From the Guidelines
Meal delivery to your unit due to lack of motivation to ambulate is generally not considered a medical necessity and would likely not be approved. Healthcare facilities typically reserve meal delivery services for patients with documented medical conditions that physically prevent them from going to dining areas, such as severe mobility impairments, acute illness, or post-surgical recovery. Lack of motivation alone is usually not sufficient justification. Instead, this situation might be viewed as an opportunity to address the underlying causes of your decreased motivation. Consider speaking with your healthcare provider about potential depression or other mental health concerns that may be affecting your motivation, as suggested by the most recent guidelines on clinical nutrition and hydration in geriatrics 1. They might recommend interventions such as counseling, physical therapy, or possibly medications if appropriate. Regular movement and social interaction during meals can actually help improve mood and motivation over time, so healthcare teams often encourage patients to attend communal dining when possible as part of their overall treatment plan.
Some key points to consider:
- The ESPEN guidelines on nutrition in dementia suggest that providing meals in a pleasant, homelike atmosphere can improve food intake and overall well-being 1.
- The ESPEN practical guideline on clinical nutrition and hydration in geriatrics recommends that older persons with malnutrition or at risk of malnutrition should be encouraged to be physically active in addition to nutritional treatment 1.
- The ADA does not endorse any single meal plan or specified percentages of macronutrients, and current nutrition recommendations advise individualization based on treatment goals, physiological parameters, and medication use 1.
- Regular movement and social interaction during meals can help improve mood and motivation, and healthcare teams often encourage patients to attend communal dining when possible as part of their overall treatment plan.
It's essential to prioritize your overall health and well-being, and addressing the underlying causes of your decreased motivation is crucial. By speaking with your healthcare provider and exploring potential interventions, you can work towards improving your mood, motivation, and overall quality of life.
From the Research
Response to Patient's Request
The patient is requesting to have their meals delivered to their unit due to a lack of motivation to ambulate for meals. This request can be considered in the context of nutritional support and mealtime assistance in hospital settings.
- Mealtime assistance can enhance nutritional intake, clinical outcomes, and patient experience, as noted in a mixed methods systematic review 2.
- Identifying patients at nutritional risk can help improve hospital-related outcomes, and specialized nutritional support is essential to meeting the nutritional needs of many patients 3.
- Patient-reported experiences of mealtime care and food access in acute and rehabilitation hospital settings highlight the importance of considering patient-reported experience in the development and evaluation of nutrition care 4.
Considerations for Meal Delivery
When considering the patient's request for meal delivery, the following points can be taken into account:
- Meal delivery can help address physical barriers to eating, such as difficulty reaching food or opening packets, which were reported by patients in a cross-sectional survey 4.
- Organisational barriers, such as insufficient menu information or being interrupted by staff when eating, can also be addressed through meal delivery 4.
- However, it is also important to consider the potential benefits of social interaction at mealtimes, which can be encouraged through mealtime assistance initiatives 2.
Next Steps
In response to the patient's request, the following next steps can be considered:
- Assess the patient's nutritional risk and develop a personalized nutrition plan, taking into account their individual needs and preferences 3.
- Explore options for meal delivery or mealtime assistance that can address the patient's physical and organisational barriers to eating 4.
- Consider involving nursing staff, volunteers, or relatives in mealtime assistance to provide social interaction and support 2.