how much do you honor client's preferences?

[Guest guest]

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of the

named recipient(s) and may contain confidential and/or privileged information.

Any unauthorized review, use, disclosure or distribution of this communication

is expressly prohibited. If you are not the intended recipient, or you received

this transmission in error, please contact the sender by reply e-mail and

destroy any and all copies of the original message.

[Guest guest]

I work with a forensic psych hospital and yes, we do have to allow for

preferences per state code. We have the patients be specific (if they say they

do not like carrots, we clarify raw vs cooked and if it is both, they count as

two separate foods) and we have an unwritten rule that we will honor up to four

specific dislikes. So far, I have never had to cut someone off at four. For

most of my patients, they say they will eat anything. If they do have any

dislikes, it is usually just one or two items. Once you ask them to be

specific, they have to think a little bit harder about what they do not like.

They are given a nutritionally equivalent substitute for their dislikes. If

they don't eat that, it was at least offered. We also have to provide snacks

between meals. The units have things like juice, milk, cereal bars, and

crackers available and those are offered at certain times in the morning and

afternoons. The evening snack is a rotating snack that is sent with the supper

meal.

Hope this helps some. This was something we were dinged with for not doing

during our last state inspection but we made changes and so far, it seems to be

working well. Hopefully the state will be pleased next time they return!

Tina , RD, LD

Clinical Dietitian

Iowa Medical & Classification Center

2700 Coral Ridge Avenue

Coralville, IA 52241

Phone:

Email: a.@...

From: rd-usa [mailto:rd-usa ] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 11:25 AM

To: rd-usa

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of the

named recipient(s) and may contain confidential and/or privileged information.

Any unauthorized review, use, disclosure or distribution of this communication

is expressly prohibited. If you are not the intended recipient, or you received

this transmission in error, please contact the sender by reply e-mail and

destroy any and all copies of the original message.

[Guest guest]

I work with a forensic psych hospital and yes, we do have to allow for

preferences per state code. We have the patients be specific (if they say they

do not like carrots, we clarify raw vs cooked and if it is both, they count as

two separate foods) and we have an unwritten rule that we will honor up to four

specific dislikes. So far, I have never had to cut someone off at four. For

most of my patients, they say they will eat anything. If they do have any

dislikes, it is usually just one or two items. Once you ask them to be

specific, they have to think a little bit harder about what they do not like.

They are given a nutritionally equivalent substitute for their dislikes. If

they don't eat that, it was at least offered. We also have to provide snacks

between meals. The units have things like juice, milk, cereal bars, and

crackers available and those are offered at certain times in the morning and

afternoons. The evening snack is a rotating snack that is sent with the supper

meal.

Hope this helps some. This was something we were dinged with for not doing

during our last state inspection but we made changes and so far, it seems to be

working well. Hopefully the state will be pleased next time they return!

Tina , RD, LD

Clinical Dietitian

Iowa Medical & Classification Center

2700 Coral Ridge Avenue

Coralville, IA 52241

Phone:

Email: a.@...

From: rd-usa [mailto:rd-usa ] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 11:25 AM

To: rd-usa

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of the

named recipient(s) and may contain confidential and/or privileged information.

Any unauthorized review, use, disclosure or distribution of this communication

is expressly prohibited. If you are not the intended recipient, or you received

this transmission in error, please contact the sender by reply e-mail and

destroy any and all copies of the original message.

[Guest guest]

I work with a forensic psych hospital and yes, we do have to allow for

preferences per state code. We have the patients be specific (if they say they

do not like carrots, we clarify raw vs cooked and if it is both, they count as

two separate foods) and we have an unwritten rule that we will honor up to four

specific dislikes. So far, I have never had to cut someone off at four. For

most of my patients, they say they will eat anything. If they do have any

dislikes, it is usually just one or two items. Once you ask them to be

specific, they have to think a little bit harder about what they do not like.

They are given a nutritionally equivalent substitute for their dislikes. If

they don't eat that, it was at least offered. We also have to provide snacks

between meals. The units have things like juice, milk, cereal bars, and

crackers available and those are offered at certain times in the morning and

afternoons. The evening snack is a rotating snack that is sent with the supper

meal.

Hope this helps some. This was something we were dinged with for not doing

during our last state inspection but we made changes and so far, it seems to be

working well. Hopefully the state will be pleased next time they return!

Tina , RD, LD

Clinical Dietitian

Iowa Medical & Classification Center

2700 Coral Ridge Avenue

Coralville, IA 52241

Phone:

Email: a.@...

From: rd-usa [mailto:rd-usa ] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 11:25 AM

To: rd-usa

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of the

named recipient(s) and may contain confidential and/or privileged information.

Any unauthorized review, use, disclosure or distribution of this communication

is expressly prohibited. If you are not the intended recipient, or you received

this transmission in error, please contact the sender by reply e-mail and

destroy any and all copies of the original message.

[Guest guest]

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I’ve always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There’s no point in serving food they’ll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don’t make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they’d be kicked off it) but

also their food preferences reduced significantly. I don’t see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water……………..

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I’ve always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There’s no point in serving food they’ll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don’t make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they’d be kicked off it) but

also their food preferences reduced significantly. I don’t see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water……………..

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I’ve always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There’s no point in serving food they’ll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don’t make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they’d be kicked off it) but

also their food preferences reduced significantly. I don’t see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water……………..

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

When I used to consult at the Jail in our area, we had numerous people try to

list foods as allergies so they wouldn't get foods they didn't like. To handle

this we required them to produce documentation from an allergist/ MD that they

had been tested for allergies or it was not adhered to. Policy was made with

this so if they tried to sue for not meeting their needs in court. We were

covered. Worked well for us and eliminated a lot of issues.

From: rd-usa [mailto:rd-usa ] On Behalf Of Digna

Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

When I used to consult at the Jail in our area, we had numerous people try to

list foods as allergies so they wouldn't get foods they didn't like. To handle

this we required them to produce documentation from an allergist/ MD that they

had been tested for allergies or it was not adhered to. Policy was made with

this so if they tried to sue for not meeting their needs in court. We were

covered. Worked well for us and eliminated a lot of issues.

From: rd-usa [mailto:rd-usa ] On Behalf Of Digna

Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] On Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

I’m glad you were successful, however, what would have happened if someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should force it down their throat.

They are adults, in jail or not. They dont want to eat what is served - fine. I

will document how picky the pt is, and that this is the etiology of unplanned wt

loss but I will not provide something they won't eat bc it is useless, they will

buy in the hospital gift shop (in my facility) or have family bring then

whatever they like and if they dont have family/visitors....too bad. The food,

if provided against their will, will not be eaten, so what have we accomplished?

power game? If someone is not willing to try new foods, if someone is not

interested in healthy eating and all they eat is hamburgers and they will have

heart attach 5 yrs later, not my problem.My job is to educate the pts/clients

(out-pt/whichever setting). Assuming there are no educational/cognitive

limitation and pts are alert and oriented X3 (if they are not, education if even

less useful and they will also eat only what they like, healthy or not) What

they do with this information is their choice and their choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

I’m glad you were successful, however, what would have happened if someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should force it down their throat.

They are adults, in jail or not. They dont want to eat what is served - fine. I

will document how picky the pt is, and that this is the etiology of unplanned wt

loss but I will not provide something they won't eat bc it is useless, they will

buy in the hospital gift shop (in my facility) or have family bring then

whatever they like and if they dont have family/visitors....too bad. The food,

if provided against their will, will not be eaten, so what have we accomplished?

power game? If someone is not willing to try new foods, if someone is not

interested in healthy eating and all they eat is hamburgers and they will have

heart attach 5 yrs later, not my problem.My job is to educate the pts/clients

(out-pt/whichever setting). Assuming there are no educational/cognitive

limitation and pts are alert and oriented X3 (if they are not, education if even

less useful and they will also eat only what they like, healthy or not) What

they do with this information is their choice and their choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

I’m glad you were successful, however, what would have happened if someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should force it down their throat.

