The use of a food instead of supplement program in a long-term care facility
Smith, Teresa B.
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This study examined the effectiveness of using fortified menu items served with the meals instead of liquid supplements between meals in a long-term care setting. Data was collected from the medical records of 30 residents. The mean age of the sample was 81.6 years. Subjects included in the study had been on highprotein supplements primarily in the form of liquid milk shakes. The subjects were started on a fortified food program identified as a Food Instead of Supplement (FIS) program and monitored for three months. Weight, calorie, and protein intakes were used to measure changes in nutritional status. Outcomes related to nutritional status such as functional ability and the presence of decubitus ulcers were also monitored for changes. Student t-tests, Wilcoxon's rank sum, and Wilcoxon's signed-rank test were use for the statistical analysis. Statistics, including means and standard deviations, were completed using the SAS statistical package. The analysis indicated a statistically significant increase in weight \ and protein intake with the use of the FIS program. Because of the small number of subjects with decubitus ulcers, statistics were not completed regarding the presence of decubitus ulcers. However, the number of subjects with decubitus ulcers was noted to have dropped with the use of the FIS program. Changes in calorie intake and functional ability were not found to be statistically significant. The results of this study indicate the FIS program was an effective method to promote weight gain in a longterm care setting. Recommendations that may improve the outcomes regarding the use of such a program include the use of fortified hot beverages with meals and offering calorie-rich and protein-rich bread items, as opposed to offering honey-butter with wheat bread.