2 Nutrition and Hydration

Individual nutrition needs

Adequate food and fluid support energy, tissue repair, strength, and normal body functions. Needs vary with factors such as illness, medicines, activity, age, and conditions affecting the heart or kidneys. Follow the individual care plan rather than assuming that everyone needs the same diet or amount of fluid.

A balanced eating pattern generally includes a variety of vegetables and fruit, grains, protein foods, and dairy or suitable alternatives. Protein foods include beans, eggs, fish, meat, nuts, and dairy. Therapeutic diets, food texture changes, and supplements should be recommended by an appropriate health professional.

Supporting nutrition

Offer foods the person enjoys that fit their care plan and cultural or religious preferences. A calm, comfortable mealtime and enough time to eat can support intake. When appropriate, offer smaller, more frequent meals or snacks.

Encourage the person to do as much as they safely can independently. Adaptive utensils or help opening packages may make eating easier. Check that dentures fit and that the person can see, reach, and manage the food and drink.

Do not pressure, force-feed, or argue. If the person declines food or drink, respect the choice, offer again later if appropriate, and report persistent poor intake.

Supporting hydration

Offer drinks regularly, including with meals and between meals, if allowed by the care plan. Keep preferred drinks accessible, and help with opening or holding a cup when needed. Some people have reduced thirst or need reminders.

Follow any prescribed fluid limit, thickened-fluid instruction, or swallowing plan. Do not change the thickness of fluids or use a straw unless directed.

Older adults and people losing fluids through fever, vomiting, diarrhea, sweating, or increased urination may be at greater risk of Dehydration. Possible signs include thirst, dry mouth, urinating less than usual, dark urine, tiredness, and dizziness. Report concerns promptly; severe dehydration can be an emergency.

Assisting with meals safely

Before helping with a meal, check the person’s identity, meal and fluid instructions, allergies, required assistance, and swallowing precautions. Wash your hands, explain what you are doing, and position the person upright and alert. Provide privacy and arrange the meal so it is easy to see and reach.

Offer small bites or sips at a manageable pace. Allow time to chew and swallow before offering more, and check that food is not being held in the cheeks. Encourage self-feeding where possible and provide only the help needed. Do not feed someone who is drowsy or lying down. Follow the care plan for how long the person should remain upright after eating or drinking.

Stop and seek help if the person coughs, chokes, has a wet or gurgling voice, becomes breathless, or appears unable to swallow. These signs may indicate Swallowing difficulty and a risk of food or fluid entering the airway. Report them to the nurse or appropriate clinician; assessment by a speech-language pathologist may be needed. Follow emergency procedures if the person is choking or cannot breathe. Never independently prescribe pureed foods, thickened liquids, or swallowing techniques.

After the meal, offer mouth care as needed, make sure the person is comfortable, and document food and fluid intake according to workplace procedure. Report a notable decline in intake, repeated meal refusal, or new difficulty eating or drinking.

Recognizing intake concerns

Reduced intake can have many causes, including poor appetite; changes in taste or smell; dry mouth; dental pain or poorly fitting dentures; chewing or swallowing difficulty; nausea; illness; medicine effects; fatigue; mood changes; memory problems; or difficulty obtaining and preparing food.

Ask about concerns respectfully and report new or persistent problems. A health professional can assess possible causes and decide whether a dietitian, dental professional, or swallowing specialist should be involved. Ongoing inadequate food intake can lead to Malnutrition. Watch for and report a pattern of eating less, unintended weight loss, or worsening weakness rather than trying to diagnose the cause yourself.