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Session Overview
Learning Objectives
By the end of this session you will be able to:
- Describe the importance of food safety, including hygiene, in the preparation and handling of food
- Explain the importance of good nutrition and hydration in maintaining health and well-being
- List of symptoms of poor nutrition and hydration
Food Safety
What we eat is vital to our health and well-being and how we look, feel and function. It is important that people have a diet that is safe to eat and has all the nutrients they need. Food safety is essential when preparing and handling food.
Not all substances and objects that can cause harm or illness can be seen. This means that people can become ill from eating food that tastes normal and looks safe. The session introduces the importance of adequate fluids and nutrition to maintain health and well-being. It includes the signs and symptoms to look out for to avoid poor nutrition and hydration. As a volunteer, you should be aware of the signs and symptoms of poor nutrition hydration and, if you have concerns, you should raise them with your volunteer co-ordinator or a member of staff.
You must not directly prepare food unless you have been fully trained.
Hazards
Whether you occasionally make someone a snack such as a sandwich, or are regularly involved in preparing meals, you should always make sure that the food is safe to eat. Food must be prepared and stored in ways that prevent it becoming contaminated with things that can cause harm or illness.
Physical – Objects that can be harmful, for example bones or bits of packaging. These could be in food when bought or introduced when preparing food. Chech for these as far as is possible.
Bacterial – Bacteria in food, for example raw foods that need to be cooked to remove the pathogens, or those found in the human gut, nose, and mouth that can be transferred to food during the storage, handling and preparation process. Effective food safety principles should be followed to remove these risks.
Allergenic – Those that may cause reactions if an individual is allergic to the food, for example nuts, shellfish, milk or gluten. These may cause an itchy skin rash, breathing problems and/or stomach cramps with vomiting or diarrhoea. In the worst case, the person may go into an anaphylactic shock. Always ensure foods that contain allergens are kept and prepared separately from foods that do not.
Chemical – Pesticides, weed killers or cleaning chemicals that could be harmful if eaten, for example pesticides attached to fresh fruit and vegetables or cleaning products sprayed onto prepared foods. Ensure all fruit and vegetables are washed before preparation and avoid spraying cleaning products close to food.
Individuals may be considered more vulnerable to the effects of contamination than others.
Basic Principles
It is essential that precautions are taken to ensure that food is safe to eat. If your volunteer role includes preparing or handling food, you must have the knowledge and skills to do so safely. Otherwise you must not prepare food. Your volunteer coordinator will identify any training that you require.
There are basic principles that you need to keep in mind to protect all individuals when handling, storing or preparing food.
Nutrition and Hydration
The food and drink that we have must provide the nutrients that our bodies need to work properly. A diet that does not include the right balance of everything we need can lead to ill-health. A healthy, balanced diet will give an individual the nutrients their body needs to function properly.
To stay healthy we need a diet that includes the correct balance of the following:
Carbohydrates – These provide most of the energy that we need. That includes energy for the basic actions that keep us alive (called the Basal Metabolic Rate) – for example, keeping the heart beating, enabling breathing, keeping blood circulating and for the production of hormones, enzymes and new tissues.
Examples are bread, potatoes, rice or pasta.
Vitamins – These support many different functions, including blood clotting, maintaining an effective immune system and allowing the body to absorb energy from foods. Fruit and vegetables are good sources of vitamins.
Minerals – These include calcium, which helps to build strong bones and teeth, and iron, which helps the blood to carry oxygen around the body. Milk products are good providers of calcium and liver and shellfish are full of iron.
Protein – This is important for the body’s cells and tissues to be repaired and replaced. You will find protein in milk products but also in meat, fish or beans.
Fibre – This promotes a healthy bowel and helps to remove waste products from the body. Fruit, vegetables, wholemeal bread, nuts and seeds are high in fibre.
The Eatwell Guide has been developed by Public Health England. It is the model used widely in the UK to illustrate a healthy diet and is suitable for most groups of people. It shows the five main food groups and the proportions of each food group recommended as part of a daily healthy diet.
Hydration
Fluid is essential for life.
Why does the body need fluid?
Without enough fluid the body cannot carry out basic processes that enable it to function correctly, such as:
- Digesting food and enabling nutrients to be absorbed
- Enabling blood to circulate around the body
- Removing waste products via urine and faeces
- Keeping cells and tissues moist, helping to avoid infection
- Controlling body temperature by perspiration
- Maintaining brain function
How much fluid does the body need?
It is recommended that individuals should have about 1∙5–2 litres of fluid each day or 6–8 cups or glasses.
Most ordinary drinks (for example, fruit juices, milk, tea and coffee in moderation and low sugar drinks) count as fluid but lots of alcohol can lead to dehydration.
