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Katiee Asked March 2, 2024

Aspiration: How do I handle a resident's requests?

I’m a chef in a care home, we have a gentleman who is on a puréed diet due to him aspirating. He has been recently asking for non-puréed food. He has dementia. I’m sure if a resident does not have dementia then they can make that decision for themselves, but what if they have dementia? I don’t want to give him solid food when medical professionals are putting him on the diet for a reason, if he cannot chose to have solid food because off dementia can his POA ask us to give him what he wants if the gentleman and the POA have spoken and chosen that he can eat what he likes? I feel bad as it can’t be nice to not be able to eat what you like but on the other hand it’s what’s best for his health he’s only been put on a puréed diet for the last 3 months, his dementia is not bad. Thank you.

JoAnn29 Mar 3, 2024
I think the question was can the man or even POA override a medical order? So answer is no. If they try, send them to the RN in charge and let her/him explain why the man can't have reg food.

AlvaDeer Mar 2, 2024
Aspiration pneumonia is not a pleasant way to go. The person who cannot swallow will get it. And while antibiotics today prevent what was once called "The old persons' friend" because it ushered him/her quickly to the gates of Pearl, it is not appropriate to allow a person with no swallow to eat and choke.
The decisions will be made by person (if able) and/or POA if needed, whether to place a tube for feeding or not.

It would be medically NEGILIGENT for a nursing home or any other care facility to feed a patient who is choking. It would have to be reported, discussed with MD and person acting as POA.

If you note choking in a patient this should be reported to the Administration. You are mandated to do this.

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lealonnie1 Mar 2, 2024
Chefs don't get to override medical orders for a patients diet. Just tell the gentleman you do not have the authority to approve a solid food diet for him, and to please speak to his doctor about it.
Katiee Mar 2, 2024
Thank you for replying yes I know I don’t have the right to override medical orders
funkygrandma59 Mar 2, 2024
If this patient is an aspiration risk, then it's up to you to honor what his doctor has ordered as far as whether his food is pureed or not.
In case you're not aware, aspiration pneumonia is in most cases fatal and thus why foods need to be pureed and drinks need to be thickened.
I'm sure you don't want to be the reason that this gentleman dies from aspiration pneumonia because you chose to serve him non pureed food right?
Think about that, as this is quite serious.
Katiee Mar 2, 2024
Thank you for answering, yes I have refused to give anything but pureed I would not want my food to be the reason something happens to him, just wanted to see I was right by refusing and if there was a way he can have solid food and I’m not able to refuse and I have to give him what he likes as I don’t think I could give him solid food if it was his or his POA choice

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