Meal Assistance For Stroke Patients: The Role Of Lvns

Licensed Vocational Nurses (LVNs) are responsible for assisting registered nurses and doctors by providing basic medical care to their patients. This includes changing bandages, checking vital signs, and feeding patients who are unable to feed themselves. After a stroke, patients often experience a loss of appetite, problems with memory and thinking, and difficulty with chewing and swallowing. As such, LVNs can play an important role in assisting stroke patients with meals by providing nutritional support and ensuring they receive adequate nourishment to aid their recovery. This may involve preparing and serving meals, as well as monitoring the patient's nutritional intake and making adjustments as needed.

Pureed fruits and vegetables

Pureed foods are a great way to improve the texture of vegetables, making them easier to eat and digest. For example, pureed cauliflower can be made to resemble mashed potatoes, and peas can be pureed into a soup. Pureed vegetables can also form the basis for pasta sauces, providing a nutrient-rich option.

When preparing pureed vegetables, it is important to first wash and peel the vegetables, and then cut them into thin slices. Steaming is the best way to cook them, as it preserves the most nutrients. However, boiling is also an option. Once the vegetables are soft, they can be pureed in a food processor or blender, with a little water added as needed.

Pureed fruits are also a good option for stroke patients. Fruit smoothies, for instance, can be a great way to incorporate more fruit into the diet while also adding extra nutrients like protein powder, nuts, seeds, or leafy greens.

It is important to note that relying too heavily on pureed fruits and vegetables may make it difficult for stroke patients to get all the nutrients they need, so it is important to vary the diet and include other sources of protein, fat, vitamins, and minerals. Additionally, an LVN should always follow the instructions and recommendations of the patient's doctor or healthcare provider when assisting with meals.

High-calorie, nutrient-dense foods

Licensed Vocational Nurses (LVNs) are responsible for assisting registered nurses and doctors by providing basic medical care to their patients. This includes feeding patients who are unable to feed themselves.

After a stroke, patients may need to change their diet to help them recover and prevent another stroke. A healthy diet will also ensure the body is getting the nutrients it needs to support neurological and physical healing.

• Oily fish, such as salmon, tuna, herring, or mackerel, are excellent sources of omega-3 fatty acids and high-quality animal protein.
• Full-fat dairy products like yogurt, milk, and cheese are calorie-dense and nutrient-dense.
• Avocados are high in healthy fats and other nutrients.
• Nuts and seeds are high in calories and also provide essential fatty acids, vitamins, and minerals.
• Fatty meats like sausages, lamb, and fatty beef cuts are calorie-dense, but may be lower in nutrients.
• Fried foods like French fries and chicken wings are high in calories but should be consumed in moderation due to their high fat and sodium content.
• Legumes, such as beans, lentils, and peas, are excellent sources of protein, vitamins, and minerals, while being low in fat.
• Whole grains, such as oats, barley, brown rice, or wild rice, are high in fiber and other essential nutrients.
• Fruits and vegetables are rich in vitamins, minerals, and antioxidants.
• Potatoes are a high-satiety food and provide resistant starch, making them a filling option.

It is important to note that stroke patients may have difficulties with chewing or swallowing, so LVNs should work with the patient's healthcare team to ensure the appropriate consistencies of foods are provided.

Soft foods

Licensed Vocational Nurses (LVNs) are responsible for assisting registered nurses and doctors by providing basic medical care to their patients. This includes feeding and assisting patients who are unable to do so themselves. After a stroke, patients may experience difficulties with eating and drinking, such as trouble swallowing, problems using utensils, and loss of appetite.