The best fluid to rehydrate the body is water.
Malnourishment
The term malnourished means that an individual’s diet does not contain the right balance of nutrients it needs to function properly. This could include under-nutrition, when a person does not get enough nutrients or over-nutrition, when a person has more nutrients than they need.
What are the common signs and symptoms that indicate a person is not having the correct balance of nutrients?
Signs and symptoms that a person is not having the correct balance of nutrients include:
- Muscle weakness
- Feeling tired all the time.
- Increased infections
- More falls
- Constipation
- Lack of energy
- Gaining or losing weight
- Changes in behaviour
- Depression
- Poor wound healing
As a volunteer, you may be the first to notice these early signs and should raise concerns with a member of staff or your manager.
Dehydration
Dehydration happens when more fluid is lost by the body than is replaced by drinking liquids. Symptoms of dehydration can range from mild to life threatening.
Early signs and symptoms of dehydration include:
- Feelings of thirst as the body tries to increase fluid levels
- Dark coloured urine as it tries to reduce fluid loss
- Headaches, tiredness and confusion, as the flow of blood to the brain decreases. (These signs might also indicate an undiagnosed health problem, for example type 2 diabetes)
Ongoing dehydration can contribute to:
- Constipation
- Urinary tract infections, which are prevalent in some groups in care
- Kidney stones and infections
- Poor wound healing
If dehydration remains untreated, it can have serious consequences. Blood circulation can be affected or kidneys can fail.
Nutrition and Hydration Assessment
When people receive any type of care or support (particularly long-term care) an assessment should be made about their nutrition and hydration. This should include food allergies, likes and dislikes and the support they need to eat and drink.
It is important to work in person-centred ways and to provide food which is suitable and that meets each individual’s needs.
Volunteers will not be expected to make this assessment but must be aware or what is involved.
Personal belief – Certain religions forbid some foods, and some recognise some days for fasting. It is important that you respect this. Some individuals choose not to eat certain foods, for example vegetarians or vegans, so it is important that you know what this means. For instance, those who are vegans do not eat dairy foods as well as not eating meat.
Health conditions – It is important to know if there are any foods a person should not have because of health conditions, for example:
- People with raised blood cholesterol levels may be advised not to have too much saturated fat such as butter, fried items and pastry.
- People with diabetes may be encouraged to avoid too much sugar found in sweets, chocolate, sugared breakfast cereals, cakes and puddings and encouraged to eat fewer of these or smaller portions.
- Those who have high blood pressure may be advised to limit salt.
- Anyone who is obese should be encouraged to limit sugary and fatty foods.
- Food allergies.
- If an individual is ‘nil by mouth’, they must not have anything to eat or drink.
Difficulties eating – Some individuals might experience difficulties in eating or drinking without help. This may be due to:
- Forgetting to eat (Perhaps due to dementia)
- Side-effects of medication which may affect appetite or cause sickness e.g. some people on certain medications for depression should not have cheese.
- Poorly fitting false teeth e.g. can they eat normally or do they need soft foods?
- Physical illness such as stroke which may have affected the individual’s muscles around their mouth for chewing or hand for lifting drinks.
- Depression which may cause poor appetite.
- A visual impairment which may affect the way a person sees their food to eat it.
- Having arthritis in the hands which means they may need help with cutting up food or opening packs like yogurts,
What equipment is available to support people in eating and drinking independently?
Equipment – Equipment to support people in eating and drinking independently includes:
- Technology such as clocks or reminder messages to tell someone when it is time to eat or drink
- Cutlery with shaped and padded handles that can help with gripping
- Two-handled mugs to help people with poor grip, tremors or weak wrists
- Cups with lids to reduce the risk of spillage
- One-way straws that help people to drink without the need to lift cups and glasses, even if muscle weakness has reduced their ability to suck
- Non-slip mats which stop plates from moving around while people are cutting food
- Plates and bowls with high sides to prevent food falling off the edges or insulated bowls which keep the food hot if the individual eats slowly
It is important that individuals are treated with dignity and respect. They should have plenty of time to eat, not be rushed and be able to choose whether they would like to use any equipment offered.
If you have concerns that an individual is not eating or drinking enough, despite being encouraged and supported, you should discuss your concerns with your manager or a member of staff. They may seek advice from a specialist such as a dietician or a nutritionist and they will ensure that additional support can be provided if needed.
Session Summary
Key Points
- Food hazards can be physical, chemical, allergenic and bacterial
- The Eatwell Guide has been developed to illustrate a healthy diet that is suitable for most groups of people
- It is recommended that individuals should have about 1∙5–2 litres of fluid each day or 6–8 cups or glasses
- Providing support for nutrition and hydration must be carried out in a person-centred way