Wednesday, October 08, 2008

Protecting the Vulnerable

My heart goes out to anyone trying to maintain a gluten-free diet in an institutional setting such as a hospital or a nursing home. Jokes about the poor food quality in such places are common, but it's no joke to actually be poisoned in a place that is supposed to be protecting your health when you aren't necessarily in a position to articulate your needs or advocate for yourself.

Tricia Thompson recently addressed the nursing home situation in her post "Gluten Free Meals for the Elderly," which includes an interview with nutrition consultant Ronni Alicea, who works with health care facilities to address medical diet issues and also owns Celinal Foods, which markets microwaveable gluten-free meals to such institutions.

One of Alicea's interesting suggestions is to have a celiac blood panel administered upon admission and annually thereafter, to monitor compliance with the diet. Makes sense to me—that's something anyone with celiac disease can do, in or out of a facility! I also like the emphasis on sticking to medical gluten-free diets to stay healthy and thereby minimize any need to resort to a nursing home.

Alicea also suggests that one raise dietary issues when considering nursing homes.
When selecting a nursing home, first discuss the diet with administration. As we know, gluten free diet management impacts every aspect of life.

In addition to receiving properly prepared gluten free meals we need to assure that (1) nursing reviews medications and snacks, (2) the activity department includes gluten free options in their activities, and (3) rehabilitation therapies are aware. It is vital that a person following a gluten-free diet does not isolate themselves because of the fear or perception that the staff does not understand their needs.

The facility administrator will coordinate the interdepartmental education with the guidance of the facility dietitian. Once you are comfortable that the facility is committed to continuing your parent’s gluten free lifestyle, it is time to discuss menu planning with the dietitian.
That's good advice, but the fact of the matter is that the selection process might be made under very rushed and frantic circumstances, that the possible nursing homes might be very limited in quantity and quantity, and that many people have their nursing homes chosen for them. That is one reason why the standards and practices maintained by nursing homes ought to be high enough to accommodate gluten-free and other medical diets with ease.

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