infants and children up to the age of 5
  • Use effective education and counseling skills to facilitate behavior change
  • Refer clients to other professional services when needs are beyond individual scope of practice, such as the Tobacco Quit Line and Right from the Start Program
  • Perform the Nutrition Care Process

During clinic, WIC nutritionists provide nutrition education and counseling to clients. Throughout my clinic experiences, I recognized a trend among WIC clients of high intake of sugary drinks; sugary drinks include soda, juice, kool-aid, Gatorade, sweet tea, etc. Juice is very popular among children, drinking several cups each day. Juice is part of a healthy diet, but don’t drink too much. No more than 4 ounces is recommended per day. I was responsible for providing nutrition education/counseling to clients on this topic and had to provide parents/caregivers with ways to decrease their children’s juice consumption and encourage their child to drink more water. These include:

  • Serve juice for breakfast. The Vitamin C in juice will help absorption of iron from breakfast cereal, oatmeal or toast
  • Add more water to the juice. Offer a glass of ½ water and ½ juice
  • Freeze juice to make a slushy on hot summer days
  • Freeze juice in ice cube trays. Add a few juice cubes to a pitcher of water

Too much juice in a child’s diet can lead to unnecessary weight gain or dental problems, such as cavities. Make sure children are consuming the RIGHT choice (water) when they’re thirsty and find creative ways to cut down juice consumption!

I enjoyed my time working at the different WIC clinics within my area. I have gotten to work with wonderful, knowledgeable dietitians and nutritionists and am very thankful for this rotation opportunity!

Breast is Best

Today was the first day of my rotations at WIC in Mon County. Women, Infants, and Children (WIC) is a special supplemental program which provides Federal grants to states for supplemental foods, health care referrals, and nutrition education for pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.

During my rotation, I got to participate in the clinic’s breastfeeding class offered to WIC’s mothers-to-be. WIC promotes exclusive breastfeeding and provides clients with the education and support to successfully breastfeed their child. Also, WIC mothers who choose to exclusively breastfeed receive the largest food package worth of vouchers. This is offered as further encouragement for mothers to choose breastfeeding over formula feeding.

As a future Registered Dietitian, I fully support breastfeeding and I hope to one day upon having children of my own. Wherever you do your reading– whether it’s peer-reviewed journal articles, trendy magazines, newspaper columns, or blog posts–you’ll find they can all agree on the facts that breast is best. Here are 10 (of countless) good reasons to breastfeed:
1. Breastmilk is your baby’s perfect food. It has all the right nutrients, in just the right amounts.
2. Breastmilk is always ready.
3. Breastmilk is amazing. It actually changes and meets the needs of your growing baby.
4. Breastmilk makes your baby’s brain grow. This means your child could do better in school.
5. Breastfed babies are sick less. They also don’t have as many allergies!
6. Breastfed babies have less diarrhea and stomach trouble because breastmilk is so easy to digest.
7. Breastfeeding helps you feel close to your baby.
8. Breastfeeding is free food for your baby.
9. Breastfeeding is easier because there’s nothing to carry, measure or heat. It makes nighttime feedings and travelling with the baby much easier.
10. Breastfeeding helps mom get back in shape. Breastfeeding burns 500 calories a day! It also helps shrink the uterus back to its normal size.

The more you know about the benefits of breastfeeding, the more you’ll want to try.

WIC Farmer’s Market Vouchers

This past Saturday (7/13/13), another intern and I distributed WIC vouchers at the Morgantown Farmers Market, assisting WIC as a part of our dietetic rotations. WIC clients could obtain these vouchers at the entrance of the market, where WIC had a table and sign set up. These vouchers are only distributed at the downtown Morgantown Farmer’s market on Spruce Street. Each WIC participant in each family receives a total of $20 worth of vouchers to spend at the farmers’ market at participating vendors. For example: a mother of two would receive $40, but if she was breastfeeding, she would receive $20 extra, for a total of $60. The vouchers have an expiration date of October 31, 2013, so this gives participants the rest of the summer to use the vouchers as they choose.

