How important is food in your culture
Nutrition (eating and drinking) is one of the indispensable basic human needs. It is used as a measure Nutrient absorption and keeping the body healthy is essential. A deviation from a balanced diet, both over- and undernourishment, has a lasting effect on the quality of life. This is not just about that quantity (Quantity) but also about the Valence (Quality) of the ingested food.
Diet represents an important part of the socialn and cultural identity Eating is also an expression of integration into certain social circles. It makes a difference whether I get a currywurst with french fries at the chip shop, with a can of Coke, or whether I take the time to enjoy only the finest dishes in a fine restaurant. Eating in one or the other environment can also connect my social class.
Not only in sick people, but also in healthy people, diet can consciously or unconsciously be a factor Expression of their state of health be in relation to yourself and your environment. Many a person “eats” their grief, their worries, their frustration (how do I feel) - which later becomes visible in our lifebuoys, the fat pads. Quite a few even take excessive starvation diets in order to be recognized by their environment (how does my environment perceive me).
Nutrition (better "not eating") can do one compensation be. I decide when to eat what and how much. This is especially noticeable when people refuse to eat. In situations of personal helplessness, the individual can perhaps try in this way to overcome his feeling of helplessness, even to reverse it.
The way of eating or abstinence from eating (not being able to, not wanting), as well as the amount and value of food, thus play a central role for Health and wellbeing. Not just in the physical area. Sick people and people in need of care are often unable to adequately supply themselves with solid food and fluids.
Often there is also a loss of hunger and thirst. Without professional support, there is a risk of malnutrition. "In industrialized countries around 20% - 60% of patients in hospitals and geriatric facilities are assumed to be malnourished (Gössler, 2008, 127, MDS 2003)". With that comes the careful observation special importance by the carers.
At a Oversupply Too much supplied nutrients (overeating) are converted into depot fat and thus cause obesity, which can lead to cardiovascular disorders, vascular diseases, orthopedic diseases and others. can lead. Overweight is currently assumed, depending on age, from a BMI value of> 24 (age 19 - 24 years) to> 29 (age> 65) Health insurance companies, p. 47, 2003)
At a Undersupply the persistent deficit of energy and / or nutrients leads to losses in nutritional status, physiological functions and health. (See the expert standard on nutrition management to ensure and promote oral nutrition in care, published by the German Network for Quality Development in Care (DNQP), p. 40, 2009) (Age 19 - 24 years) to <24 (Age> 65) assumed (see basic statement, nutrition and fluid supply for older people, published by the medical service of the central associations of health insurance companies, p. 47, 2003)
According to the expert standard nutrition management to ensure and promote oral nutrition in care, ed. German Network for Quality Development in Nursing (DNQP), people who are overweight, those who lose weight for therapeutic reasons, and children and adolescents are not taken into account at this point.
Special attention is to be dedicated to those people who, due to their personal situation, stop drinking and eating (dying process). The DyingFood and drink are to be offered, but there should be no pressure whatsoever. He only eats and drinks as much as he willingly wants! The effects of dehydration in the dying have not yet been adequately researched. The available studies do not provide conclusive evidence that dying people actually benefit from artificial hydration.
Both artificial nutrition and artificial hydration are available therefore rather to be classified as a symbolic act in which care is to be expressed.
“You can't just starve him / her!” Even professional people cannot always escape this view.
A realistic assessment of the situation of an elderly person in need of care is therefore dependent on careful observation and documentation based on this. Due to the complexity of the processes during a dying process, it must be taken into account that, in addition to the statements on the "terminal restrictions" (see below), the risks and their resulting goals and measures are also checked and, if necessary, applied.
What is important to know is that Thirst felt exclusively in the mouth a dried out oral mucosa is responsible for the feeling of thirst. Burge (1993) has shown that an artificial intake of fluids does not affect the feeling of thirst. This means that dying people are not urged to eat and drink, but rather correctly the oral mucosa is always kept moist. In addition, there is careful lip care (McCann 1994). The four most important studies on the usefulness of artificial hydration in dehydration in the dying phase show that there is no connection between laboratory parameters, feeling thirsty and fluid intake (Burge, McCann, Ellershaw and Vullo Navich).
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