Long Term Care Dietitians are some of the most educated and intelligent people I have ever worked with.  I’ve been asked many times, what does a Long Term Care Dietitian do?  I always answer, everything… 

If anyone has worked as a long term care Dietitian and didn’t find it interesting.  I would challenge them that they really didn’t see the opportunities.  Being a long term care Dietitian isn’t for everyone, but it is an extremely rewarding career.

The Long Term Care Dietitian

Long Term Care Dietitians Role

Committees

I have sat on countless committees in my years as a long term care Dietitian.  Some committees that Dietitians sit on are: Palliative Care, Quality Assurance, Wound Care, High Risk, Weight, Ethics, End of Life, Palliative Care, and many more.  

I always recommend that Dietitian’s get involved in as many committees as they can.  RD’s can make a huge impact on each committee that they get involved in.

There is zero reason that an RD can’t take charge on a committee such as wound care.  I’ve been a joint chair-person on a wound care committee because it is ESSENTIAL that an RD is heavily involved.  Wound care nutrition is key to a wound healing, so it’s important an RD is involved.

I’ve gotten feedback from some Dietitian’s that they don’t feel comfortable taking charge.  Some Dietitian’s are concerned that Nurses should be in charge, I say, why not both?  Read this blog here for tips on how to become a leader on your team.  

Get involved on all the committees you can! 

MDS and Nutrition Care Planning

MDS and Nutrition Care Planning is never on the top of the ‘favourite list’ of a Dietitian.  It is a monotonous and time consuming project.  But there is great value in a nutrition care plan being properly developed.  Read this blog if you want the care planning process broken down and easy to understand.  

Developing a reliable nutrition care plan should reflect the exact care it will take to care for a resident.  For example, in the nutrition care plan it should have every detail of what a resident needs to eat a meal.  If a resident requires partial assistance, adaptive utensils, glasses to eat, this should all be in it.  

I’ll be releasing a nutrition care planning tool soon!  Click here and enter your e-mail to be informed of the date AND receive a discount code.  

Though MDS and nutrition care planning may not be your favourite thing to do, an RD needs to keep up.  

Click here if you want a great tool to stay up to date on all your MDS and nutrition care planning needs.  

Nutrition and Food Service Team

Being a part of the Nutrition and Food Service team is integral to a Dietitian’s job in long term care.  It is a regulation and requirement in almost every jurisdiction I have ever looked at that an RD approves the menu.  

Click here if you want an easy to understand resource for EVERY regulation an RD needs to know (This is for Dietitians both in Canada & United States & anywhere else you practice!).  Regulations surrounding RD’s are standard in most countries.  There may be minor differences, but the resource is largely universal!

Not only does the RD do menu approval they may be involved in menu development, therapeutic diet alterations, job description development, policy & procedure manual approval, staff coaching and so much more!

Being a Dietitian in long term care requires you to work hand in hand with the NFS team.  You are the nutrition expert in the building and it’s your job to make sure that your patients get the best nutrition possible.

I will have a little caveat here about being a part of the NFS team (getting on my soapbox for a minute here).  While I am a huge advocate for being a team player, the Dietitian has NOT been hired to be a kitchen staff member.  Let me say it again, the Dietitian is NOT the cook!  

The big C has really put pressure on staffing in long term care homes.   I’m fully aware, I’ve worked through the pandemics.  But it is NOT impossible to find staff and sometimes the RD needs to be the squeaky wheel that tells management to get its act together.  

I have worked as both the Nutrition and Food Services Director (in multiple facilities) as well as the Clinical Dietitian.  I have A LOT of experience working on all sides of this issue.  I’ve also been on management teams in every facility I’ve worked in.

I know from experience, it is not impossible to find staff.  They may not be able to find the perfect staff member with work history in the area, and you may have to settle for someone who doesn’t know the job.  But investing in staff training and education can go a long way.

I say all that because I think RD’s need to draw a line in the sand with management at times about this issue.  If you’re a new RD, you need to know that you set your own boundaries.  Don’t be afraid to say no.