At the Morgantown Farmer’s market, there are a large number of vendors; however, not all of these accept WIC vouchers. Participating vendors display an orange sign that families can look for when shopping at the market. This year, WIC was given $2,500 worth of vouchers. The amount of vouchers WIC is given each year depends on the redemption rate from the previous year; in 2011, this rate for Mon County was 60%.

I think the vouchers provided by WIC for the farmer’s market are awesome. The clients seem to love to use them and I think any time any individual attends a farmer’s market, it just sets the mood for nutrition. Everywhere you look, you can see natural, whole foods. WIC Farmer’s Market vouchers give clients the ability to access locally grown fresh fruits and vegetables and that’s something to be excited about!

Marketing Stereotypes: Dannon Oikos Yogurt

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The picture above depicts Dannon’s newest slogan for its Oikos Greek Yogurt. I pulled this image directly from their website and as you can see, the company has trademarked the product as “Too Delicious To Be Nutritious.” This marketing strategy reinforces the stereotype that healthy food tastes bad. Placing the claim on a food that “if it’s nutritious, it can’t be delicious” disparages people eating healthy foods. This shameful marketing only reiterates public thoughts and behaviors that nutrition professionals are battling against every day.

To Dannon, I’m sorry you think nutritious can’t be delicious. I disagree. Please don’t continue to market the Oikos yogurt using this unhelpful stereotype.

If you agree with me and also want to put an end to this type of marketing, tweet to @Dannon @Oikos and let them know that you believe nutritious IS delicious.

Day 1 of Carrot Sticks

Today was the first day of Carrot Sticks at the Shack Neighborhood House. If you didn’t read my first post about Carrot Sticks, the program is designed to educate children, ages k-2, about proper nutrition with a twist of culture. Throughout this program, we’ll explore European culture through its cuisine and today’s lesson featured Italy. At the beginning of today’s lesson, I wanted the kids to get excited about nutrition as much as I am. So, I had the idea of the children acting like “nutrition ninjas.” Who doesn’t like to pretend to be a ninja? Well, what exactly do nutrition ninjas do? Fight off “bad” foods? Exactly. But how do they do it? We decided to advocate the Academy of Nutrition and Dietetics Kids Eat Right slogan: Shop Smart. Cook Healthy. Eat Right. So, nutrition ninjas fight off bad foods by shopping smart, cooking healthy, and eating right. We had the kids chant this throughout the lesson to get excited about nutrition. They loved it.

Today, each group learned about 5 different foods from different food groups that are staples in Italy. These included:

  • Whole wheat pasta
  • Olives
  • Fava beans
  • Broccoli
  • Mozzarella cheese

The children participated in an activity where we compared Italy’s Food Guide Pyramid with our MyPlate. Volunteers came up and played a game similar to “pin the tail on the donkey” and put each food in the correct food group on both Italy’s Pyramid and MyPlate. This allowed the children to understand the different concepts between the two.

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After the activity, I explained to the children that 3 of these foods are high in calcium. Some of the children had heard of calcium before but believed that it was only in milk. I told them that more foods (like broccoli, cheese, and whole wheat pasta) contain calcium. I also highlighted that calcium is necessary for growing strong bones and teeth and to make sure eat foods with calcium every day to get the amount you need (1,000 mg).

The last thing we did in today’s lesson was healthy snack time. We fixed veggie pizzas that looked like faces, which we knew the kids would enjoy. We used mini whole wheat bagels and cream cheese for the head. We had black and green olives for eyes, red, yellow, and green peppers for the mouth, and carrot sticks for the nose. It was exciting to introduce children to new foods. Making healthy snacks seem fun, as in a veggie face pizza, is an effective way for kids to try new foods or foods they claim “they don’t like.” I heard more than once someone say, “I don’t like vegetables but I ate them anyway!” Today was great and I am really looking forward to the rest of this rotation. Until next week, nutrition ninjas!

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