They are adults, in jail or not. They dont want to eat what is served - fine. I

will document how picky the pt is, and that this is the etiology of unplanned wt

loss but I will not provide something they won't eat bc it is useless, they will

buy in the hospital gift shop (in my facility) or have family bring then

whatever they like and if they dont have family/visitors....too bad. The food,

if provided against their will, will not be eaten, so what have we accomplished?

power game? If someone is not willing to try new foods, if someone is not

interested in healthy eating and all they eat is hamburgers and they will have

heart attach 5 yrs later, not my problem.My job is to educate the pts/clients

(out-pt/whichever setting). Assuming there are no educational/cognitive

limitation and pts are alert and oriented X3 (if they are not, education if even

less useful and they will also eat only what they like, healthy or not) What

they do with this information is their choice and their choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

I’m glad you were successful, however, what would have happened if someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

I have found that my pickiest eaters are the people who were homeless prior to

admission. I try to accomodate them as much as possible within the budget and

staffing constraints, as being in a facility is sometimes more difficult for

them to adjust to than many other residents.

 

Madalyn

 

To: rd-usa <rd-usa >

Sent: Wednesday, June 15, 2011 11:07 PM

Subject: RE: how much do you honor client's preferences?

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should  force it down their

throat. They are adults, in jail or not. They dont want to eat what is served

-  fine. I will document how picky the pt is, and that this is the etiology of

unplanned wt loss but I will not provide something they won't eat bc it is

useless, they will buy in the hospital gift shop (in

my facility) or have family bring then whatever they like and if they dont have

family/visitors....too bad. The food, if provided against their will, will not

be eaten, so what have we accomplished? power game? If someone is not willing to

try new foods, if someone is not interested in healthy eating and all they eat

is hamburgers and they will have heart attach 5 yrs later, not my problem.My job

is to educate the pts/clients (out-pt/whichever setting). Assuming there are no

educational/cognitive limitation and pts are alert and oriented X3 (if they are

not, education if even less useful and they will also eat only what they like,

healthy or not) What they do with this information is their choice and their

choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

 

   

     

     

      I’m glad you were successful, however, what would have happened if

someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it. 

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

I have found that my pickiest eaters are the people who were homeless prior to

admission. I try to accomodate them as much as possible within the budget and

staffing constraints, as being in a facility is sometimes more difficult for

them to adjust to than many other residents.

 

Madalyn

 

To: rd-usa <rd-usa >

Sent: Wednesday, June 15, 2011 11:07 PM

Subject: RE: how much do you honor client's preferences?

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should  force it down their

throat. They are adults, in jail or not. They dont want to eat what is served

-  fine. I will document how picky the pt is, and that this is the etiology of

unplanned wt loss but I will not provide something they won't eat bc it is

useless, they will buy in the hospital gift shop (in

my facility) or have family bring then whatever they like and if they dont have

family/visitors....too bad. The food, if provided against their will, will not

be eaten, so what have we accomplished? power game? If someone is not willing to

try new foods, if someone is not interested in healthy eating and all they eat

is hamburgers and they will have heart attach 5 yrs later, not my problem.My job

is to educate the pts/clients (out-pt/whichever setting). Assuming there are no

educational/cognitive limitation and pts are alert and oriented X3 (if they are

not, education if even less useful and they will also eat only what they like,

healthy or not) What they do with this information is their choice and their

choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

 

   

     

     

      I’m glad you were successful, however, what would have happened if

someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it. 

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

When I worked in a Psych hospital anorexia nervosa patients would use it as

a " tool " not to eat...

On Fri, Jun 17, 2011 at 9:47 PM, Madalyn Friedberg wrote:

> **

>

>

> I have found that my pickiest eaters are the people who were homeless prior

> to admission. I try to accomodate them as much as possible within the budget

> and staffing constraints, as being in a facility is sometimes more difficult

> for them to adjust to than many other residents.

>

> Madalyn

>

>

>

> To: rd-usa <rd-usa >

> Sent: Wednesday, June 15, 2011 11:07 PM

> Subject: RE: how much do you honor client's preferences?

>

> I completely agree Digna.As someone noted before, this is a requirement to

> provide verity of food and alternatives as possible. If someone asked for

> lobster tail and that's the only thing they want to eat....tough, I work in

> a city hospital and we will not be able to accommodate.On a different token,

> I have very picky pts. Pts who were homeless before, now are complaining

> about every food item possible and they have long list of dislikes. So when

> they eventually complain about poor variety I say: " hey, you eliminated

> everything else " .I am not the food police (see below) and I refuse to become

> one. If someone doesn't want to eat something no one should force it down

> their throat. They are adults, in jail or not. They dont want to eat what is

> served - fine. I will document how picky the pt is, and that this is the

> etiology of unplanned wt loss but I will not provide something they won't

> eat bc it is useless, they will buy in the hospital gift shop (in

> my facility) or have family bring then whatever they like and if they dont

> have family/visitors....too bad. The food, if provided against their will,

> will not be eaten, so what have we accomplished? power game? If someone is

> not willing to try new foods, if someone is not interested in healthy eating

> and all they eat is hamburgers and they will have heart attach 5 yrs later,

> not my problem.My job is to educate the pts/clients (out-pt/whichever

> setting). Assuming there are no educational/cognitive limitation and pts are

> alert and oriented X3 (if they are not, education if even less useful and

> they will also eat only what they like, healthy or not) What they do with

> this information is their choice and their choice only.

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments

> that take your breath away. " - Carlin " People don't forget the truth,

> they just become better in lying " (Revolutionary Road)

>

> To: rd-usa

> From: dignacassens@...

> Date: Wed, 15 Jun 2011 19:02:53 -0700

> Subject: RE: how much do you honor client's preferences?

>

>

>

>

>

>

> I’m glad you were successful, however, what would have happened if

> someone

>

> truly allergic received the food they were listed as being allergic to?

> I’ve

>

> never been to an MD for a shellfish allergy – except back in the 60’s

> before

>

> knowing I was deadly allergic. How would I produce that documentation now?

>

> Certainly not by eating it to prove it.

>

> Digna

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

>

> tnordin@...

>

> Sent: Wednesday, June 15, 2011 10:20 AM

>

> To: rd-usa

>

> Subject: RE: how much do you honor client's preferences?

>

> When I used to consult at the Jail in our area, we had numerous people try

>

> to list foods as allergies so they wouldn't get foods they didn't like. To

>

> handle this we required them to produce documentation from an allergist/ MD

>

> that they had been tested for allergies or it was not adhered to. Policy

> was

>

> made with this so if they tried to sue for not meeting their needs in

> court.

>

> We were covered. Worked well for us and eliminated a lot of issues.

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

> Behalf

>

> Of Digna Cassens

>

> Sent: Tuesday, June 14, 2011 6:46 PM

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> Subject: RE: how much do you honor client's preferences?

>

> In the skilled or long-term MH facilities I have been in charge of we treat

>

> the residents just like we do those in other facilities, unless their

>

> requests compromise their health and welfare. The behavioralists and treat

>

> their issues as well in conjunction w the RD and dietary manager since

> often

>

> they do revolve around food. I've always provided a semi-select menu with a

>

> standard list of 2 or 3 alternates per meal plus the main entrée and a

>

> second popular entre. There's no point in serving food they'll not eat or

>

> throw away, and exacerbate their negative behaviors.

>

> In the acute MH facility there were levels of choice; if on a 72 hr hold,

> no

>

> choices as most had lost their rights through their outside behavior, and 3

>

> days don't make that much difference in the long run. For those on

> long-term

>

> treatment, 2 weeks to 3 months, then the choices were layered, or based on

>

> their behavioral earnings, until they earned the final choice to be able to

>

> go to the cafeteria escorted with the group. The only items they could not

>

> chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

>

> chocolate off the menu and nobody noticed).

