age care

 by Gillian Robinson

Diabetic diets – clinically appropriate in aged care or not?

When balancing the clinical needs, requests and preferences of each resident in-conjunction with their right to choose, a number of factors need to be taken into consideration.  We all recognise that theory and practice can change over time so when I asked Liz Beaglehole (Registered Dietitian) her professional view on this topic is, she offered the following:

 

The recommendation for older adults with diabetes in aged care facilities with stable diabetes is to provide an unrestrictive diet as much as possible. The notion of a ‘diabetic diet’ is outdated due to the increased risk of hypos and unwanted weight loss.

 

This is very individual however, a frail 80 year old woman with diabetes will likely have no diet restrictions however an obese 70 year old who may be otherwise stable would benefit from a more restrictive diet.  Advice from a dietitian for individuals is recommended.

 

Overall, guidance from the resident about their wants is probably what determines the diet provided. This may be in accordance with recommendations or not.

 

Generally, the medications should be fitted to the usual eating pattern of the resident.  In aged care facilities there are regular meals and generally balanced carbohydrates over the main meals (assuming good food intake) so usually this is fine.  If someone has a reduced food intake, and is on insulin then a unrestrictive diet would be best.

 

For my menu planning I tend not to plan any special diabetic options on the cycle menus.  I may include a low fat / low sugar dessert option if sites request, but generally my philosophy for aged care is not to restrict foods!

 

Liz is involved with a PEN (practiced based evidence in nutrition) review of the question ‘Do institutionalized, older adults (65 years of age or older) who closely follow a diet prescription have better control of their chronic disease (e.g. diabetes) than those who do not?‘ This is due by the end of March so further practice updates from this review may be available then.  Liz noted that generally the evidence suggests there are no benefits with a prescriptive diet vs a more liberal one.

This article was kindly contributed by Liz Beaglehole NZRD (Canterbury Dietitians).

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 by Gillian Robinson

Food Control Plan registration update

Those of you who are members of the New Zealand Aged Care Association (NZACA) may be aware that we (Healthcare Compliance Solutions Ltd) have been contracted by the NZACA to develop what is known as an Industry Body Customised Food Control Plan (FCP). This is to be approved by the Ministry of Primary Industries (MPI) and made available to all NZACA members. This customised plan comes under section 40 of the Food Safety Act and has been developed with the intention of streamlining audit process for Age Related Residential Care providers to use. There is an extended date for registering under this plan. 31st March was the date noted for registration however for this process, the date for completion of the registration process for use of the Industry Body NZACA FCP will be 31st May 2018. 

 

Instead of registering with the local Council, those members who are taking advantage of the national customised food control plan will register directly with Ministry of Primary Industries.  What is being worked towards currently is for this plan then to be audited by your Certification Designation Auditor Agency auditors in conjunction with your other audits. It is our understanding that the deadline for registering with MPI has changed to take the Food Control Plan approval into consideration so please check with NZACA to verify when you need to have your registration completed by.

 

How far have things progressed currently?  We have submitted the draft of the customised plan to MPI for approval.  The content of this plan goes beyond the standard Food Control Plan as it will need to also meet Certification and ARRC funding agreement audit criteria. This is designed to be an all in one set of documents so that as noted, it assists with the streamlining of audit.  We understand this approval process could take 4 – 6 weeks with a period of refinement if necessary and finalising of the documentation to follow, before a Gazette notice would be published.  This notice is necessary to proceed with association members using the Industry Body customised FCP as part of their other certification audit processes.

 

A huge thank you to Liz Beaglehole (Registered Dietitian) from Canterbury Dietitians who assisted at short notice with the reviewing of documentation contents which form part of the FCP.

 

There is work to be completed behind the scenes in an attempt to align audit time-frames which are not the same for all providers so while the intent is clear, the reality of achieving what we are setting out to do, is yet to be confirmed.

 

We support the work of the NZACA and were very pleased to be able to support the age care sector in this way.  We undertake to do what we can to support this process to a successful outcome.  NZACA will be updating their members as we work through this process.  If you are not a member, this may be a good time to join to take advantage of just one of the benefits they offer to support their members.

If you would like further support with the implementation of your Food Control Plan, please feel free to contact us.

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 by Gillian Robinson

Aged Care Managers and Nurses Study Days

April 12th and 13th, 2018 – Christchurch

Presenters: 

 

Gillian Robinson – Bachelor of Nursing, Registered Nurse, Lead Auditor, Management Consultant, Author
Liz Beaglehole – New Zealand Registered Dietitian, with a Post-graduate Diploma in Dietetics (with distinction), Canterbury Dietitians.
Ben Harris – Medical Laboratory Scientist, Honorary Lecturer for the University of Otago

Incorporating clinical and management topics, these study days are designed to provide the opportunity to learn together and gain a greater understanding of each others roles and aged care industry expectations. Gain your professional development hours by joining your colleagues for two fun days of learning.

Topics include:

Day One – Thursday 12th April – 9.00am to 4.30pm

  • Age-related Residential Care (ARRC) – understanding the DHB funding service specifications
  • Quality and Risk Management – striving and achieving excellence
  • Clinical Leadership – how to lead the clinical team effectively
  • Clinical Documentation – What, when, how and why to document
  • Clinical Assessment and Care Planning – bringing it all together for better resident outcomes
  • Microbiome – why understanding this is so important
  • Multi-Drug Resistant Organisms (MDROs) – the current and pending impact

Day two – Friday 13th April (9.00am start, finish approximately 1.00pm) 

  • Urinary Tract Infections – to dip or not?!
  • Norovirus and Influenza – latest updates
  • Food Safety – Food Safety and Nutrition
  • Question and Answer session

Attendees will supply their own lunch.  Morning and afternoon tea will be provided.

Venue: Chapel Street Centre, Cnr Harewood Road and Chapel Street, Papanui, Christchurch.   (Easy access from the airport)

Numbers will be limited so register today.

To register – email gill@agedcarecompliance.com and supply the names and designations of each staff member attending, and confirmation if they will be attending day one or day two or both days?

 

The attendance fee for this content filled education is $155 (plus GST per attendee to cover both days), $85.00 plus GST per attendee to cover either day one or day  two.

We will respond with confirmation of registrations. Certificates of attendance will be provided.

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