The use of modified diets in nursing homes

Shu-Jan Janicy Lan, Purdue University

Abstract

This study investigated the use of modified diets in nursing homes. Two hundred and twelve elderly residents in eleven facilities constituted the sample for the study. Modified diets are either diets modified in nutrient content or diets modified in food consistency. The prevalences of both categories of modified diets and specific nutrient modified diets were determined. The specific nutrient modified diets included sodium restricted diets, calorie controlled diets, low fat and/or low cholesterol diets, high fiber diets, and the bland diet. The relationships of the use of various nutrient modified diets as a whole to eleven independent variables consisting of selected characteristics of the elderly residents and their physicians were assessed. These independent variables were sex, age, level of care, duration of stay, and four diagnoses of the elderly-- coronary heart disease or arteriosclerosis, hypertension, diabetes mellitus, and peptic ulcer; specialty of the physician, whether the physician was the medical director, and the length of time the physician had been practicing. The relationship of food consistency to chewing, swallowing, or other physiological problems was also examined. Whether feeding problems led to weight change among the elderly was assessed. The opinions on implementation of modified diets as reported by ten dietitians who consulted in the eleven facilities were tabulated. The findings of this study were summarized as follows: Of the 212 elderly subjects, 49 per cent were on nutrient modified diets, 47.2 per cent were on regular diets, and 3.8 per cent were on tube feedings. Among nutrient modified diets, sodium restricted and calorie controlled diets are the diets most commonly prescribed in nursing homes: 28.4 and 24.5 per cent of the 212 subjects, respectively were on these two diets. There was only one subject in each of the following diets: low fat diet, high fiber diet, and bland diet. None were on low cholesterol diets although more than half of the elderly subjects had CHD or artherosclerosis. Of eleven independent variables, only the three selected diagnoses of the elderly--CHD, hypertension, and diabetes mellitus--were significantly related to the use of various nutrient modified diets. About half of the all subjects had alterations in food consistency. Thus, 35.4 per cent had chewing and/or swallowing problems and 11.8 per cent had other physiological problems such as coma, blindness, contracture, etc. There was not significant difference of weight change between those who had to be fed and those fed themselves.

Degree

Ph.D.

Advisors

Justice, Purdue University.

Subject Area

Nutrition

COinS