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Meal Preparation and Nutrition 101

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Basic Nutrition

Our bodies require a source of energy to carry out our activities of daily living and to rebuild tissue. This energy source is provided by the food we eat. The number of calories in a food refers to the amount of energy provided when the body breaks down food. In addition to providing calories for energy, food also provides substances that are needed to repair, maintain, and grow new cells. Examples of nutrients found in food would be proteins, fats, carbohydrates, minerals, and vitamins. The amount and types of food we need are different for each stage of life. Children need more protein and calories because they are still growing new tissue. People who are recovering from illness and surgery may require additional calories, protein, and iron for their bodies to repair tissue. People who are malnourished or under weight will need to increase their calories. Overweight people might need to decrease the amount of fat and calories they take in.

You might be preparing meals and shopping for many different types of Clients. It is important that you know what type of diet your Client is following. See the diet chart on the following page.

Special Diets

   
Type of Diet

Who would be
on this type of diet?

   
Special

Regular

People with no dietary limitations.

None

Soft

People with difficulty chewing or swallowing.

Food must be chopped or strained

Low Sodium (low salt)

People with heart or kidney disease or high blood pressure.

Avoid canned vegetables, soups lunchmeats, cheese, fast foods no added salt.

Low Fat

People who have diseases of the heart, gallbladder or liver and are overweight.

Avoid butter, bacon, milk, ice cream and fried foods.

Low Cholesterol

People with high cholesterol.

Avoid eggs, butter, organ meats, milk, cream, cheese and animal fats.

Low Calorie

People who need to lose weight.

Avoid fried foods, desserts, cream sauces and gravies.

Low Residue

People who need foods that are easy to digest.

Avoid whole grain breads, cereals, raw fruits and raw vegetables.

Diabetic

Diabetics

Avoid foods high in sugar, alcohol or sweetened beverages. Diabetics should eat at regular intervals and should not skip meals.

Bland

People who need to avoid foods that irritate the digestive tract.

Avoid fried foods, raw vegetables/ fruit, whole grain products

High Protein

People with wounds or those who need extra protein to repair or heal body tissues.

Eat foods high in protein such as meat, milk, cheese, eggs, fish, and dried beans.

High Calorie

People who need to gain weight.

Eat foods high in calories such as milk, butter, cream sauces, peanut butter, butter, cheese, and ice cream.

Planning a Menu

You may be asked to shop for groceries and prepare meals for Clients. Planning menus ahead of time helps you to prepare balanced meals and make wiser purchases at the store. It is important to involve the Client in planning their menu. Find out food preferences, diet restrictions, and any difficulties the Client may have eating. When planning a menu, you should consider:

  1. Variety - A well balanced diet consists of different kinds of foods.
  2. Texture - Consider the Client’s condition and type of diet when planning texture in the meal. Normally, combining food of different textures will make the meal more appealing. If they have dental problems or mouth ulcers, they will need soft foods.
  3. Flavors - Keep strong flavored foods as the spotlight, with milder tasting foods on the side. Keep in mind that foods with strong odors and tastes may be repulsive to Clients with nausea. Foods with a lot of acid will be irritating to anyone with mouth ulcers.
  4. Color - A pleasant looking meal is more appealing and may improve their appetite.
  5. Cost - Always consider the budget when shopping for Clients. Many elderly Clients choose between buying food and buying medicine. Processed foods are usually higher in cost and contain more salt and fat.
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Purchasing Food

Plan before you shop. Using a list saves time and money. Know what type of dietary restrictions the Client might have. Read labels. The ingredient listed first makes up the largest portion of that food. Check for salt or sodium content. If the Client is on a low salt diet, avoid foods such as canned soups, soy sauce, processed cheese, lunchmeats, pickled foods, bacon, and frozen dinners. Don't buy or prepare too much food at one time to avoid wasting spoiled food. Remember that fruits and vegetables that are in season are usually cheaper. Dried beans, eggs, and peanut butter provide a good source of inexpensive protein. Cuts of meat that are less tender can be used in casseroles or pot roasts. Bread crumbs and pasta can be used as fillers to make a meat dish serve more.

