Palliative care nutrition presented by Ella Monaghan (MDiet, BF&Nutr)
The World Health Organisation defines palliative care as;
“An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”
There is a misconception that if someone is living the palliative trajectory there is not much more that we can do from a dietetics point of view but to suggest they ‘eat and drink as tolerated’. Ella gives us the tools to take a closer look at our palliative clients.
She clarifies the role of the dietitian in palliative care which involves:
- Understanding the emotional, social and cultural significance of food –implementing strategies to support quality of life
- Assessing clinical impact symptoms impacting on oral intake
- (e.g. altered taste/smell, loss of appetite, bowel habits, nausea, vomiting, dry mouth)
- Implementing nutritional strategies to assist with symptoms (e.g. nausea, vomiting, diarrhoea and constipation)
- Discussing the patients' nutritional goals and providing education and support for changes in intake with clinical decline – including supporting loved ones
Ella encourages us to have a conversation with our clients about their nutrition goals. It becomes clear that nutritional management can encompass a range of potentially helpful strategies:
- Interventions to assist with symptom management (nausea, vomiting, constipation, diarrhoea, dry mouth etc)
- Aiming to meet nutritional requirements
- Promoting weight gain
- Regular monitoring of biochemistry
- Weekly weights
- Enteral nutrition
- Oral nutritional supplements
- Discharge planning (nutrition education, setting up with ONS regimens for home/placement)
- Optimising oral intake with food/fluid of preference
To illustrate the supportive and important role of the dietitian, Ella describes the nutritional management of one of her clients using the ADIME approach.
Ella Monaghan is passionate about evidence-based palliative care, focusing on symptom management and nutrition to enhance quality of life. She has extensive experience as a dietitian, including roles at Eastern Health, Australian Defence Force, Department of Veterans’ Affairs, and as Lead Dietitian & Allied Health Manager.
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