At EHPAD de Mauriac, in Cantal, everything is about feeding the residents. This pilot program was even awarded during the Francophone Nutrition Days. It aims to monitor the risks of malnutrition and to limit the muscle decline of the residents.
Contrary to some exercises for the elderly under the eyes of the authorities, the food of the residents is a priority for the EHPAD in Mauriac (Cantal), with tailor-made menus prepared after analyzing the remains on the trays. Behind the windows of the canteen, kissed by the sun on this March day, a dozen residents, some in wheelchairs, are seated for lunch. On the menu: mixed salad, deviled pork, sautéed courgettes, cheese, natural fruit. “It’s good (…) I haven’t eaten so well at home!“welcomes Marie-Louise Delord, a centenarian with a lively gaze. The carers assist the most dependent, serve drinks, take news, before clearing the trays. The scene takes a more unusual turn when they scrutinize the remains left on the plates, a tablet in hand Objective: to record the consumed quantity of each item on the tray.
“100% glass; mixed pork, a few tablespoons … 25%; the hip 50%“, says Annabelle Chatonnier, a caregiver. In total, 1,318 ingredients used for the recipes were inserted into a catering software, with their characteristics in grams of protein and kilocalories, to monitor the risks of malnutrition and, in fact , limit muscle decline in residents. “When we post article by article, we can know exactly what people ate“Explains Marie Blanquet, physician in charge of the clinical research unit of the hospital center, which hosts the EHPAD. Then “we compare how much consumed and how much is covered in terms of energy and protein, according to the patient’s profile”, continues Véronique Neves, dietician at the center.
Taste problem? Of consistency? Aversion to meat? “We adapt the menu“, ensures:”If Mrs So-and-so rarely eats her meat, there is no point in putting meat on her. We will double the cheeses and have a higher protein intake“.”When patients have an appetite for sweets, and if we find that they do not meet their needs, we will offer them some more desserts, to satisfy those needs.“adds Dr Blanquet. This allows for a finer analysis than other EHPADs where the amount consumed is often assessed as a whole. The pilot program, extended to all patients in the hospital, received the award for the best initiative for facilities with less than 500 beds at the Journées francophones de la Nutrition in Lille, in November 2021. Nurses, nursing auxiliaries, service agents, cooks, all staff have been trained with the aim of extending it to other establishments del Cantal and beyond, because 76% of elderly patients suffer from chronic malnutrition, as demonstrated by a clinical study conducted in collaboration with the hospitals of Riom and Clermont-Ferrand.
“As we age, more often than not there is a decrease in appetite for meat and this can lead to malnutrition.“explains Dr Blanquet. In the elderly, these protein deficiencies lead to a loss of muscle mass, which is also closely monitored by the nursing staff. Vivien Chomettat, an adapted physical activity teacher at Mauriac hospital, regularly screen for sarcopenia. (loss of muscle quality and quality) using a measuring device that allows patients’ muscle strength to be tested “.Depending on the results, we adapt a higher protein diet or a physical activity focused on building muscle“, explains. In the end, the quality of life of the elderly is improved, which also makes it possible to avoid hospitalization and to limit costs for the health system. Because malnutrition often leads to “more falls, more infections, more bedsores“, Enumerates the dietician Véronique Neves. “If we can anticipate power management before the complications come, we win: it’s time spent first, time saved later.“, He concludes.