• Choose a category
• All
• Classic-Fiction

8 Food presentation

Food is presented to patients/clients in a way that takes into account portion capacity and what appeals to them as individuals

9 Monitoring

The amount of food patients actually eat is monitored, recorded and leads to action when there is cause for concern

10 Eating to promote health

All opportunities are used to encourage the patients/clients to eat to promote their own health

Other factors which may influence future food intake (e.g. surgery, chemotherapy or radiotherapy) also need to be taken into consideration when planning nutritional support, as clinical experience shows these may exert a deleterious effect on appetite and the ability to maintain an adequate nutritional intake (Newman et al. 1998).

DH 2001b. © Crown copyright.

Reproduced under the terms of the Click-use Licence.

Box 8.2 Ten key characteristics of good nutritional care in hospitals

All patients are screened on admission to identify the patients who are malnourished or at risk of becoming malnourished. All patients are re-screened weekly.

All patients have a care plan which identifies their nutritional care needs and how they are to be met.

The hospital includes specific guidance on food services and nutritional care in its Clinical Governance arrangements.

Patients are involved in the planning and monitoring arrangements for food service provision.

The ward implements Protected Mealtimes to provide an environment conducive to patients enjoying and being able to eat their food.

All staff have the appropriate skills and competencies needed to ensure that patients’ nutritional needs are met. All staff receive regular training on nutritional care and management.

Hospital facilities are designed to be flexible and patient centred with the aim of providing and delivering an excellent experience of food service and nutritional care 24 hours a day, every day.

The hospital has a policy for food service and nutritional care which is patient centred and performance managed in line with home country governance frameworks.

Food service and nutritional care are delivered to the patient safely.

The hospital supports a multidisciplinary approach to nutritional care and values the contribution of all staff groups working in partnership with patients and users.

Modification of diet

Practical information on modification of diet can be found in the Royal Marsden Hospital Patient Information Series Eating Well When You Have Cancer – A Guide for Cancer Patients (Royal Marsden NHS Trust 2002), Diet and Cancer (MCS 2009) and Have You Got a Small Appetite? (NAGE, n.d.). See also Table 8.5.

Table 8.5 Suggestions for modification of diet

Eating difficulty Dietary modification

Anorexia Serve small meals and snacks, for example twice-daily snack options

Make food look attractive with garnish

Fortify foods with butter, cream or cheese to increase energy content of meals

Use alcohol, steroids, megestrol acetate or medroxyprogesterone as an appetite stimulant

Encourage food that patient prefers

Offer nourishing drinks between meals. In hospital consider a ‘cocktail’ drinks round

Sore mouth Offer foods that are soft and easy to eat

Avoid dry foods that require chewing

Avoid citrus fruits and drinks

Avoid salt and spicy foods

Allow hot food to cool before eating

Dysphagia Offer foods that are soft and serve with additional sauce or gravy

Some foods may need to be blended: make sure food is served attractively

Supplement the diet with nourishing drinks between meals

Nausea and vomiting Have cold foods in preference to hot as these emit less odour

Keep away from cooking smells

Sip fizzy, glucose-containing drinks

Eat small frequent meals and snacks that are high in carbohydrate (e.g. biscuits and toast)

Try ginger drinks and ginger biscuits

Early satiety Eat small, frequent meals. In hospital access an ‘out-of-hours’ meal service

Avoid high-fat foods which delay gastric emptying

Avoid drinking large quantities when eating

Use prokinetics, for example