January 18, 2023

Ensuring Healthy Diets & Good Nutrition

“Many do not realize the prevalence of malnutrition in our society,” says staff nutritionist Lois Fahey, RD, LD, CNSC. “In my former roles working in hospitals for decades, I diagnosed malnutrition, and tried to start patients on their journey to improved health, but I always worried about the continuity of care after discharge.”

Since joining Granite VNA just over a year ago, Lois has made nearly 400 home visits to patients who need dietary support. Prior to this, Granite VNA relied on a contract nutritionist who consulted with nurses by phone, but Lois has quickly become an integral part of our patient care team. “A physician recently referred to the nurse and me as ‘boots on the ground’ because of our close monitoring of his medically complex patient,” she said.

Lois regularly cares for patients who have specific needs such as intravenous (IV) nutrition or tube feeds, conditions such as congestive heart failure (CHF) that require specific diets, and patients who have difficulty understanding or following a prescribed nutrition plan. 

Changing one’s diet can be a real challenge for various reasons but having the support of a nutritionist who visits in-person helps patients to adapt. Lois works collaboratively with patients to assess their usual diet and the foods and beverages they keep on-hand and teaches them how to understand nutrition labels and to choose healthy foods that are appropriate for them.

In some cases, the change is straight-forward. A patient may need to follow a low sodium diet, in which case, Lois will typically visit in-person once or twice, and then follow up regularly by phone to monitor the patient’s progress. In other instances, she may need to check-in more frequently.

“In one case, I knew I was making progress when I visited a patient and noticed canned foods lined up on the counter,” Lois said. “I asked him why the cans were there, and he said he was giving them away because they were not low sodium. Sometimes it takes a while before people understand, but this was a win!”

Lois also helps to reduce barriers to eating that impact patients’ nutrition and health. For instance, some patients may have trouble swallowing or their appetite may be suppressed due to illness, in which case Lois may recommend high protein, high calorie liquid nutrition. For those who struggle with food insecurity, Lois will help them enroll in Meals-on-Wheels. Some people simply ‘lose their way’ in terms of their diet – people who have depression, or who may be dealing with grief, illness or isolation can lose interest in eating. Lois helps by quickly establishing rapport with patients and providing ongoing support and encouragement.

In addition to providing direct patient care, Lois works with our community health services team to provide community wellness programming as part of our Aging Mastery Program®, where she educates participants on how good nutrition through healthy eating impacts us as we age, including preventing falls. Lois also collaborates with our community health educators who help patients make action plans toward lifestyle and behavior changes to meet their personal wellness goals and improve their quality of life.