>

> For the psychotic clients I suggest working with the treatment team. I also

>

> found that in those that earned attendance at the locked dining program

>

> were better behaved (of course, bc otherwise they'd be kicked off it) but

>

> also their food preferences reduced significantly. I don't see the problem

>

> of giving 2 choices; coleslaw or lettuce? One green and one other color

>

> vegetable?

>

> You can bring the horse to water.................

>

> Digna

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

>

> <mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

>

> Behalf Of

>

> Lawson

>

> Sent: Tuesday, June 14, 2011 9:25 AM

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> <mailto:rd-usa%40yahoogroups.com>

>

> Subject: how much do you honor client's preferences?

>

> Let me preface this with I work at a mental health facility.

>

> And we have a non-select menu.

>

> We are CONSTANTLY getting client's complaining about what is being served

>

> that they don't like certain foods. " I don't like coleslaw... " " I don't

>

> like green vegetables... " I imagine you get what I'm talking about here.

>

> Most of the time we are able to accommodate these preferences, but it

>

> appears that it has gotten out of control.

>

> So my question is at what point do you say ENOUGH?

>

> And another question... we have quite a few clients that are psychotic and

>

> give us a long list of preferences. Almost to the point of only eating a

>

> few select items. At what point are we held accountable for only sending a

>

> small amount of food variety to help make sure that they are eating (as

> they

>

> would refuse to eat all other foods) but not providing the correct RDA's?

>

> Thanks!

>

>

>

> This message, including any attachments, is intended solely for the use of

>

> the named recipient(s) and may contain confidential and/or privileged

>

> information. Any unauthorized review, use, disclosure or distribution of

>

> this communication is expressly prohibited. If you are not the intended

>

> recipient, or you received this transmission in error, please contact the

>

> sender by reply e-mail and destroy any and all copies of the original

>

> message.

>

>

[Guest guest]

When I worked in a Psych hospital anorexia nervosa patients would use it as

a " tool " not to eat...

On Fri, Jun 17, 2011 at 9:47 PM, Madalyn Friedberg wrote:

> **

>

>

> I have found that my pickiest eaters are the people who were homeless prior

> to admission. I try to accomodate them as much as possible within the budget

> and staffing constraints, as being in a facility is sometimes more difficult

> for them to adjust to than many other residents.

>

> Madalyn

>

>

>

> To: rd-usa <rd-usa >

> Sent: Wednesday, June 15, 2011 11:07 PM

> Subject: RE: how much do you honor client's preferences?

>

> I completely agree Digna.As someone noted before, this is a requirement to

> provide verity of food and alternatives as possible. If someone asked for

> lobster tail and that's the only thing they want to eat....tough, I work in

> a city hospital and we will not be able to accommodate.On a different token,

> I have very picky pts. Pts who were homeless before, now are complaining

> about every food item possible and they have long list of dislikes. So when

> they eventually complain about poor variety I say: " hey, you eliminated

> everything else " .I am not the food police (see below) and I refuse to become

> one. If someone doesn't want to eat something no one should force it down

> their throat. They are adults, in jail or not. They dont want to eat what is

> served - fine. I will document how picky the pt is, and that this is the

> etiology of unplanned wt loss but I will not provide something they won't

> eat bc it is useless, they will buy in the hospital gift shop (in

> my facility) or have family bring then whatever they like and if they dont

> have family/visitors....too bad. The food, if provided against their will,

> will not be eaten, so what have we accomplished? power game? If someone is

> not willing to try new foods, if someone is not interested in healthy eating

> and all they eat is hamburgers and they will have heart attach 5 yrs later,

> not my problem.My job is to educate the pts/clients (out-pt/whichever

> setting). Assuming there are no educational/cognitive limitation and pts are

> alert and oriented X3 (if they are not, education if even less useful and

> they will also eat only what they like, healthy or not) What they do with

> this information is their choice and their choice only.

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments

> that take your breath away. " - Carlin " People don't forget the truth,

> they just become better in lying " (Revolutionary Road)

>

> To: rd-usa

> From: dignacassens@...

> Date: Wed, 15 Jun 2011 19:02:53 -0700

> Subject: RE: how much do you honor client's preferences?

>

>

>

>

>

>

> I’m glad you were successful, however, what would have happened if

> someone

>

> truly allergic received the food they were listed as being allergic to?

> I’ve

>

> never been to an MD for a shellfish allergy – except back in the 60’s

> before

>

> knowing I was deadly allergic. How would I produce that documentation now?

>

> Certainly not by eating it to prove it.

>

> Digna

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

>

> tnordin@...

>

> Sent: Wednesday, June 15, 2011 10:20 AM

>

> To: rd-usa

>

> Subject: RE: how much do you honor client's preferences?

>

> When I used to consult at the Jail in our area, we had numerous people try

>

> to list foods as allergies so they wouldn't get foods they didn't like. To

>

> handle this we required them to produce documentation from an allergist/ MD

>

> that they had been tested for allergies or it was not adhered to. Policy

> was

>

> made with this so if they tried to sue for not meeting their needs in

> court.

>

> We were covered. Worked well for us and eliminated a lot of issues.

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

> Behalf

>

> Of Digna Cassens

>

> Sent: Tuesday, June 14, 2011 6:46 PM

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> Subject: RE: how much do you honor client's preferences?

>

> In the skilled or long-term MH facilities I have been in charge of we treat

>

> the residents just like we do those in other facilities, unless their

>

> requests compromise their health and welfare. The behavioralists and treat

>

> their issues as well in conjunction w the RD and dietary manager since

> often

>

> they do revolve around food. I've always provided a semi-select menu with a

>

> standard list of 2 or 3 alternates per meal plus the main entrée and a

>

> second popular entre. There's no point in serving food they'll not eat or

>

> throw away, and exacerbate their negative behaviors.

>

> In the acute MH facility there were levels of choice; if on a 72 hr hold,

> no

>

> choices as most had lost their rights through their outside behavior, and 3

>

> days don't make that much difference in the long run. For those on

> long-term

>

> treatment, 2 weeks to 3 months, then the choices were layered, or based on

>

> their behavioral earnings, until they earned the final choice to be able to

>

> go to the cafeteria escorted with the group. The only items they could not

>

> chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

>

> chocolate off the menu and nobody noticed).

>

> For the psychotic clients I suggest working with the treatment team. I also

>

> found that in those that earned attendance at the locked dining program

>

> were better behaved (of course, bc otherwise they'd be kicked off it) but

>

> also their food preferences reduced significantly. I don't see the problem

>

> of giving 2 choices; coleslaw or lettuce? One green and one other color

>

> vegetable?

>

> You can bring the horse to water.................

>

> Digna

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

>

> <mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

>

> Behalf Of

>

> Lawson

>

> Sent: Tuesday, June 14, 2011 9:25 AM

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> <mailto:rd-usa%40yahoogroups.com>

>

> Subject: how much do you honor client's preferences?

>

> Let me preface this with I work at a mental health facility.

>

> And we have a non-select menu.

>

> We are CONSTANTLY getting client's complaining about what is being served

>

> that they don't like certain foods. " I don't like coleslaw... " " I don't

>

> like green vegetables... " I imagine you get what I'm talking about here.

>

> Most of the time we are able to accommodate these preferences, but it

>

> appears that it has gotten out of control.

>

> So my question is at what point do you say ENOUGH?

>

> And another question... we have quite a few clients that are psychotic and

>

> give us a long list of preferences. Almost to the point of only eating a

>

> few select items. At what point are we held accountable for only sending a

>

> small amount of food variety to help make sure that they are eating (as

> they

>

> would refuse to eat all other foods) but not providing the correct RDA's?

>

> Thanks!

>

>

>

> This message, including any attachments, is intended solely for the use of

>

> the named recipient(s) and may contain confidential and/or privileged

>

> information. Any unauthorized review, use, disclosure or distribution of

>

> this communication is expressly prohibited. If you are not the intended

>

> recipient, or you received this transmission in error, please contact the

>

> sender by reply e-mail and destroy any and all copies of the original

>

> message.

