utrition Concerns in Discharge Planning for lder Adults: A Need for Multidisciplinary ollaboration

a m o c n h r c i BSTRACT his survey of 84 case managers (CMs) (88% response ate) in 11 south Florida hospitals, in one for-profit health are system, sought to identify their discharge planning oncerns regarding the food and nutrition needs of older atients, how they addressed these concerns, and the egree to which registered dietitians (RDs) were inolved. Most CMs were female (82 of 84, 98%), older than ge 40 (59 of 84, 70%), and were registered nurses (51 of 4, 61%). Almost all (82 of 84, 98%) reported job barriers, ncluding excessive patient loads and responsibilities and imited community services. Almost all said that nutriion-related diseases and factors (eg, chewing/swallowing roblems, poor appetite, modified diets, poor dentition) trongly influenced discharge planning. Many perceived ommunity nutrition resources (eg, congregate meals, ood stamps, shopping assistance, outpatient dietitians) s not readily available. While physicians, nurses, social orkers, and physical therapists were identified as very mportant in discharge planning, RDs were not; almost alf of CMs consulted them infrequently, if at all. Stratgies for the six nutrition-related case scenarios were nconsistent. Home-health agencies were chosen most ofen and outpatient RDs least often. Comprehensive disharge planning must include more attention to nutrition ith greater input from clinical, outpatient, home health, nd community RDs through, for example, attendance at ospital discharge planning rounds, inservices for CMs, nd better marketing of RD services. More RDs can and