Home Health Aide Training – Complex Modified Diets

Oftentimes, as a home health care aide, your job will include helping a patient to prepare food. While the standard rules of food preparation do apply for most of your patients (i.e. following the Food Pyramid), there are also a large number of different modified diets, some of them quite complex that you may need to follow. Here’s what you need to know:

Increasing or Decreasing Intake of Certain Foods

The most common type of modified diet simply requires either an increase or a decrease in the intake of certain kinds of foods. For example, a patient suffering from chronic high blood pressure may be advised to decrease the amount of sodium in the diet. This would entail more than leaving the salt shaker in the cupboard. You also need to check the nutrition information on all prepared foods for the total sodium content that they include.

Other times there may be a need to increase intake of certain foods. For example, some patients may need to have in increase in the amount of protein they take in. Again, consulting the nutrition information on prepared foods will be important. It’s also important to check on which whole foods include high concentrations of the necessary items (in the case of protein, most lean meats and poultry will be high in protein).

Specific Foods Not Allowed

Other times, you may need to consider that specific foods will either be allowed or not allowed. For example, some patients may require a gluten free diet which means ensuring that all wheat based products are specially prepared to be gluten free.

Liquid or Soft Diets

Some of your patients may require a modified diet which includes only soft or liquid foods. This is often the case when patients have trouble chewing or swallowing due to injury or old age. In these cases, it’s very important to ensure that your patients are still getting the necessary nutrients in their diets so that they will remain healthy. For example, you may need to puree fresh fruit and vegetables along with meat and poultry to make it liquid so that the food can be drunk.

Bland Food

Some of your home health care patients may have dietary requirements which include bland foods. This is often the case when they are suffering from gastrointestinal problems. In this case, sharp spices such as pepper should be avoided. Salt should be kept to a minimum as well when working on such a diet.

Low Cholesterol

Your patient may need a low cholesterol diet if the doctor has determined that they are suffering from high cholesterol. Generally this means avoiding fat (low fat milk, lean meat and chicken, etc.) and checking the nutrition labels on prepared foods to ensure that cholesterol levels are kept to a minimum.

Diabetic Patients

There are several schools of thought regarding diabetic patients and you should follow the dietary guidelines prescribed by the attending doctor when working with patients who need such diets. The American Diabetes Association for example includes a series of exchanges where specific amounts of different kinds of foods are allowed to be eaten in order to keep a balanced diet. Other modified diabetic diets may include low carbohydrate diets or low glycemic diets. Diets high in complex carbohydrates and low in simple carbohydrates are also quite common for diabetic patients.

Preparing Food

Given that there are a number of different ways in which food must be prepared for those with modified diets, it’s important to understand the different ways that food can be prepared for these complex modified diets. Some common methods include:

Chopping, mashing or grinding– In all three cases, these basically involve taking whole foods and breaking them down into smaller pieces. In the case of chopping, it’s exactly what it sounds like. You chop the food with a knife. Mashing food means using a fork to mash cooked foods and grinding generally means using a food processor to grind dry foods.

Puree-When a modified diet calls for pureed food, this means that you’ll have to first cook the food until it becomes tender and then run it through a food processor. The texture should be similar to that of mashing, though much smoother than that.

Precautions:

It is important to remember that when working on mechanically altered diets that certain issues may come up. These include:

Loss of Appeal-Often, pureed or mashed foods lose their appeal for your patients and must be dressed up in some way to ensure that they will still want to eat them.

Loss of Nutrients-Because pureed food requires significant cooking time, nutrients may be lost in the process of preparing the foods. You need to take this into account when preparing foods while at the same time keeping track of the caloric requirements of your patients.

Chopping Food-When chopping food, you should use a clean knife and a cutting board. Avoid chopping other foods on the same chopping board where raw meat was cut. When handling raw meat, remember that wood cutting boards will absorb the liquids from the meats and so should be avoided.

Keep Things Clean-In all cases, all equipment used to process food for your patients modified diets must be kept absolutely clean. This means for example that you must be careful to wash equipment once you’ve used it and not allow it to sit and dry.

Storage-If foods that you have mechanically prepared for your patient’s modified diets must be stored, be sure to keep them in air tight containers and to make sure that foods are kept fresh by either freezing or refrigerating them rather than simply leaving them in the cupboard.

Prevent Bacteria-Finally, pureed or cooked foods should be served right away or frozen to ensure that bacterial infections cannot form on them. Hot foods should be served while still hot and cold foods should be served cold to ensure that they are safe. Never serve meat which has been left out of refrigeration for more than two hours and be sure to keep dairy products and eggs refrigerated as well.