>

>

[Guest guest]

When I worked in a Psych hospital anorexia nervosa patients would use it as

a " tool " not to eat...

On Fri, Jun 17, 2011 at 9:47 PM, Madalyn Friedberg wrote:

> **

>

>

> I have found that my pickiest eaters are the people who were homeless prior

> to admission. I try to accomodate them as much as possible within the budget

> and staffing constraints, as being in a facility is sometimes more difficult

> for them to adjust to than many other residents.

>

> Madalyn

>

>

>

> To: rd-usa <rd-usa >

> Sent: Wednesday, June 15, 2011 11:07 PM

> Subject: RE: how much do you honor client's preferences?

>

> I completely agree Digna.As someone noted before, this is a requirement to

> provide verity of food and alternatives as possible. If someone asked for

> lobster tail and that's the only thing they want to eat....tough, I work in

> a city hospital and we will not be able to accommodate.On a different token,

> I have very picky pts. Pts who were homeless before, now are complaining

> about every food item possible and they have long list of dislikes. So when

> they eventually complain about poor variety I say: " hey, you eliminated

> everything else " .I am not the food police (see below) and I refuse to become

> one. If someone doesn't want to eat something no one should force it down

> their throat. They are adults, in jail or not. They dont want to eat what is

> served - fine. I will document how picky the pt is, and that this is the

> etiology of unplanned wt loss but I will not provide something they won't

> eat bc it is useless, they will buy in the hospital gift shop (in

> my facility) or have family bring then whatever they like and if they dont

> have family/visitors....too bad. The food, if provided against their will,

> will not be eaten, so what have we accomplished? power game? If someone is

> not willing to try new foods, if someone is not interested in healthy eating

> and all they eat is hamburgers and they will have heart attach 5 yrs later,

> not my problem.My job is to educate the pts/clients (out-pt/whichever

> setting). Assuming there are no educational/cognitive limitation and pts are

> alert and oriented X3 (if they are not, education if even less useful and

> they will also eat only what they like, healthy or not) What they do with

> this information is their choice and their choice only.

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments

> that take your breath away. " - Carlin " People don't forget the truth,

> they just become better in lying " (Revolutionary Road)

>

> To: rd-usa

> From: dignacassens@...

> Date: Wed, 15 Jun 2011 19:02:53 -0700

> Subject: RE: how much do you honor client's preferences?

>

>

>

>

>

>

> I’m glad you were successful, however, what would have happened if

> someone

>

> truly allergic received the food they were listed as being allergic to?

> I’ve

>

> never been to an MD for a shellfish allergy – except back in the 60’s

> before

>

> knowing I was deadly allergic. How would I produce that documentation now?

>

> Certainly not by eating it to prove it.

>

> Digna

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

>

> tnordin@...

>

> Sent: Wednesday, June 15, 2011 10:20 AM

>

> To: rd-usa

>

> Subject: RE: how much do you honor client's preferences?

>

> When I used to consult at the Jail in our area, we had numerous people try

>

> to list foods as allergies so they wouldn't get foods they didn't like. To

>

> handle this we required them to produce documentation from an allergist/ MD

>

> that they had been tested for allergies or it was not adhered to. Policy

> was

>

> made with this so if they tried to sue for not meeting their needs in

> court.

>

> We were covered. Worked well for us and eliminated a lot of issues.

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

> Behalf

>

> Of Digna Cassens

>

> Sent: Tuesday, June 14, 2011 6:46 PM

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> Subject: RE: how much do you honor client's preferences?

>

> In the skilled or long-term MH facilities I have been in charge of we treat

>

> the residents just like we do those in other facilities, unless their

>

> requests compromise their health and welfare. The behavioralists and treat

>

> their issues as well in conjunction w the RD and dietary manager since

> often

>

> they do revolve around food. I've always provided a semi-select menu with a

>

> standard list of 2 or 3 alternates per meal plus the main entrée and a

>

> second popular entre. There's no point in serving food they'll not eat or

>

> throw away, and exacerbate their negative behaviors.

>

> In the acute MH facility there were levels of choice; if on a 72 hr hold,

> no

>

> choices as most had lost their rights through their outside behavior, and 3

>

> days don't make that much difference in the long run. For those on

> long-term

>

> treatment, 2 weeks to 3 months, then the choices were layered, or based on

>

> their behavioral earnings, until they earned the final choice to be able to

>

> go to the cafeteria escorted with the group. The only items they could not

>

> chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

>

> chocolate off the menu and nobody noticed).

>

> For the psychotic clients I suggest working with the treatment team. I also

>

> found that in those that earned attendance at the locked dining program

>

> were better behaved (of course, bc otherwise they'd be kicked off it) but

>

> also their food preferences reduced significantly. I don't see the problem

>

> of giving 2 choices; coleslaw or lettuce? One green and one other color

>

> vegetable?

>

> You can bring the horse to water.................

>

> Digna

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

>

> <mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

>

> Behalf Of

>

> Lawson

>

> Sent: Tuesday, June 14, 2011 9:25 AM

>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> <mailto:rd-usa%40yahoogroups.com>

>

> Subject: how much do you honor client's preferences?

>

> Let me preface this with I work at a mental health facility.

>

> And we have a non-select menu.

>

> We are CONSTANTLY getting client's complaining about what is being served

>

> that they don't like certain foods. " I don't like coleslaw... " " I don't

>

> like green vegetables... " I imagine you get what I'm talking about here.

>

> Most of the time we are able to accommodate these preferences, but it

>

> appears that it has gotten out of control.

>

> So my question is at what point do you say ENOUGH?

>

> And another question... we have quite a few clients that are psychotic and

>

> give us a long list of preferences. Almost to the point of only eating a

>

> few select items. At what point are we held accountable for only sending a

>

> small amount of food variety to help make sure that they are eating (as

> they

>

> would refuse to eat all other foods) but not providing the correct RDA's?

>

> Thanks!

>

>

>

> This message, including any attachments, is intended solely for the use of

>

> the named recipient(s) and may contain confidential and/or privileged

>

> information. Any unauthorized review, use, disclosure or distribution of

>

> this communication is expressly prohibited. If you are not the intended

>

> recipient, or you received this transmission in error, please contact the

>

> sender by reply e-mail and destroy any and all copies of the original

>

> message.

>

>

[Guest guest]

absolutely true.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: mffrd10019@...

Date: Fri, 17 Jun 2011 18:47:49 -0700

Subject: Re: how much do you honor client's preferences?

I have found that my pickiest eaters are the people who were homeless

prior to admission. I try to accomodate them as much as possible within the

budget and staffing constraints, as being in a facility is sometimes more

difficult for them to adjust to than many other residents.

Madalyn

To: rd-usa <rd-usa >

Sent: Wednesday, June 15, 2011 11:07 PM

Subject: RE: how much do you honor client's preferences?

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should force it down their throat.

They are adults, in jail or not. They dont want to eat what is served - fine. I

will document how picky the pt is, and that this is the etiology of unplanned wt

loss but I will not provide something they won't eat bc it is useless, they will

buy in the hospital gift shop (in

my facility) or have family bring then whatever they like and if they dont have

family/visitors....too bad. The food, if provided against their will, will not

be eaten, so what have we accomplished? power game? If someone is not willing to

try new foods, if someone is not interested in healthy eating and all they eat

is hamburgers and they will have heart attach 5 yrs later, not my problem.My job

is to educate the pts/clients (out-pt/whichever setting). Assuming there are no

educational/cognitive limitation and pts are alert and oriented X3 (if they are

not, education if even less useful and they will also eat only what they like,

healthy or not) What they do with this information is their choice and their

choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

I’m glad you were successful, however, what would have happened if someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

absolutely true.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: mffrd10019@...

Date: Fri, 17 Jun 2011 18:47:49 -0700

Subject: Re: how much do you honor client's preferences?

I have found that my pickiest eaters are the people who were homeless

prior to admission. I try to accomodate them as much as possible within the

budget and staffing constraints, as being in a facility is sometimes more

difficult for them to adjust to than many other residents.

