Op-Ed: Are Long Term Care Dietitians the REAL Experts?

I recently had a conversation with an individual about why I consider myself an expert in older adult and elderly nutrition. 

Come on I thought, I’m a long term care Dietitian.

After all, I don’t have a PhD in the area (I do have a Master’s degree).  I haven’t taken any credentialing exam that declares me as such.  I don’t do research for any university currently in the area.

So I was asked, what can you do to prove that you are an expert in the area?

I’ll admit, I was slightly baffled by the question, and if I’m being totally honest, slightly insulted. 

As I took a few days to consider the question.  It led me to ask them, well who do you consider an expert in older adult and elderly nutrition, and why?

Thankfully the person showed a lot of grace in our discussion, but it led me to a conclusion. 

We really need to reevaluate who we are calling experts in our field in Dietetics.  

Who Are the Current Experts?

Some of the people that they named as experts in the field, do in fact have the RD credentials. 

Though it was often followed by a long list of other titles, most of which I have no idea what they are or what body certified them. 

Many were also of course PhD’s in the field which in some universe (ours I suppose) gives them expert status.

I don’t write this to insult those who have PhD’s in the area, as I do think there is a place for them. 

But if I were to ask them if they had ever practised in a long term care home as a Clinical Dietitian, I would bet you that the majority of them would say no.

If I asked them if they had ever practised as a Clinical Dietitian period, most would say no also.

Or you would get varying degrees of answers that it was for a very short period of time, or they went straight from their internship into a PhD program and only practised part time for a year or two.

We call them experts in our field, and yes they do contribute to the research. 

But how can you be an expert in how a long term care home runs when you have never worked the day to day? 

How can you know the struggles of a long term care Dietitian in the area if you’ve never been in their position?

An internship doesn’t allow you to see all facets of how a long term care home runs, or the struggles that a Dietitian will have.  

But if you ask a long term care Dietitian what they want to see improved, they will have a WEALTH of knowledge on what the needs are.  

What Does a Long Term Care Dietitian Know?

Only a practicing long term care Dietitian could tell you how to handle situations like these:

  1. How to manage a patient with pressure injuries that is on a modified texture diet
  2. How to manage an elderly patient with Diabetes that for quality of life reasons does not want to be on a controlled carbohydrate diet
  3. How to speak with loved ones that don’t understand the nutrition care plan
  4. How to speak with loved ones about end of life nutrition, and what to do when they are overcome with emotions
  5. How to build positive relationships with staff members even when there are disagreements about caring for the patient
  6. How to build and develop a nutrition care plan that reflects the person-centred care that we are focused on
  7. What to do when a patient is refusing a modified texture diet but the Dietitian knows they’re at high risk of choking
  8. Why a facility can’t implement food moulds daily for pureed texture diets

All of these are things that a Dietitian deals with on a daily basis and SO MUCH MORE!

You could read all the scientific literature in the world but it won’t prepare you for how to handle these scenarios.

The only way to learn how to handle these scenarios is:

1) On the job practice and 2) Learn from other long term care Dietitians that have been there before.

As a Dietitian, I have taken course after course trying to improve my skills in various areas. Time after time I can always tell when the course was created by a practicing Dietitian and when it clearly was not.

I’ll be completely honest here, I find the courses written by someone who has not been a long term care Dietitian completely useless.

I can’t stand when I spend money on courses and they are so irrelevant or have no actionable steps for me to implement.

We all have our different learning styles, but I know that what I want to see in learning materials for Dietitians, is practical tips!

This is why no matter who develops resources, courses, or learning materials, they should always be reviewed by a practicing Dietitian.

I write all of this not to disparage anyone but to make the point that actual practising Clinical Dietitians need a seat at the table when decisions and policies are being made.

If researchers want to know how to really help us with their research, they should talk to us.

I’ve been in the research world before.  After all, I completed my Masters degree working on the largest long term care study of it’s kind in the world. 

I know what goes on, and I know how research goes from a theory to research to publication.  

I was fortunate that at the time I did my research I was already a practising long term care Dietitian.  I understood the needs and practicality of my recommendations.

I want more of this in our world!

If we really want to push the changes and show the importance of Clinical Dietitians, we need to listen to them. 

So Who Are the Experts?

If we really want to ask, who are experts in the long term care nutrition field?

It’s Long Term Care Dietitians.

It’s the Dietitian that:

– Goes into work day in and day out even when the days are mentally exhausting

– Works through an incredibly TOUGH pandemic

– Deals with surveyors interrogating them over their documentation

– Has the toughest conversations about end of life with a family member

– Has a patient cry on their shoulder over their current state

– Has to try to convince a Doctor that the patient’s care plan really needs adjusting

– And goes back everyday with a smile on their face knowing that what they do makes a difference

So if anyone wants to know who the expert in long term care nutrition is.  It’s you, the long term care Dietitian.

You may or may not have the fancy titles behind your name, but that doesn’t matter.  You have the practice, the experience, and know what will actually work.

So give yourself more credit and know that you are doing an amazing job changing the lives of your patients.

I created this website and develop the articles, resources, and shop products to help every practicing Dietitian that stumbles on my site. I want to make sure that everything is useful for you.

If there’s any area you want written about, or a resource that you’re looking for, just reach out to me! I’m always happy to help Dietitians.

Do you want to know all that a long term care Dietitian does? Check out this article.

Have you ever considered yourself an expert in long term care nutrition?  Do you work in a different area?  Let me know in the comments!

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