Dietitian

The Accredited Practising Dietitian’s (APD) role in working with an older adult receiving palliative care at the end of life is the assessment, management and support in helping individuals maintaining adequate nutrition and hydration and to optimise their quality of life and any symptoms related to nutrition and oral intake. Dietitians recognise that eating also has an emotional, social and cultural significance and that changes in food intake may be distressing for the person, family and carers.

Key Points

The Dietitian liaises within the interprofessional care team to promote best outcomes. Dietitians who work with older adults receiving palliative care at the end of life may contribute in numerous ways during end of life: Assessment of the individual’s symptoms which may interfere with appetite or eating and their sense of what is important. Common tools are listed below in the Tools and Resources tab.

The results of the nutrition assessment will guide what input is provided, such as:

• Working with the individual and their family/carers to create realistic goals and expectations for diet and oral intake.
• Ongoing assessment for
  • changes in dietary intake, weight, and swallowing (in close consultation with the speech pathologist)
  • quality of life in relation to eating and drinking
  • need for nutritional supplements
  • level of independence with shopping and cooking.

Further services a Dietitian might provide

• Supporting the multidisciplinary team with the nutritional management of symptom-related problems such as loss of appetite, altered taste and smell, dysphagia or cachexia.
• Can facilitate discussions on the potential benefits and burdens of supplemented oral, enteral, and parenteral nutrition.
• Advise on preparation, fortification, supplementation, and relaxation of previous dietary restrictions as appropriate for the individual and their needs.
• Work closely with a speech pathologist to maximise eating and drinking options where a swallow deficit has been assessed.