Madalyn

To: rd-usa <rd-usa >

Sent: Wednesday, June 15, 2011 11:07 PM

Subject: RE: how much do you honor client's preferences?

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should force it down their throat.

They are adults, in jail or not. They dont want to eat what is served - fine. I

will document how picky the pt is, and that this is the etiology of unplanned wt

loss but I will not provide something they won't eat bc it is useless, they will

buy in the hospital gift shop (in

my facility) or have family bring then whatever they like and if they dont have

family/visitors....too bad. The food, if provided against their will, will not

be eaten, so what have we accomplished? power game? If someone is not willing to

try new foods, if someone is not interested in healthy eating and all they eat

is hamburgers and they will have heart attach 5 yrs later, not my problem.My job

is to educate the pts/clients (out-pt/whichever setting). Assuming there are no

educational/cognitive limitation and pts are alert and oriented X3 (if they are

not, education if even less useful and they will also eat only what they like,

healthy or not) What they do with this information is their choice and their

choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

I’m glad you were successful, however, what would have happened if someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

that's a whole different manipulation of AN. My pts are just picky, but if you

give them cheeseburger, they will ask for seconds, every day.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: nrord1@...

> Date: Sat, 18 Jun 2011 07:20:53 -0400

> Subject: Re: how much do you honor client's preferences?

>

> When I worked in a Psych hospital anorexia nervosa patients would use it as

> a " tool " not to eat...

>

> On Fri, Jun 17, 2011 at 9:47 PM, Madalyn Friedberg

wrote:

>

> > **

> >

> >

> > I have found that my pickiest eaters are the people who were homeless prior

> > to admission. I try to accomodate them as much as possible within the budget

> > and staffing constraints, as being in a facility is sometimes more difficult

> > for them to adjust to than many other residents.

> >

> > Madalyn

> >

> >

> >

> > To: rd-usa <rd-usa >

> > Sent: Wednesday, June 15, 2011 11:07 PM

> > Subject: RE: how much do you honor client's preferences?

> >

> > I completely agree Digna.As someone noted before, this is a requirement to

> > provide verity of food and alternatives as possible. If someone asked for

> > lobster tail and that's the only thing they want to eat....tough, I work in

> > a city hospital and we will not be able to accommodate.On a different token,

> > I have very picky pts. Pts who were homeless before, now are complaining

> > about every food item possible and they have long list of dislikes. So when

> > they eventually complain about poor variety I say: " hey, you eliminated

> > everything else " .I am not the food police (see below) and I refuse to become

> > one. If someone doesn't want to eat something no one should force it down

> > their throat. They are adults, in jail or not. They dont want to eat what is

> > served - fine. I will document how picky the pt is, and that this is the

> > etiology of unplanned wt loss but I will not provide something they won't

> > eat bc it is useless, they will buy in the hospital gift shop (in

> > my facility) or have family bring then whatever they like and if they dont

> > have family/visitors....too bad. The food, if provided against their will,

> > will not be eaten, so what have we accomplished? power game? If someone is

> > not willing to try new foods, if someone is not interested in healthy eating

> > and all they eat is hamburgers and they will have heart attach 5 yrs later,

> > not my problem.My job is to educate the pts/clients (out-pt/whichever

> > setting). Assuming there are no educational/cognitive limitation and pts are

> > alert and oriented X3 (if they are not, education if even less useful and

> > they will also eat only what they like, healthy or not) What they do with

> > this information is their choice and their choice only.

> >

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> > To: rd-usa

> > From: dignacassens@...

> > Date: Wed, 15 Jun 2011 19:02:53 -0700

> > Subject: RE: how much do you honor client's preferences?

> >

> >

> >

> >

> >

> >

> > I’m glad you were successful, however, what would have happened if

> > someone

> >

> > truly allergic received the food they were listed as being allergic to?

> > I’ve

> >

> > never been to an MD for a shellfish allergy – except back in the 60’s

> > before

> >

> > knowing I was deadly allergic. How would I produce that documentation now?

> >

> > Certainly not by eating it to prove it.

> >

> > Digna

> >

> > From: rd-usa [mailto:rd-usa ] On Behalf Of

> >

> > tnordin@...

> >

> > Sent: Wednesday, June 15, 2011 10:20 AM

> >

> > To: rd-usa

> >

> > Subject: RE: how much do you honor client's preferences?

> >

> > When I used to consult at the Jail in our area, we had numerous people try

> >

> > to list foods as allergies so they wouldn't get foods they didn't like. To

> >

> > handle this we required them to produce documentation from an allergist/ MD

> >

> > that they had been tested for allergies or it was not adhered to. Policy

> > was

> >

> > made with this so if they tried to sue for not meeting their needs in

> > court.

> >

> > We were covered. Worked well for us and eliminated a lot of issues.

> >

> > From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

> > Behalf

> >

> > Of Digna Cassens

> >

> > Sent: Tuesday, June 14, 2011 6:46 PM

> >

> > To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > Subject: RE: how much do you honor client's preferences?

> >

> > In the skilled or long-term MH facilities I have been in charge of we treat

> >

> > the residents just like we do those in other facilities, unless their

> >

> > requests compromise their health and welfare. The behavioralists and treat

> >

> > their issues as well in conjunction w the RD and dietary manager since

> > often

> >

> > they do revolve around food. I've always provided a semi-select menu with a

> >

> > standard list of 2 or 3 alternates per meal plus the main entrée and a

> >

> > second popular entre. There's no point in serving food they'll not eat or

> >

> > throw away, and exacerbate their negative behaviors.

> >

> > In the acute MH facility there were levels of choice; if on a 72 hr hold,

> > no

> >

> > choices as most had lost their rights through their outside behavior, and 3

> >

> > days don't make that much difference in the long run. For those on

> > long-term

> >

> > treatment, 2 weeks to 3 months, then the choices were layered, or based on

> >

> > their behavioral earnings, until they earned the final choice to be able to

> >

> > go to the cafeteria escorted with the group. The only items they could not

> >

> > chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

> >

> > chocolate off the menu and nobody noticed).

> >

> > For the psychotic clients I suggest working with the treatment team. I also

> >

> > found that in those that earned attendance at the locked dining program

> >

> > were better behaved (of course, bc otherwise they'd be kicked off it) but

> >

> > also their food preferences reduced significantly. I don't see the problem

> >

> > of giving 2 choices; coleslaw or lettuce? One green and one other color

> >

> > vegetable?

> >

> > You can bring the horse to water.................

> >

> > Digna

> >

> > From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

> >

> > <mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

> >

> > Behalf Of

> >

> > Lawson

> >

> > Sent: Tuesday, June 14, 2011 9:25 AM

> >

> > To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > <mailto:rd-usa%40yahoogroups.com>

> >

> > Subject: how much do you honor client's preferences?

> >

> > Let me preface this with I work at a mental health facility.

> >

> > And we have a non-select menu.

> >

> > We are CONSTANTLY getting client's complaining about what is being served

> >

> > that they don't like certain foods. " I don't like coleslaw... " " I don't

> >

> > like green vegetables... " I imagine you get what I'm talking about here.

> >

> > Most of the time we are able to accommodate these preferences, but it

> >

> > appears that it has gotten out of control.

> >

> > So my question is at what point do you say ENOUGH?

> >

> > And another question... we have quite a few clients that are psychotic and

> >

> > give us a long list of preferences. Almost to the point of only eating a

> >

> > few select items. At what point are we held accountable for only sending a

> >

> > small amount of food variety to help make sure that they are eating (as

> > they

> >

> > would refuse to eat all other foods) but not providing the correct RDA's?

> >

> > Thanks!

> >

> >

> >

> > This message, including any attachments, is intended solely for the use of

> >

> > the named recipient(s) and may contain confidential and/or privileged

> >

> > information. Any unauthorized review, use, disclosure or distribution of

> >

> > this communication is expressly prohibited. If you are not the intended

> >

> > recipient, or you received this transmission in error, please contact the

> >

> > sender by reply e-mail and destroy any and all copies of the original

> >

> > message.

