What's the connection?
Proper nutrition and hydration is fundamental to your client’s quality of life. Success with rehabilitation is at least partially reliant on the foundational building blocks of adequate nutrition and hydration. Common symptoms such as fatigue, “brain fog” and spasticity can all be affected by underlying medical conditions. Dehydration, deficiencies of certain vitamins and minerals and/or gut problems such as constipation, are all quite common in clients with brain injuries and neurological conditions and can make fatigue, “brain fog” and spasticity worse. You want to make sure these basics are covered before seeking out more expensive therapies and pharmaceuticals to solve the problem. Adequate nutrition and hydration also helps make rehabilitation more cost effective by supporting clients to get the most out of all of their therapeutic input.
During my initial assessment, I review the client’s: medical history, weight changes, medication, skin integrity, bowels habits, swallowing issues, nausea/vomiting and oral health issues in addition to looking at their food and fluid intake. I then go back to the office to conduct a nutrient analysis of the client’s diet to see if they are meeting their requirements for vitamins, minerals, fluid and protein. A complete report is provided with all of my findings and recommendations. I can also work in partnership with the Speech and Language Therapist (if appropriate) to develop a bespoke list of meal and snack ideas that meet any requirements for texture modification. If your client is also trying to lose weight, I will also look at their physical activity levels and behavioural issues and liaise with the Physiotherapist and Neuropsychologist as appropriate.
It’s important to know that I’m not expecting perfection when it comes to eating habits. My approach is completely client-centred and I always consider the client’s likes and dislikes and work within the parameters of their situation (eg. Financial constraints, time constraints of carers, the client’s need to do independent meal preparation, etc).
It is sometimes a delicate balancing act between what the client wants to do (eg. Take aways and fast food), ensuring their minimum nutrient requirements are met and making their diet as nutritious as possible to manage other symptoms such as fatigue and constipation. Sometimes a capacity assessment needs to be done to see if a client understands the consequences of their food choices.
Follow up appointments can be conducted in person, by phone or by Skype/Facetime depending on the client’s needs. Sometimes clients need weekly follow up and support and other times they may only need to be reviewed every 2 months. Arrangements are completely flexible and designed to get the best outcome in the shortest time possible.
I help people with brain injuries and neurological conditions maximise their health while eating foods that they love.
As a registered dietitian with over 20 years of community-based experience, I’ve helped hundreds of clients achieve their goals.
I decided to specialise in brain injuries and neurological conditions after seeing so many vulnerable patients stuck eating mashed potatoes, yogurt and nutrition supplements everyday because no one else had taken the time to think of suitable foods which looked better, and tasted better and were better for them. THAT….JUST….ISN’T…..RIGHT!
But reading about these conditions wasn’t enough. I needed to actually live it to learn the nitty-gritty details that carers, families and clients need in order to actually implement the advice I was giving. So….I ate a pureed diet myself for seven days. I will admit, my first few attempts at pureed meals did not taste good at all! But after a bit of practice and research, I learned all the little details that made an enormous difference to how much I enjoyed eating pureed food. For example, using a blender made the food too runny and it was extremely difficult to prepare a small amount of food at one time. I had much better luck using either a mini food processor or a potato ricer. My food preferences also changed dramatically overnight. Without the texture of food to provide sensory stimulation, I started varying the temperature of the food, choosing drinks with carbonation, and choosing foods which made my tongue “tingle” so I could still get pleasure from what I was eating.
Drinking thickened fluids was a separate experiment. Some thickeners I didn’t mind at all and others made me wish I could be tube fed. I initially made a lot of mistakes when preparing drinks with thickener and sometimes ended up with lumps or gelatinous globs (the consistency of raw egg white) in my drink (not pleasant!) However, a little milk foamer whisk for £2 solved that problem quickly and easily and made sure the thickener was nicely distributed so my drinks were much more pleasant. There are many different thickeners available and I can work with the Speech and Language Therapist to help your client find one which matches their lifestyle, taste preferences and the types of beverages they like to consume (for example, milky drinks tend to do much better with gum-based thickeners).
If I have to eat pureed food again to help your client (or do anything else to help me really understand what they are going through)… I will gladly do it in a heartbeat. Because these clients are already struggling enough….and life is short…who wants to spend it eating foods they don’t like?
What people are saying
I have recently started working with Sheri and she oversees the nutrition plan for my client. This client does not enjoy food due to oral motor hypersensitivity and he needs his support staff to fully understand how to prepare his meals and what type of meals to prepare. Good nutrition is vital to ensure he has good skin condition as a wheelchair user and he needs the “fuel” to enjoy his busy daily schedule. Sheri has ensured the staff are monitoring his food intake, his weight and BMI. She ensures the care plan covers nutritional advice and provides training for the support team. A really excellent service and he is steadily gaining weight.
Ali McNamara – Director/Case Manager
I have been working with Sheri since 2016. She has a very functional client centred approach to managing nutrition and the complications around diet that can follow a brain injury.
She has taken the time to personally understand what it is like to eat a modified diet and from her own experiences has looked carefully into ways in which clients can maintain nutritional goals whilst having as ‘normal ‘ a diet as possible. Her supplement shakes have been a great hit with my clients.
Sheri has certainly increased my knowledge around the impact of brain injury on nutrition and the impact of nutrition on brain injury. I would have no hesitation in recommending Sheri.
Jo Frost – Director & Speech and Language Therapist
Sheri uses a client focussed and dynamic approach to working with complex clients with acquired brain injury.
Through this approach she is able to engage clients and their support teams to help them achieve the best possible outcomes.
Laura Pell – Case Manager
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