Dietitian's role in palliative care can be helpful
May 24, 2010 at 12:24 a.m.
Updated May 25, 2010 at 12:25 a.m.
By Linda Crisp
Palliative care is the medical specialty that helps patients and their families with complex symptom management during an illness. The dietitian can be a helpful member of the palliative care team by addressing problems with eating such as poor appetite, nausea and weight loss to ensure the patient is able to enjoy his or her meals.
Serious chronic illness is often the cause of pain and other symptoms such as fatigue, eating problems and stress. Patients need to feel better to enjoy life and to tolerate and improve the outcome of their treatments. The palliative-care team is dedicated to solving these problems.
The palliative-care team includes board certified physicians, advanced practice nurses, nurses, social workers, pharmacists and chaplains, in partnership with the patient's primary doctor. This team not only helps coordinate the management of disease and symptoms, but also helps patients understand their condition and choices for care.
The dietitian in palliative care contributes time to visit with the patient and family to discuss past eating problems, and helps determine what foods the patient is presently able to tolerate or enjoy. In the case of poor appetite and weight loss, the dietitian plans a way to add calories and protein to the patient's diet. Swallowing or chewing problems are addressed with changes of texture and meal content to better meet the patient's needs. If a specialized or restricted diet is prescribed, the dietitian is able to provide information to the patient and family to make the diet easier to understand and follow at home.
When patients are unable to eat, and face difficult decisions regarding options for feeding such as tube feedings or IV nutrition, the dietitian can recommend appropriate choices for nutrition support.
The dietitian works alongside and gains insight from the speech pathologist, physical therapist and the entire palliative-care team with the goal of maximizing the well-being of the patient.
Palliative care is not the same as hospice care since it is provided at any time during a serious illness and is not restricted to end-of-life care. The Center to Advance Palliative Care states on their Website "It is appropriate for people of any age and at any point in an illness" (www.getpalliativecare.org).
Palliative care gives the dietitian the ability to work alongside the entire medical team to provide nutritional care to patients throughout the course of a serious illness, benefiting both the patient and the caregivers.
Linda Crisp is a registered and licensed dietitian who is a board certified specialist in oncology nutrition. Send questions or comments to firstname.lastname@example.org.