> >

> >

[Guest guest]

that's a whole different manipulation of AN. My pts are just picky, but if you

give them cheeseburger, they will ask for seconds, every day.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: nrord1@...

> Date: Sat, 18 Jun 2011 07:20:53 -0400

> Subject: Re: how much do you honor client's preferences?

>

> When I worked in a Psych hospital anorexia nervosa patients would use it as

> a " tool " not to eat...

>

> On Fri, Jun 17, 2011 at 9:47 PM, Madalyn Friedberg

wrote:

>

> > **

> >

> >

> > I have found that my pickiest eaters are the people who were homeless prior

> > to admission. I try to accomodate them as much as possible within the budget

> > and staffing constraints, as being in a facility is sometimes more difficult

> > for them to adjust to than many other residents.

> >

> > Madalyn

> >

> >

> >

> > To: rd-usa <rd-usa >

> > Sent: Wednesday, June 15, 2011 11:07 PM

> > Subject: RE: how much do you honor client's preferences?

> >

> > I completely agree Digna.As someone noted before, this is a requirement to

> > provide verity of food and alternatives as possible. If someone asked for

> > lobster tail and that's the only thing they want to eat....tough, I work in

> > a city hospital and we will not be able to accommodate.On a different token,

> > I have very picky pts. Pts who were homeless before, now are complaining

> > about every food item possible and they have long list of dislikes. So when

> > they eventually complain about poor variety I say: " hey, you eliminated

> > everything else " .I am not the food police (see below) and I refuse to become

> > one. If someone doesn't want to eat something no one should force it down

> > their throat. They are adults, in jail or not. They dont want to eat what is

> > served - fine. I will document how picky the pt is, and that this is the

> > etiology of unplanned wt loss but I will not provide something they won't

> > eat bc it is useless, they will buy in the hospital gift shop (in

> > my facility) or have family bring then whatever they like and if they dont

> > have family/visitors....too bad. The food, if provided against their will,

> > will not be eaten, so what have we accomplished? power game? If someone is

> > not willing to try new foods, if someone is not interested in healthy eating

> > and all they eat is hamburgers and they will have heart attach 5 yrs later,

> > not my problem.My job is to educate the pts/clients (out-pt/whichever

> > setting). Assuming there are no educational/cognitive limitation and pts are

> > alert and oriented X3 (if they are not, education if even less useful and

> > they will also eat only what they like, healthy or not) What they do with

> > this information is their choice and their choice only.

> >

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> > To: rd-usa

> > From: dignacassens@...

> > Date: Wed, 15 Jun 2011 19:02:53 -0700

> > Subject: RE: how much do you honor client's preferences?

> >

> >

> >

> >

> >

> >

> > I’m glad you were successful, however, what would have happened if

> > someone

> >

> > truly allergic received the food they were listed as being allergic to?

> > I’ve

> >

> > never been to an MD for a shellfish allergy – except back in the 60’s

> > before

> >

> > knowing I was deadly allergic. How would I produce that documentation now?

> >

> > Certainly not by eating it to prove it.

> >

> > Digna

> >

> > From: rd-usa [mailto:rd-usa ] On Behalf Of

> >

> > tnordin@...

> >

> > Sent: Wednesday, June 15, 2011 10:20 AM

> >

> > To: rd-usa

> >

> > Subject: RE: how much do you honor client's preferences?

> >

> > When I used to consult at the Jail in our area, we had numerous people try

> >

> > to list foods as allergies so they wouldn't get foods they didn't like. To

> >

> > handle this we required them to produce documentation from an allergist/ MD

> >

> > that they had been tested for allergies or it was not adhered to. Policy

> > was

> >

> > made with this so if they tried to sue for not meeting their needs in

> > court.

> >

> > We were covered. Worked well for us and eliminated a lot of issues.

> >

> > From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

> > Behalf

> >

> > Of Digna Cassens

> >

> > Sent: Tuesday, June 14, 2011 6:46 PM

> >

> > To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > Subject: RE: how much do you honor client's preferences?

> >

> > In the skilled or long-term MH facilities I have been in charge of we treat

> >

> > the residents just like we do those in other facilities, unless their

> >

> > requests compromise their health and welfare. The behavioralists and treat

> >

> > their issues as well in conjunction w the RD and dietary manager since

> > often

> >

> > they do revolve around food. I've always provided a semi-select menu with a

> >

> > standard list of 2 or 3 alternates per meal plus the main entrée and a

> >

> > second popular entre. There's no point in serving food they'll not eat or

> >

> > throw away, and exacerbate their negative behaviors.

> >

> > In the acute MH facility there were levels of choice; if on a 72 hr hold,

> > no

> >

> > choices as most had lost their rights through their outside behavior, and 3

> >

> > days don't make that much difference in the long run. For those on

> > long-term

> >

> > treatment, 2 weeks to 3 months, then the choices were layered, or based on

> >

> > their behavioral earnings, until they earned the final choice to be able to

> >

> > go to the cafeteria escorted with the group. The only items they could not

> >

> > chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

> >

> > chocolate off the menu and nobody noticed).

> >

> > For the psychotic clients I suggest working with the treatment team. I also

> >

> > found that in those that earned attendance at the locked dining program

> >

> > were better behaved (of course, bc otherwise they'd be kicked off it) but

> >

> > also their food preferences reduced significantly. I don't see the problem

> >

> > of giving 2 choices; coleslaw or lettuce? One green and one other color

> >

> > vegetable?

> >

> > You can bring the horse to water.................

> >

> > Digna

> >

> > From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

> >

> > <mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

> >

> > Behalf Of

> >

> > Lawson

> >

> > Sent: Tuesday, June 14, 2011 9:25 AM

> >

> > To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > <mailto:rd-usa%40yahoogroups.com>

> >

> > Subject: how much do you honor client's preferences?

> >

> > Let me preface this with I work at a mental health facility.

> >

> > And we have a non-select menu.

> >

> > We are CONSTANTLY getting client's complaining about what is being served

> >

> > that they don't like certain foods. " I don't like coleslaw... " " I don't

> >

> > like green vegetables... " I imagine you get what I'm talking about here.

> >

> > Most of the time we are able to accommodate these preferences, but it

> >

> > appears that it has gotten out of control.

> >

> > So my question is at what point do you say ENOUGH?

> >

> > And another question... we have quite a few clients that are psychotic and

> >

> > give us a long list of preferences. Almost to the point of only eating a

> >

> > few select items. At what point are we held accountable for only sending a

> >

> > small amount of food variety to help make sure that they are eating (as

> > they

> >

> > would refuse to eat all other foods) but not providing the correct RDA's?

> >

> > Thanks!

> >

> >

> >

> > This message, including any attachments, is intended solely for the use of

> >

> > the named recipient(s) and may contain confidential and/or privileged

> >

> > information. Any unauthorized review, use, disclosure or distribution of

> >

> > this communication is expressly prohibited. If you are not the intended

> >

> > recipient, or you received this transmission in error, please contact the

> >

> > sender by reply e-mail and destroy any and all copies of the original

> >

> > message.

> >

> >

[Guest guest]

I agree,  whenever we have a difficult patient regarding food likes/dislikes

about 90% of the time they are on public aide.  And yes they will eat the

burgers

>

> > **

> >

> >

> > I have found that my pickiest eaters are the people who were homeless prior

> > to admission. I try to accomodate them as much as possible within the budget

> > and staffing constraints, as being in a facility is sometimes more difficult

> > for them to adjust to than many other residents.

> >

> > Madalyn

> >

> >

> >

> > To: rd-usa <rd-usa >

> > Sent: Wednesday, June 15, 2011 11:07 PM

> > Subject: RE: how much do you honor client's preferences?

