Social Health Operators (OSS) and administration of meals. What can and can’t support staff do?
The Social health workers (OSS) have always been involved in the administration of meals and often do it independently. What are their responsibilities and competencies in this specific area of care? Let’s try to find out together by analyzing the degree of autonomy of the operators based on current regulations and the Professional profile of the category.
When we talk about diet oh you nutrition of the Patient it is clear that we are dealing with a rather fundamental topic in the context of daily assistance (which must be tackled in a multidisciplinary way with the contribution of Doctors, Nurses, Physiotherapists, Dietitians and so on), especially when it is necessary to take into account the therapy taken, the presence of degenerative problems (acute or chronic) and the overall pathological state of the patient. And this especially when there are possible relapses, repeated hospitalizations, loss of autonomy and social relationships.
Therefore malnutrition (for intrinsic or extrinsic reasons of/to the patient) remains important.
What is Malnutrition?
Il Ministry of Health in 2021 clarifies that “nutrition is one of the most important aspects that contributes to the health of the elderly. Adequate nutrition is important for maintaining daily activity and for preserving functional autonomy. Aging is accompanied by physiological, psychological, social and economic changes which can expose one to inadequate nutrition”.
The provisions of the Ministry are not always paid attention to.
Sometimes the overall clinical condition of the patient is neglected. For example, malabsorption in the elderly should be one of the first elements to bear in mind upon the user’s arrival in a hospital setting or for its management at home.
The data in the literature unequivocally demonstrate – say the Ministry of Health – a prevalence of malnutrition due to defect in the geriatric age, which is particularly high in subjects characterized by “unsuccessful aging”, with poor quality of life, poor ability to independently carry out basic daily activities, frailty, multiple pathologies, etc.
The prevalence of malnutrition due to defect ranges from 34% in free-living elderly subjects up to 70% in long-term care facilities and RSA (National Guidelines for Hospital and Assistance Catering, Ministry of Health 2011), with considerable variations for each study setting a studio (Cereda, 2016; Dent, 2012; Guigoz, 2006; Kaiser, 2010).
Factors affecting proper nutrition.
The OSSand before him Medico e Nursemust take into account factors that influence the food style of each person.
These factors are usually classified into:
- environmental: climatic characteristics can influence the choice of
foods; - social: the economy of the area where you live can influence the consumption of
foods (industry, fishing, agriculture); - cultural: traditions and culture characterize the food style;
- cheap: the economic provisions, the number of people who work
within the family nucleus they determine the food lifestyle; - psychological: the emotional state can determine excesses or deficiencies in
food consumption; - religious: they can lead to restrictions or even prolonged fasts.
The satisfaction of nutrition and hydration needs may require, based on the patient’s level of autonomy, a partial or total help action by the OSS.
The reasons for the limitations or compromises of the patient’s autonomy.
The reasons that lead to a limitation or impairment of autonomy can be:
- non-optimal physiological conditions: such as aging which leads to a gradual impairment of functions and can be aggravated by the presence of one or more diseases;
- incapacity or psycho-physical instability;
- pathological conditions.
The functions of the OSS in the specific field.
The Health and Social Worker has the task of preparing the person for food intake, according to a precise scheme of actions:
- help the patient to wash his hands and teeth. Accurate hygiene of the oral cavity allows you to improve the perception of the taste of food. Some medications can leave a “bad taste in the mouth” taste and cause loss of appetite;
- ventilate the room and clean the table on which the meal will be made. Meal time
it must be a pleasant moment for the assisted person therefore try to create a comfortable situation by eliminating any source of disturbance; - help the person to be correct posture. If possible, the meal should be eaten in a sitting position, in bed, in an armchair or on a chair to avoid the onset of pneumonia and suffocation due to the aspiration of food or liquids into the airways;
- check and verify that the meal corresponds to the diet that the person must follow;
- at the end of the meal, write down and report to the nurse the amount of food and liquids taken and any difficulty in swallowing.
Helping the assisted person is essential as it ensures the intake of the meal and contributes to maintaining, reinforcing and recovering the autonomy of the person in satisfying this need and those related to it.
Ensure effective and appropriate food intake.
L’OSSunder the supervision of the‘Nursemust ensure that the patient takes meals, perhaps through appropriate forms (where to indicate the date, time, type of meals and quantity actually taken, hydration, dysphagia, etc.).
In ensuring the patient’s effective food intake, the operator must:
- arrange the dishes and cutlery so as to be easily accessible by the person, taking into consideration any neurological disorders, paresis, fractures and other problems;
- prepare the meals, for example by cutting the meat, opening the sealed packages and the water, pouring it into the glass;
- feed or help the Assisted if he is not autonomous or is partially autonomous, using the spoon, respecting the times of swallowing, alternating solid foods with liquid foods, forming small boluses and if possible conversing with the person as this allows time for chewing, swallowing and reduces discomfort due to addiction.
Recovery of the patient’s residual functions.
The Social Health Operator, it is well known, has, among other things, the task of contributing to maintaining, reinforcing, recovering the autonomy of the Patient, putting him in the conditions to satisfy his needs independently, even partially:
- indicating the arrangement of the foods on the plate, do not mix the foods so as not to alter the tastes;
- teaching the use of aids such as glasses or cups with handles, cutlery with
special handles that fit easily in the hand.
The OSS must pay particular attention in case of assistance to the person suffering from dementia or neurological problems (and therefore also dysphagia), as the patient may have partial or total difficulties in satisfying the need for adequate nutrition, which if not supported correctly can lead to malnutrition and weight loss.
Read also:
OSS: how to manage dysphagia?
OSS Professional Profile. State-Regions Agreement of 22 February 2001. Fields of work and responsibilities.
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