In-depth Case Study: Analyzing Nutrition & Hydration and Key Elements

This case study examines the biophysical and psychosocial processes pertinent to a patient, John, who experienced a stroke and subsequent swallowing difficulties, and his wife, Dulcie, who struggles with his dietary restrictions. It identifies the Malnutrition Universal Screening Tool (MUST) as an appropriate assessment tool, highlighting its key elements such as BMI score, weight loss score, and acute illness considerations. The study outlines three priorities of care, including maintaining fondness towards food, indulging in quick nutritional meals, and ensuring regular intake of small meals throughout the day. Furthermore, it discusses equity, rights, and access issues relevant to the case, referencing Australian government initiatives for older persons' nutrition and the right to choose a guardian for healthcare decisions. The case underscores the importance of addressing both the physical and emotional aspects of nutrition and hydration in patient care.

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Title: Nutrition & Hydration
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Discuss the biophysical and psychosocial processes pertinent to the case.
Biophysical processes- John had a stroke and it resulted in difficulties to swallow food. The
speech pathologist has instructed him to follow a puree diet and he is also asked to follow the
medication warfarin, which is for reducing the clots that result in a stroke. Both John and his
wife struggled with the new change in diet (Burns, 2016). John does not like the texture of thick
drinks. Dulcie, John’s wife cannot see the struggle of his husband and would bring a picnic
basket to the hospital, with food that the pathologist instructed not to eat. Dulcie just wanted
John to enjoy the food and went against the doctor.
Psychosocial process- Dulcie has always been a person who loves to feed her family and friends
with good food. It was difficult for her to see her husband struggle with his food. She wanted
him to enjoy his food and thus went against the pathologist advice too. She was so worried about
his husband diet, that she lost her own appetite and thus was losing ample amount of weight. She
is suffering from depression as she does not want his husband to drink the thick drinks (Holmes,
2010). Dulcie is completing ignoring the nutrition diet that was recommended by the doctor and
is spoiling John’s health by feeding him with other food.
Identify an assessment tool appropriate for use in this case and discuss key elements of the
tool.
According to the symptoms of Dulcie story, the Malnutrition Universal Screening Tool is
appropriate for this case. The three main components of this tool are-

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 BMI Score- The Body Mass Index score provides with the status of the chronic protein-
energy that is based on the person’s height and weight. It informs about the person’s
nutritional risk category.
 Weight Loss Score- It provides with the information regarding the risk of under-
nutrition. It requires the unplanned weight loss that might have occurred in an individual
in the last 3-6 months (Sander, 2015).
 Acute Illness- If an individual is already suffering from any acute illness, then there are
high chances of nutritional risks. People who have swallowing difficulties after stroke or
head injuries or are critically ill are some of the patients who have high nutrition risks.
Discuss 3 priorities of care for this person.
The three tips that should be followed by people like Delcie are-
 They should maintain their fondness towards food and should eat with frequently with
other people.
 They should indulge in quick nutritional meals like eggs, chicken salad, a hot meat pie
and many other simple foods that are high on nutrition and is hearty.
 They should keep a regular in-take of small meals throughout the day. Also, they should
always carry a nutritious drink with them.
Discuss any equity, rights and access issues relevant to the case.
The Australian government provides equal rights to each citizen of the nation. For the
older person’s nutrition, the Australian nutrition screening initiative has been taken and also the
Eat for health campaign has been started for the elderly people. Also, as Delcie lives alone, she

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has the right to select a guardian for her, who will take care of her during her treatment and that
person will be responsible for taking the important decisions for her, in times of emergency
(Watson, Zhang and Wilkinson, 2010).
References
Burns, J. (2016). Patient safety and hydration in the care of older people. Nursing Older People,
28(4), pp.21-24.
Holmes, S. (2010). Fundamentals of human nutrition Geissler Catherine Fundamentals of human
nutrition and Powers HilaryChurchill Livingstone
Elsevier£22.99324pp9780443069727. Nursing Older People, 22(6), pp.8-8.
Sander, R. (2015). Exercise lowers falls risk and improves life for older people. Nursing Older
People, 27(7), pp.15-15.
Watson, S., Zhang, Z. and Wilkinson, T. (2010). Nutrition risk screening in community-living
older people attending medical or falls prevention services. Nutrition & Dietetics, 67(2), pp.84-
89.