> >

> > I completely agree Digna.As someone noted before, this is a requirement to

> > provide verity of food and alternatives as possible. If someone asked for

> > lobster tail and that's the only thing they want to eat....tough, I work in

> > a city hospital and we will not be able to accommodate.On a different token,

> > I have very picky pts. Pts who were homeless before, now are complaining

> > about every food item possible and they have long list of dislikes. So when

> > they eventually complain about poor variety I say: " hey, you eliminated

> > everything else " .I am not the food police (see below) and I refuse to become

> > one. If someone doesn't want to eat something no one should  force it down

> > their throat. They are adults, in jail or not. They dont want to eat what is

> > served -  fine. I will document how picky the pt is, and that this is the

> > etiology of unplanned wt loss but I will not provide something they won't

> > eat bc it is useless, they will buy in the hospital gift shop (in

> > my facility) or have family bring then whatever they like and if they dont

> > have family/visitors....too bad. The food, if provided against their will,

> > will not be eaten, so what have we accomplished? power game? If someone is

> > not willing to try new foods, if someone is not interested in healthy eating

> > and all they eat is hamburgers and they will have heart attach 5 yrs later,

> > not my problem.My job is to educate the pts/clients (out-pt/whichever

> > setting). Assuming there are no educational/cognitive limitation and pts are

> > alert and oriented X3 (if they are not, education if even less useful and

> > they will also eat only what they like, healthy or not) What they do with

> > this information is their choice and their choice only.

> >

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> > To: rd-usa

> > From: dignacassens@...

> > Date: Wed, 15 Jun 2011 19:02:53 -0700

> > Subject: RE: how much do you honor client's preferences?

> >

> >

> >

> >

> >

> >

> >       I’m glad you were successful, however, what would have happened

if

> > someone

> >

> > truly allergic received the food they were listed as being allergic to?

> > I’ve

> >

> > never been to an MD for a shellfish allergy – except back in the 60’s

> > before

> >

> > knowing I was deadly allergic. How would I produce that documentation now?

> >

> > Certainly not by eating it to prove it.

> >

> > Digna

> >

> > From: rd-usa [mailto:rd-usa ] On Behalf Of

> >

> > tnordin@...

> >

> > Sent: Wednesday, June 15, 2011 10:20 AM

> >

> > To: rd-usa

> >

> > Subject: RE: how much do you honor client's preferences?

> >

> > When I used to consult at the Jail in our area, we had numerous people try

> >

> > to list foods as allergies so they wouldn't get foods they didn't like. To

> >

> > handle this we required them to produce documentation from an allergist/ MD

> >

> > that they had been tested for allergies or it was not adhered to. Policy

> > was

> >

> > made with this so if they tried to sue for not meeting their needs in

> > court.

> >

> > We were covered. Worked well for us and eliminated a lot of issues.

> >

> > From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On

> > Behalf

> >

> > Of Digna Cassens

> >

> > Sent: Tuesday, June 14, 2011 6:46 PM

> >

> > To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > Subject: RE: how much do you honor client's preferences?

> >

> > In the skilled or long-term MH facilities I have been in charge of we treat

> >

> > the residents just like we do those in other facilities, unless their

> >

> > requests compromise their health and welfare. The behavioralists and treat

> >

> > their issues as well in conjunction w the RD and dietary manager since

> > often

> >

> > they do revolve around food. I've always provided a semi-select menu with a

> >

> > standard list of 2 or 3 alternates per meal plus the main entrée and a

> >

> > second popular entre. There's no point in serving food they'll not eat or

> >

> > throw away, and exacerbate their negative behaviors.

> >

> > In the acute MH facility there were levels of choice; if on a 72 hr hold,

> > no

> >

> > choices as most had lost their rights through their outside behavior, and 3

> >

> > days don't make that much difference in the long run. For those on

> > long-term

> >

> > treatment, 2 weeks to 3 months, then the choices were layered, or based on

> >

> > their behavioral earnings, until they earned the final choice to be able to

> >

> > go to the cafeteria escorted with the group. The only items they could not

> >

> > chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

> >

> > chocolate off the menu and nobody noticed).

> >

> > For the psychotic clients I suggest working with the treatment team. I also

> >

> > found that in those that earned attendance at the locked dining program

> >

> > were better behaved (of course, bc otherwise they'd be kicked off it) but

> >

> > also their food preferences reduced significantly. I don't see the problem

> >

> > of giving 2 choices; coleslaw or lettuce? One green and one other color

> >

> > vegetable?

> >

> > You can bring the horse to water.................

> >

> > Digna

> >

> > From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

> >

> > <mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

> >

> > Behalf Of

> >

> > Lawson

> >

> > Sent: Tuesday, June 14, 2011 9:25 AM

> >

> > To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> >

> > <mailto:rd-usa%40yahoogroups.com>

> >

> > Subject: how much do you honor client's preferences?

> >

> > Let me preface this with I work at a mental health facility.

> >

> > And we have a non-select menu.

> >

> > We are CONSTANTLY getting client's complaining about what is being served

> >

> > that they don't like certain foods. " I don't like coleslaw... " " I don't

> >

> > like green vegetables... " I imagine you get what I'm talking about here.

> >

> > Most of the time we are able to accommodate these preferences, but it

> >

> > appears that it has gotten out of control.

> >

> > So my question is at what point do you say ENOUGH?

> >

> > And another question... we have quite a few clients that are psychotic and

> >

> > give us a long list of preferences. Almost to the point of only eating a

> >

> > few select items. At what point are we held accountable for only sending a

> >

> > small amount of food variety to help make sure that they are eating (as

> > they

> >

> > would refuse to eat all other foods) but not providing the correct RDA's?

> >

> > Thanks!

> >

> >

> >

> > This message, including any attachments, is intended solely for the use of

> >

> > the named recipient(s) and may contain confidential and/or privileged

> >

> > information. Any unauthorized review, use, disclosure or distribution of

> >

> > this communication is expressly prohibited. If you are not the intended

> >

> > recipient, or you received this transmission in error, please contact the

> >

> > sender by reply e-mail and destroy any and all copies of the original

> >

> > message.

> >

> >

[Guest guest]

I'll never forget a man at the hospital where I was in charge of the kitchen who

was homeless.  He was on a 2 gm Na diet and kept asking for ham sandwiches and

getting upset when my staff said no.  I went to speak with him and the nurses

warned me saying he was mean and nasty and pretty much how could someone who was

there for free be so demanding.  I thought a lot about my approach, went in

called him Mr. and introduced myself.  I told him I couldn't give him the ham

and why but that I could offer him roast beef or turkey and would he like one of

those instead.  By the time I walked out that door he was calling me sweetie

and doll and was so happy.  My department didn't have any more problems with

him.  Everyone wants to feel important and it's often not about anything other

than they finally get some say in their life.  I say let them have it if it

makes them feel good in an otherwise tough existence!

 

Barbara Romero, RD

Subject: RE: how much do you honor client's preferences?

To: " rd-usa " <rd-usa >

Date: Saturday, June 18, 2011, 7:45 AM

absolutely true.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: mffrd10019@...

Date: Fri, 17 Jun 2011 18:47:49 -0700

Subject: Re: how much do you honor client's preferences?

 

   

     

     

      I have found that my pickiest eaters are the people who were homeless

prior to admission. I try to accomodate them as much as possible within the

budget and staffing constraints, as being in a facility is sometimes more

difficult for them to adjust to than many other residents.

Madalyn

To: rd-usa <rd-usa >

Sent: Wednesday, June 15, 2011 11:07 PM

Subject: RE: how much do you honor client's preferences?

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should  force it down their

throat. They are adults, in jail or not. They dont want to eat what is served

-  fine. I will document how picky the pt is, and that this is the etiology of

unplanned wt loss but I will not provide something they won't eat bc it is

useless, they will buy in the hospital gift shop (in

my facility) or have family bring then whatever they like and if they dont have

family/visitors....too bad. The food, if provided against their will, will not

be eaten, so what have we accomplished? power game? If someone is not willing to

try new foods, if someone is not interested in healthy eating and all they eat

is hamburgers and they will have heart attach 5 yrs later, not my problem.My job

is to educate the pts/clients (out-pt/whichever setting). Assuming there are no

educational/cognitive limitation and pts are alert and oriented X3 (if they are

not, education if even less useful and they will also eat only what they like,

healthy or not) What they do with this information is their choice and their

choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

 

   

     

     

      I’m glad you were successful, however, what would have happened if

someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it. 

