Developing nutrition care plan examples I hope is really helping you build for your patients! Now building a nutrition care plan example for a patient with Parkinson’s Disease can be tough. They have a large mixture of nutrition issues and it changes quickly.
I’ve recently been working with a Parkinson’s Disease support group, so I want to be sure that you know everything there is to know about supporting the patient and their family.
Parkinson’s Disease presents differently from the early, middle to late stages. The Dietitian needs to constantly evolve the nutrition care plan to reflect that.
A patient with PD will likely be affected by:
- Their ability to eat independently
- Increasing risk of Dysphagia (80% experience it!)
- Constipation (Very prevalent)
- Appetite decreasing
- Weight loss
- Extended meal time needs (2-3 hours!)
I won’t go in depth in this article about the nutrition care process for a patient with Parkinson’s Disease. The nutrition care plan and nutrition care process are two different articles.
The nutrition care process is much more in depth and I will cover PD for you in an article. If you sign up for our email list – you’ll be the first to know when it’s released!
Let me help you build this nutrition care plan for a patient with Parkinson’s Disease!
You can also check back here to see new nutrition care plan examples to help guide you no matter what the nutrition diagnosis! We’ll be adding them as a new section to the website!
Building a Nutrition Care Plan
If you haven’t read the basic nutrition care plan building article, I recommend starting there. You can click here to read it.
You don’t need to reinvent the wheel for nutrition care plans. If you have a list of basic nutrition goals, we can use those as a foundation every time.
Building a nutrition care plan will always include:
- Nutrition Problem/Diagnosis
- Nutrition Goals
- Nutrition Interventions
Does that look familiar?
It’s because it’s basically just the Nutrition Care Process.
If you have performed the Nutrition Care Process for your patient, then you will just restructure it for your nutrition care plan.
Like I said above though, the nutrition care process is going to be a much more in depth version of your nutrition care plan.
The nutrition care process will have:
- Nutrition Diagnosis: this will include all the information leading up to how you came up with the diagnosis. You will include all the anthropometric, biochemical, related medical, social, and much more!
- Nutrition Intervention: this will include all the details of what you are proposing. Also include information about who you talked to, the patient, loved ones, and medical team.
- Nutrition Monitoring and Evaluation Plan: you need to include exactly how you’re going to be monitoring your patient as well as the frequency of such. You will not only have this in your nutrition assessment form, you will also write an ADIME chart note on it.
If you want a full nutrition care process example you can click here to read a full article on it!
Nutrition Care Plan Example for Parkinson’s Disease
The start of all our nutrition care plans is figuring out what the nutrition diagnosis is going to be.
We already know here that PD is going to be the root cause of our nutrition diagnosis. But we obviously cannot change or prevent PD.
Instead your nutrition care plan is going to be focused on reducing the side effects on their nutrition.
You can have multiple nutrition diagnoses, each will have its own nutrition goals and interventions.
For this nutrition care plan example, we’re going to have the following nutrition diagnoses related to Parkinson’s Disease:
- Unintentional Weight Loss
- Altered GI Function (Constipation)
- Self Feeding Difficulty
We could come up with MANY more nutrition diagnosis for a PD patient. But we’ll stick with the top 3 issues for now.
Since I covered unintentional weight loss in a previous article that you can read here, I’ll go through the other 2 nutrition diagnoses.
I talked about the nutrition diagnosis for unintentional weight loss in a previous example, so like I’ve said before, check out that article!
I use ‘Altered GI Function’ as a nutrition diagnosis here because a patient with PD has altered GI function BECAUSE of PD.
PD causes the muscles that contract the bowels to weaken over time, so they don’t experience as many bowel movements.
I also use ‘Self Feeding Difficulty’ as a nutrition diagnosis because this WILL happen over time. PD has various types, but with most we will typically see their ability to self feed diminish.
These will likely be your top 3 nutrition diagnosis with a patient with PD.
You may also see Dysphagia arise as they get into the later stages, and I will cover that in a Nutrition Care Process example for Parkinson’s Disease.
How to Phrase a Nutrition Diagnosis:
Mrs. Smith has had unintentional weight loss of 7.5% in 1/12. (See previous example).