I have been pushed in the past to be trained as a cook and have refused.  While I appreciate the thought behind it, that’s not what I’m there for, nor would I ever feel comfortable in that position.  I know my area of expertise, and cooking for 300 vulnerable patients is not it.  

It’s not – not being a team player, it’s knowing where to draw a line.

You can still help with service if they’re short handed, you can pour drinks, sit with patients.  It’s all a part of being a team player.  But there is a line.  

Management Team

I absolutely love when Dietitians get involved on the management team.  Love love love it.  I have been on the management team in every facility I’ve worked. 

When I was first asked to join a management team I had big time ‘imposter syndrome’.  I thought, who in their right mind promotes a Dietitian to the management team?  The reality was in my internship I didn’t have a ton of exposure to Dietitians being managers.  

I was fortunate that my CEO at the time saw potential in me.  From that point on, I have never taken a job where there was no potential to work with or on the management team.  

Dietitians have such a unique perspective in health care.  Unlike most professions, Dietitians have the time to get to know their patients on a different level.  Our assessments contain a lot of personal information that contributes to their nutritional intake.  

Our days typically aren’t set in stone about what needs to be done.  We have a lot of flexibility to decide what’s a priority on each day.  This allows us to really observe and understand the way a facility works.

If you’re on the fence about moving towards management, I really encourage you to look into it.  Be open to the experience because you never know where it may lead.  

I have yet to see a Dietitian be a CEO of a long term care facility or health facility, but I KNOW I will see it one day.  

Long Term Care Dietitian Guidelines

This is probably the steepest learning curve for all new Dietitians to long term care.  There are some pretty strict long term care nutrition guidelines.

These long term care nutrition guidelines govern EXACTLY how you need to practice, document, follow up, and which patients require more attention.  It’s pretty shocking how detailed the guidelines are.

Luckily I went through these guidelines (it’s like a foreign language reading through it all) and broke it down for my lovely readers.  

If you want to know exactly what a Long Term Care Dietitian needs to do on a daily basis to be sure they’re doing their job right, check out this book.  This is the golden book for Long Term Care Nutrition Guidelines.

Knowing exactly what you need to do in your job can take the stress out of being a new Long Term Care Dietitian.  And that’s why I’m here, to take the stress away from working in long term care!

Education

Most long term care RD’s provide a lot of nutrition education as a job requirement.  For the most part it’s a pretty enjoyable part of the job.  You’re likely given freedom to choose whatever you want to educate staff on.

Nutrition Month is a really fun time to bring some light hearted education to your staff.  Offering prizes for participation, meal ideas for shift workers (obviously useful), and other creative outlets are a great morale builder.

If you can get creative with your education delivery, staff will have awesome buy in and likely learn who the heck you are!

Clinical Dietitian Responsibilities

You can see the many long term care dietitians jobs that fall under our umbrella.  Anytime I’ve read over a long term care dietitian’s job description it never seems to encompass everything.  

I don’t think a long term care Dietitian could ever tell you exactly what their day plans are because it changes.  Like I said before, Dietitians in long term care have so much flexibility.  Your day can be dictated by what you deem is priority that day.

Long term care Dietitians days are extremely busy.  But there are so many aspects of the day that are SO rewarding!  

I can honestly say that getting to know my patients and their families’ has been an absolute honour.  I have been so fortunate to have so many people love and care about me in my career.  I have very fond memories of being pregnant and the patients and their families wishing me well.  

Working in long term care will be one of the most rewarding experiences of your life.  I promise you that.  

Audits

Audits are a requirement working in long term care.  Performing audits is typically associated with the quality assurance team.  The purpose of audits is to continually improve the care provided to patients.

I am a big advocate for audits, but audits are only as useful as what you do with them.  RD’s that are requested to perform audits should also ensure that the results are being acted on.

For example if an RD performs a tray accuracy audit and there are multiple mistakes found.  A final report will be briefly written on the deficiency → then an action plan is formed → implementation → audit again.