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

This message, including any attachments, is intended solely for the use of

the named recipient(s) and may contain confidential and/or privileged

information. Any unauthorized review, use, disclosure or distribution of

this communication is expressly prohibited. If you are not the intended

recipient, or you received this transmission in error, please contact the

sender by reply e-mail and destroy any and all copies of the original

message.

[Guest guest]

Barabara,

Didn't apprecaite your a bit of condescending tone, though I'll give you the

benefit of the doubt as we didn't have a face-to-face conversation.

BUT - it is very easy to be so approachable to one (!!!!) pt. I want you to

change shoes with your subordinat and take 10 like that A DAY! Every day!

Nonetheless - I had many cases that nurses told me " dont bother with him/her

they are abusive verbally ect " . and I did, and pt got the respect (I give them

all, regardless of backgrouns) and call ALL my pt Mr or MRS, never use first

name, to the point that I dont even know their first names. Its also a

barrier/limit setting.

and I have no problem with their attitute, nor I have a problem if they insist

on cheeseburger even after I educate them on the risks involved with high fat,

high salt diet. We have a big veriety of food but pts are very finicky and if I

have 120 pt I dont have 1/2hr a day to re-educate each and every one of them, I

do, though, educate them when re-eval is due and in between, if I see that they

care, most of them don't.

I educate them all, but when they complain that they dont get great veriety, I

remind them of the limitations the created for tehmselves.

There is no point for me to give them healthier food if it will end up in the

garbage.

OK...and now....

Who Flew Out of teh Coocku Nest (I do, right now)

Merav Levi, RD, MS, CDN

A dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin

" People don't forget the truth, they just become better in lying " (Revolutionary

Road)

To: rd-usa

From: leobarbr@...

Date: Sun, 19 Jun 2011 17:28:51 -0700

Subject: RE: how much do you honor client's preferences?

I'll never forget a man at the hospital where I was in charge of the kitchen who

was homeless. He was on a 2 gm Na diet and kept asking for ham sandwiches and

getting upset when my staff said no. I went to speak with him and the nurses

warned me saying he was mean and nasty and pretty much how could someone who was

there for free be so demanding. I thought a lot about my approach, went in

called him Mr. and introduced myself. I told him I couldn't give him the ham

and why but that I could offer him roast beef or turkey and would he like one of

those instead. By the time I walked out that door he was calling me sweetie and

doll and was so happy. My department didn't have any more problems with him.

Everyone wants to feel important and it's often not about anything other than

they finally get some say in their life. I say let them have it if it makes

them feel good in an otherwise tough existence!

Barbara Romero, RD

Subject: RE: how much do you honor client's preferences?

To: " rd-usa " <rd-usa >

Date: Saturday, June 18, 2011, 7:45 AM

absolutely true.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: mffrd10019@...

Date: Fri, 17 Jun 2011 18:47:49 -0700

Subject: Re: how much do you honor client's preferences?

I have found that my pickiest eaters are the people who were homeless

prior to admission. I try to accomodate them as much as possible within the

budget and staffing constraints, as being in a facility is sometimes more

difficult for them to adjust to than many other residents.

Madalyn

To: rd-usa <rd-usa >

Sent: Wednesday, June 15, 2011 11:07 PM

Subject: RE: how much do you honor client's preferences?

I completely agree Digna.As someone noted before, this is a requirement to

provide verity of food and alternatives as possible. If someone asked for

lobster tail and that's the only thing they want to eat....tough, I work in a

city hospital and we will not be able to accommodate.On a different token, I

have very picky pts. Pts who were homeless before, now are complaining about

every food item possible and they have long list of dislikes. So when they

eventually complain about poor variety I say: " hey, you eliminated everything

else " .I am not the food police (see below) and I refuse to become one. If

someone doesn't want to eat something no one should force it down their throat.

They are adults, in jail or not. They dont want to eat what is served - fine. I

will document how picky the pt is, and that this is the etiology of unplanned wt

loss but I will not provide something they won't eat bc it is useless, they will

buy in the hospital gift shop (in

my facility) or have family bring then whatever they like and if they dont have

family/visitors....too bad. The food, if provided against their will, will not

be eaten, so what have we accomplished? power game? If someone is not willing to

try new foods, if someone is not interested in healthy eating and all they eat

is hamburgers and they will have heart attach 5 yrs later, not my problem.My job

is to educate the pts/clients (out-pt/whichever setting). Assuming there are no

educational/cognitive limitation and pts are alert and oriented X3 (if they are

not, education if even less useful and they will also eat only what they like,

healthy or not) What they do with this information is their choice and their

choice only.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: dignacassens@...

Date: Wed, 15 Jun 2011 19:02:53 -0700

Subject: RE: how much do you honor client's preferences?

I’m glad you were successful, however, what would have happened if someone

truly allergic received the food they were listed as being allergic to? I’ve

never been to an MD for a shellfish allergy – except back in the 60’s before

knowing I was deadly allergic. How would I produce that documentation now?

Certainly not by eating it to prove it.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

tnordin@...

Sent: Wednesday, June 15, 2011 10:20 AM

To: rd-usa

Subject: RE: how much do you honor client's preferences?

When I used to consult at the Jail in our area, we had numerous people try

to list foods as allergies so they wouldn't get foods they didn't like. To

handle this we required them to produce documentation from an allergist/ MD

that they had been tested for allergies or it was not adhered to. Policy was

made with this so if they tried to sue for not meeting their needs in court.

We were covered. Worked well for us and eliminated a lot of issues.

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Tuesday, June 14, 2011 6:46 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: how much do you honor client's preferences?

In the skilled or long-term MH facilities I have been in charge of we treat

the residents just like we do those in other facilities, unless their

requests compromise their health and welfare. The behavioralists and treat

their issues as well in conjunction w the RD and dietary manager since often

they do revolve around food. I've always provided a semi-select menu with a

standard list of 2 or 3 alternates per meal plus the main entrée and a

second popular entre. There's no point in serving food they'll not eat or

throw away, and exacerbate their negative behaviors.

In the acute MH facility there were levels of choice; if on a 72 hr hold, no

choices as most had lost their rights through their outside behavior, and 3

days don't make that much difference in the long run. For those on long-term

treatment, 2 weeks to 3 months, then the choices were layered, or based on

their behavioral earnings, until they earned the final choice to be able to

go to the cafeteria escorted with the group. The only items they could not

chose were soft drinks, caffeinated beverages and chocolate (I wisely kept

chocolate off the menu and nobody noticed).

For the psychotic clients I suggest working with the treatment team. I also

found that in those that earned attendance at the locked dining program

were better behaved (of course, bc otherwise they'd be kicked off it) but

also their food preferences reduced significantly. I don't see the problem

of giving 2 choices; coleslaw or lettuce? One green and one other color

vegetable?

You can bring the horse to water.................

Digna

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

Lawson

Sent: Tuesday, June 14, 2011 9:25 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: how much do you honor client's preferences?

Let me preface this with I work at a mental health facility.

And we have a non-select menu.

We are CONSTANTLY getting client's complaining about what is being served

that they don't like certain foods. " I don't like coleslaw... " " I don't

like green vegetables... " I imagine you get what I'm talking about here.

Most of the time we are able to accommodate these preferences, but it

appears that it has gotten out of control.

So my question is at what point do you say ENOUGH?

And another question... we have quite a few clients that are psychotic and

give us a long list of preferences. Almost to the point of only eating a

few select items. At what point are we held accountable for only sending a

small amount of food variety to help make sure that they are eating (as they

would refuse to eat all other foods) but not providing the correct RDA's?

Thanks!

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