Mrs. Smith has reduced bowel occurrences resulting in constipation.
Mrs. Smith has self feeding difficulty.
You can keep these short and sweet. Some will teach you to write it in first person, PES statement style, sentences. But that’s not my style and I’ve always passed audits.
I prefer to be straight to the point, I include the patient’s name, the nutrition diagnosis, and if I can I include some objective data.
Like I said earlier, you can have multiple nutrition problems/nutrition diagnoses, but we are just focusing on one in this article.
This is where you can really expand on your nutrition goals for your NCP.
I typically recommend having more than one nutrition goal, but some would argue you only need one. Find what works best for you and your patient.
You need to include enough information in your nutrition goal that an auditor will see that you have been specific. I don’t think you can do this in one nutrition goal.
How To Phrase Nutrition Goals:
- Mrs. Smith will have increased bowel movements.
- Mrs. Smith will have reduced occurrences of constipation.
- Mrs. Smith will eat a diet that promotes regular bowel movements.
- Mrs. Smith will not experience discomfort related to constipation.
You will separate the sections where you have multiple nutrition diagnosis. You don’t want to clump them all together because the way we deal with one nutrition diagnosis is not the same as others.
- Mrs. Smith will be provided tools necessary to allow her to remain independent at meals.
- Mrs. Smith will be able to self feed to remain as independent as possible.
- Mrs. Smith will have staff assistance at meals should she want assistance.
If you notice each of our nutrition goals has:
- Personalised – name included.
- A nutrition goal focused on weight promotion.
- A measurable aspect to it – can be a date, a weight number, a percentage. All are designated to Mrs. Smith.
You want your nutrition goals to have a central focus based on the nutrition diagnosis.
Her nutrition diagnosis was unintentional weight loss, so you want your goals to all either promote weight maintenance, or intake.
Don’t go on a tangent and include something related to her chewing and swallowing. If you have a chewing/swallowing goal, that is unlikely to relate to weight.
If you have chewing and swallowing as a goal, you should have some type of chewing/swallowing impairment in your diagnosis/problem list.
If you want to read more about a Dysphagia care plan, click here to read the article.
The nutrition interventions are all going to be focused on reducing the nutrition side effects that PD has on the patient.
We cannot cure PD and we cannot ‘treat’ the root cause. But we can reduce side effects such as constipation, difficulty self feeding, and try our best at preventing weight loss.
You are transcribing what your nutrition interventions are into the nutrition care plan. It’s as simple as that.
You do not need to overthink this, just write exactly what you prescribed.
How to Phrase Nutrition Interventions:
- Mrs. Smith will be on a high fibre diet.
- Mrs. Smith will have increased fluids >2000 mL per day.
- Mrs. Smith will be given fruit-lax daily at MedPass.
- Mrs. Smith will have her bowel habits recorded for a one-month period.
Again, separate out what nutrition interventions are for what nutrition diagnosis. The following are for her self feeding difficulty.
- Mrs. Smith will be provided with wide handled utensils with a hand grip at all meals.
- Mrs. Smith will be provided all fluids in a two handled mug.
- Mrs. Smith will have a staff provide assistance as needed during meals.
- Mrs. Smith will have a grip mat under her plate at all meals.
Do you notice that every nutrition intervention listed here has been tailored to be specific to Mrs. Smith?
If an auditor came through and read through Mrs. Smith’s nutrition care plan, they would know exactly:
- How to serve Mrs. Smith meals
- What her diet type is
- Where she eats her meals
- Her weigh schedule
- Where her meal intake is recorded and how frequently
- How much food and fluids she receives daily
- Her snack and snack schedule
- Specific diet instructions
All of these nutrition interventions acknowledge and address that Mrs. Smith has been losing weight, deals with constipation and has self feeding difficulty.
If you want to learn how to find the root cause of weight loss in elderly, read this article for some great tips!
Closing Thoughts on the Nutrition Care Plan Example
Building a nutrition care plan is a fairly simple process once you have the steps in place.
On this website you will find many nutrition care plans going forward AND a basic nutrition care plan builder coming!