Nutrition in Residential Care Settings

Health, Wellness and Nutrition

Introduction

In this assignment, I will discuss various aspects of nutrition in a Residential Care setting. I will look at the opportunities and challenges a social care worker has in addressing the holistic and nutritional needs of the clients and staff. I will look at some of special dietary considerations and the social factors that are involved in a residential care setting.

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Residential Care

Residential Care is an alternative care for young people whose family are unable to care for them. These centres are managed by the Family Support Agency, now Tulsia, or by a voluntary or private Company. There are usually between two and six young people living in each house. In 2013, there were 321 children in residential centres. (www.dcya.gov.ie)

The children who live in residential care deserve the very best care that social care workers can provide. To achieve this, their nutritional needs have to be met to ensure that each person can reach their full potential. Social care workers have a duty to look after and provide good wholesome food at the centre. Food is an important part of everyone’s life therefore social care workers need to support children in residential care to make healthy choices and give them practical skills and knowledge to enable them to make the right choices for their health and wellbeing.( Caroline walker Trust) The food pyramid is the recommended guide that is use in Ireland. Foods are divided into different parts in the pyramid to show the recommended intake of each food group. It states that you should eat

• Plenty of bread, rice pasta and other starchy foods preferably wholegrain varieties with six or more servings for all ages. Although men and boys may eat up to twelve servings depending on how active they are.
• Plenty of fruit and vegetables, at least six or more portions
• Three servings of milk, cheese or yoghurt. Children and teenagers will need more.
• Some meat, fish, eggs beans, pulses, and other non-sources of protein. Two servings is sufficient.
• Very small amounts of fats and oil.
• A very small amount or none of foods or drinks that is high in sugar.( Safe food.)

A report published in England by Save the Children in 1998, Look Ahead: Young people in Residential Care and Food stated that, many young people who had left residential care were unequipped to live independently. For example, they did not have the skills to shop and cook and this led to unhealthy lives. Young people who had left the service said that they did not learn enough food skills. Less than half of the young people said they had never helped to prepare a meal most of the actives they had taken part in involved setting the tables, washing up or peeling the vegetables. Less than a third said they had a role in the menu planning. The study also showed that a major barrier in residential care was the Health and Safety regulations that excluded young people from the kitchen. (eatingwellchildren2001pdf)

Special Dietary Considerations

Children and young people need the right balance of food and nutrients to enjoy a healthy life. The key is to get the balance right, to provide essentianal vitamins, minerals, protein and fibre into the diet. If there are insufficient nutrients in the diet, this can lead to diseases and bad health. Childhood obesity has increased over the past few years. Obesity affects children in a number of ways including physical mental and emotional wellbeing. If it continues into adult life, it can have serious affects on health such as diabetes, heart disease stroke and some types of cancers. section 3 nutrition guidance scotish download.

Putting into practise a healthy eating plan in a residential care setting, needs to be approached in a sensitive way. It may take time for young people, to adopt a healthier eating plan and to feel comfortable eating in a group. Some young people may choose eat a vegetarian diet. The staff must ensure that this type of diet is varied as much as possible to make sure that good sources of iron, zinc, protein and calcium are included in their diet.

Some children in residential care may have a food intolerance or food allergy, which is a reaction to a food or ingredient. Some foods can cause a severe allergic reaction (anaphylactic shock) to such food as peanuts, shellfish or eggs. This should be highlighted in the child’s care plan. Anaphylaxis is the most serious type of allergic reaction and you could die without the proper medical intervention. Although food is the most common allergic reaction insect stings and sometimes exercise can cause anaphylactic shock. The symptoms usually occur within minutes but it can also take a few hours after exposure. As social care workers, it is crucial to be aware of the signs and symptoms as it can happen to anyone at any time. ( www.anaphylaxis.ca)

Unlike this serious life threatening allergy are those who suffer from celiac disease. This disease causes the person to react to gluten which is the protein found in wheat. People with celiac disease have an intolerance to wheat products such as bread, cakes, and biscuits. It causes damage to the lining of the small intestine and thus prevents the absorption of nutrients. The only way to manage celiac disease is to avoid all foods that contain gluten to prevent further damage. (Celiac society of Ireland)

Diabetes like celiac disease is also an autoimmune condition that results in the body unable to burn up sugar (glucose) properly. This happens when the pancreas does not produce sufficient insulin a natural hormone that regulates blood sugar level. Insulin helps the sugar in the blood enter the cells of thee organs in the body. Without this process to much sugar would build up in the blood. As a result, this can cause faintness weakness and coma. There are two types of Diabetes;

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Type 1 Diabetes occurs mostly in children and young people. It requires the person to take insulin injections as well as a healthy nutritious diet and exercise. In the residential centre, the staff would have to monitor the person’s diet to make sure that the amount of insulin is carefully balanced against the food that supplies the sugar and the amount of excise that is burning off the sugar.

Type 2 Diabetes is on the rise and it is generally seen in older adults. It can be kept under control with a good healthy diet usually there is no need for insulin but some people need to take tablets. (Kirkpatrick, 2004)

Social factors

Mealtimes are an important part of our culture. It is where children learn about behaviour and develop new skills. It also offers a sense of belonging. Children in residential care may never have experienced this with their own family. Mealtimes should be an enjoyable experience where staff and children can share stories. When planning a meal it is important to take every person likes and dislikes into consideration. Children who have special diets or those who are vegetarian need a variety of suitable nutritious food. Child care (Placement of Children in Residential Care) Regulations, 1995, Part 111, Article 11. www.dcya.gov.ie xxxxxxxxxxput in

It is important to build good relationships between staff and children. The care workers ought to look for the views of the children around food and food-related issues. This should be a fundamental part of day-to-day activities at the centre. Social care workers at residential centres have an opportunity to improve children’s experience and health and wellbeing in areas of food practise. It is important for staff to adopt a healthy eating plan, as this will serve as a good example to the children. Children need to develop practical skills around budgeting, buying, preparing and cooking of food as this will prepare them for when the leave the centre. www.Scotland. Gov.uk.

Food can work as powerful symbolic medium where thoughts, feelings, and relationships are played out and it can be a useful tool for children who have experienced neglect. Through food, children can experience consistency and nurture and develop autonomy with a sense of control. It can demonstrate trust and care. Food is a simple way for a social care worker to monitor the ethos and the culture of the centre. By reflecting on the food practices and attitudes towards food, you can see how your centre is doing in many ways.

Reflection

I have found this module both interesting and challenging. I did not realise how complex and intense it would be. I have really enjoyed learning about nutrition and I have integrated this new knowledge into my family life. It has changed the way I look at food. I would also like to do a course on nutrition, as it is such an important aspect of overall health and wellbeing. I have a good understanding now on infections and diseases, which is so important to social care practise and in my own personal life. The subject that has had the most impact on was the subject of child abuse. I found it very informative and very challenging. This subject has really opened my eyes to the realness of the work that is involved in social care practise.

I feel this module is central to social care practise and it has prepared me for social work. I have gained practical every day skills that I will require, to work as a social care worker.