• Starchy vegetables: Potatoes, butternut squash, sweet potatoes, and winter squashes can be peeled, cooked, and mashed with a nutritive liquid such as milk. If the patient still has difficulty swallowing, these vegetables can be made into soups, which are easier to consume and can be highly nutritious and tasty.
• Meat and fish: Meat and fish can be prepared as usual and then shredded finely, ensuring the removal of all gristle, sinews, and bones. Finely shredded or minced meat and fish can be served with sufficient gravy to aid swallowing. If the patient is unable to swallow minced meat or fish, these foods can be liquidised with added liquid, such as gravy or milk.
• Eggs: Stroke patients with mild dysphagia may be able to eat soft scrambled eggs. For those with more severe dysphagia, the nutritive benefits of eggs can be added to other liquidised foods, such as soups or vegetables. It is important to ensure that the food is not too hot when mixing in raw egg to prevent coagulation and the formation of hard particles that inhibit swallowing. Traditional custard made with fresh eggs and milk can also be a tasty treat for stroke patients.
• Milk and dairy products: Milk and yoghurt are highly useful for keeping stroke patients nourished and healthy. They can be consumed as beverages or added to fruit or vegetable smoothies, soups, scrambled eggs, and custard. Yoghurt is especially useful for helping patients with dysphagia ingest their ground-up medications. Other dairy products, such as cottage cheese, can be included in smoothies but may need to be diluted with additional milk.
• Grains and cereals: While breads and baked grains may be challenging to chew and swallow, porridges are usually easier to consume, especially when milk is added to dilute them. Barley, rice, and other soft-cooked grains can be included in soup recipes and pureed or liquidised. Smooth porridges, such as Tastee Wheat and Maltabella, are suitable for patients with some swallowing ability. Passing porridges through a sieve can help remove husks or hard pieces that may hinder swallowing.
• Fruits: Fruits should be peeled and have all pips removed. Start with fresh, finely chopped fruit, and if this is problematic, try using chopped or mashed canned or boiled fruit. If swallowing is still difficult, the fruit can be liquidised with added milk, milk powder, or powdered vitamin and mineral supplements. Honey can be added to acidic fruits to improve the taste. It is important to make smaller quantities of smoothies as stroke patients may not be able to consume large volumes, and storing smoothies may lead to discolouration and loss of nutritional value.

Nutritional supplements

• Amino acid supplementation: Amino acid supplementation plays a crucial role in preventing muscle protein hypercatabolism, which often occurs after a stroke. Rehabilitation combined with amino acid supplementation can help improve muscle mass and functional efficiency in the early post-stroke phase. Leucine-enriched amino acid supplements have proven effective in post-stroke patients with sarcopenia.
• Vitamin D: Vitamin D deficiency is common among stroke survivors and is associated with decreased muscle strength, balance, and physical performance. While the results of studies on the effect of vitamin D supplementation on post-stroke rehabilitation are contradictory, most indicate that it can support nervous system functions and enhance the rehabilitation process.
• Probiotics: Probiotics are the "good" bacteria that comprise the microbiome, which influences brain health and function through the gut-brain axis. Gut health plays a crucial role in brain health, so probiotics are essential for stroke recovery.
• Vitamin B12: Vitamin B12 deficiency is associated with a type of inflammation that damages blood vessels, which can lead to stroke. Supplementing with vitamin B12 can enhance stroke recovery by boosting the function and development of the brain and nerve cells, encouraging neuroplasticity.
• Vitamin B3 (niacin): Niacin directly enhances neuroplasticity and is thought to improve "good" cholesterol levels, which are typically low in stroke survivors.
• DHA (docosahexaenoic acid): DHA is an essential omega-3 fatty acid critical for healthy brains. DHA is necessary for brain growth in infants and the maintenance of normal brain function in adults. It may also help reduce stroke risk factors like hypertension and atherosclerosis.
• Coenzyme Q10 (CoQ10): CoQ10 is a powerful antioxidant that protects against free radicals, which are associated with cardiovascular disease, a precursor to stroke. Low CoQ10 levels have been linked to greater tissue damage to the brain during a stroke.

Other supplements that may be beneficial for stroke patients include vitamin C, fish oil, folic acid, ginkgo, and panax notoginseng. However, it is important to consult with a physician before taking any supplements, as they can interfere with medications and have unintended side effects.

Foods to avoid

While a healthy diet can help stroke patients heal and prevent another stroke, there are certain foods that should be avoided.

Firstly, it is important to limit the consumption of salt and sugar. Salt is directly linked to high blood pressure, which is a significant risk factor for strokes. The American Heart Association recommends consuming no more than 2,300 milligrams of sodium per day. Sugar, on the other hand, can cause weight gain and increase the risk of type 2 diabetes, both of which are risk factors for strokes.

Secondly, processed foods should be avoided as they often contain high levels of sugar and salt, which may contribute to plaque buildup and lead to an ischemic stroke. This includes foods like processed meats, crackers, certain breads, chips, and sugary beverages.

Thirdly, saturated fats should be limited as they can raise cholesterol levels, increasing the risk of stroke. Foods high in saturated fats include fried foods, red meat, coconut oil, palm oil, and full-fat dairy products.

Finally, caffeine should be avoided, especially by stroke patients with high blood pressure, as it causes a short-term spike in blood pressure.

It is important to note that these are general guidelines, and individual dietary needs may vary. Consulting with a doctor or dietitian is essential to create a personalized diet plan that takes into account any pre-existing health conditions and stroke risk factors.

Frequently asked questions