The audit process, like I talk about extensively here, is a key factor in passing any organisation auditing your facility.

Be active, be involved, perform audits, and develop action plans!

Resident Council

Resident council is a time for patients and their families to attend and give suggestions.  Similar to audits the purpose of resident council meetings is to improve the care being given.

The Dietitian is typically included in this in the capacity of nutrition and food services.  Patients will give suggestions on menu improvements, complaints, and much more.  

I have always used resident council meetings to get ideas for meals they want to try, float new nutrition ideas to them, and see if there are ways I can improve nutrition care. 

It can be tough listening to complaints but that’s just a part of the job.  It’s best to view it as how can I improve the care for my patients?

Care Conferences & Family Meetings

I’ll be honest, this is not always an easy part of the job.  I have gone through many tough care conferences and family meetings.  We all experience this and learn from the experiences.

On the other hand, it can also be a very rewarding part of the job.  It all depends on how the family or patient views the care they’re receiving.  

As a new Dietitian I think it is an extremely valuable growth experience.  At care conferences and family meetings, the patient and/or their loved ones are welcome to voice any and all concerns.  They can also heap praise on how much they love the staff.

Take all of it in stride.  If a care conference turns into a complaint fest, understand that their loved ones just want what’s best.  They are the patient’s advocate, especially if the patient can’t be vocal any longer.  

Try to put yourself in their position when a meeting is quite tough.  What if that was your loved one?  

Long Term Care Dietitian Resources

It can be hard to find long term care Dietitian resources, especially ones that were made specially for Dietitians.  Many long term care Dietitian resources out there I have found haven’t been made by a practising Dietitian.  

That is exactly why I started this website and developed products.  All of the products have been developed because I used them daily or I saw a HUGE need for them.  

Everything I do here is to make the job of a long term care Dietitian easier.  I love the field and care about my fellow long term care Dietitians.  So let’s look at a few.

1.  This is the essential pocket guide long term care Dietitian resource.  If you feel like you don’t know exactly what your job expectations are, you don’t know if you’re following all the Dietitian guidelines in long term care, you aren’t sure that you know all the requirements, this is for you.

This guide was developed through regulations for Dietitians.  I have made it an easy to understand guide. 
Click here to buy the product!

2.  The Long Term Care Dietitian Resource Guide was our first eBook released!  This book goes through various health conditions, gives actual documentation examples, how to investigate what could be the underlying cause and much more!  Click here to buy the eBook!

3. The Dietitian Planner & Patient Organiser is one of my favourite tools.  I use this thing every single day in practice!  It’s a daily planner that is actually tailored to the needs of a Dietitian, not just a random planner. 
   Click here to buy the planner and check out the other colours!

Long Term Care Dietitians Salary

A long term care Dietitian’s salary varies based on years of experience, location, contract or salary, in-house, etc.

On the low end I’ve seen some jobs listed at $23/hour (don’t ever accept a job that pays this low).  On the high end I have had some RD friends get paid as high as $40-$50 an hour.  The high end jobs like that though are typically in isolated communities, the RD has to travel hours to get there, and they are contracted.

The average for a long term care Dietitian is about $28/hour¹ according to salary.com.

I think it’s important that Dietitian’s push for higher salaries.  You have to go into a job opportunity understanding how much you have to offer.  $28/hour to me is very low.  That is a starting wage for a long term care Dietitian in my opinion.  If you have a few years of experience, whether or not it is in long term care or not, you should be asking for a minimum $33/hour.  

Dietitian skills are transferable.  You will definitely get a higher wage if you have long term care experience.  But just because you’re an RD coming from hospital doesn’t mean you don’t know what you’re doing.  Your clinical skills are likely quite strong, and you can pick up the rest quickly.

Long term care RD’s based on workload should be getting closer to $40/hour… But that is my pipe dream that I will continue to advocate for everywhere I go!

I hope that article gave you a great picture of what long term care Dietitians responsibilities and opportunities are!

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