If you are assigned as a Homemaker for the Client, you may be asked to run errands like getting prescriptions or do grocery shopping. It is important to remember the following:

  1. Save all receipts. Carefully write down how much money you were given, how much you spent, and how much change you brought back.
  2. Have the Client check each item off the receipt.
  3. The Client will know exactly what has been purchased.
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Safe Handling and Storage of Food

  1. Never buy more food than you can safely store.
  2. Make sure the refrigerator is working properly and defrosted if needed.
  3. Check the expiration date on food when you are shopping. Buy the food with the longest time before it expires.
  4. Store flour, sugar, cereal and pasta in tightly covered containers.
  5. Promptly refrigerate all meat, milk, eggs, and open sauces.
  6. Remember that ground meat and lunch meat will spoil more quickly than other types of meat.
  7. Meat that will not be used right away should be frozen. Meat should be thawed in the refrigerator or in the microwave, not at room temperature.
  8. Do not leave leftover foods sitting out at room temperature. Refrigerate immediately.
  9. Clean any cutting boards or utensils with hot soapy water and a mild bleach solution, especially after contact with poultry.
  10. Keep fresh fruits and vegetables in the “crisper” drawer of the refrigerator in plastic bags or tightly covered containers.
  11. Store canned goods in a cool dry place. Avoid buying dented cans. Rinse all canned fruits and vegetables to remove excess salt and sugars if the Client is not supposed to have any extra salt or sugars.
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Preparing a Meal

  1. Make sure your work surface is clean.
  2. Wash your hands before and after handling food.
  3. Place the pot on the correct size burner.
  4. Cover pots when they are cooking. Do not leave cooking food unattended.
  5. When possible prepare food for more than one meal. Refrigerate or freeze left over food. Reheat before serving.
  6. Use the correct appliance for the job.
  7. Clean all work surfaces and utensils when you are finished.
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Feeding a Client

As a Caregiver, you may have Clients who are unable to prepare their meals, set up meals, or feed themselves. Your supervisor will mark on your assignment sheet the amount of assistance required.

Rules to remember:

  • Allow the Client to assist with their feeding as much as possible.
  • Provide a calm atmosphere with pleasant conversation.
  • Sit down instead of standing.
  • Don't rush the Client.
  • Be gentle with spoons and forks.
  • Use straws if needed.
  • Feed foods separately rather than mixed.
  • When giving the Client something to drink, touch it to their lips first before actually pouring some into their mouth.
  • Make sure the food and drink are the correct temperature.
  • Report any problem an Client has swallowing to your supervisor.
  • NEVER PUT LIQUIDS OR FOOD INTO AN UNCONSCIOUS PERSON'S MOUTH.
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Procedure for Feeding a Client

  1. Wash your hands.
  2. Explain to the Client what you are going to do. (If the Client wears dentures and they are not in place, get them for the Client)
  3. Assist the Client with washing their hands as needed.
  4. Position the Client in a comfortable, upright position.
  5. If possible bring the Client into the kitchen or dining area for their meal. If the Client cannot come to the table, make sure the Client's bed is positioned with the back as high as possible.
  6. Place the over-bed or over-chair table across the Client's lap.
  7. Wash your hands. Clean the dishes and kitchen area.
  8. Document any observations about the amount of food eaten and any difficulty chewing or swallowing.
  9. Place the meal, silverware, and/or adaptive equipment in front of the Client.
  10. Sit near the Client and assist them as needed.
  11. If the Client is totally dependent in feeding, ask them which foods they would like first. Fill the fork or spoon only half full (or less depending on the Client's ability to swallow).
  12. Allow the Client plenty of time to chew and swallow their food. Observe for any difficulty chewing or swallowing.
  13. Use a straw for liquids if needed. Offer liquids between amounts of solid foods.
  14. Provide pleasant conversation. Do not rush the Client.
  15. Remove the tray when the Client is finished. Clean their face and hands.
  16. Return the Client to a comfortable position. Note the amount of food eaten.
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Food Groups

Grain Group

Key Message

Make half your grains whole

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Grain Group foods provide complex carbohydrates and fiber. Two categories make up the Grain Group — whole grains and refined grains. Whole grains include the entire grain kernel:

Refined grains, such as white rice, pasta or white bread, have the bran and germ removed to give them a finer texture. Many refined grains are "enriched" to replenish the B vitamins — niacin, thiamin, folic acid and riboflavin, and the iron removed during processing. Fiber and other trace nutrients, however, are not added back after processing.

MyPyramid recommends that people of all ages eat whole grains for at least half of their daily Grain Group servings. Use the ingredient list and the % Daily Value (%DV) on the Nutrition Facts label for choosing whole grains more often:

Foods in the Grain Group

Foods from wheat, corn, oats, buckwheat, barley, rice and rye in the Grain Group include:

Cookies, donuts and cakes are extra foods and are in the "Others" category. Proportionately, these foods provide few nutrients compared to calories.

Vegetable Group

Key Message

Vary your veggies

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Vegetables provide vitamins A and C, potassium, fiber and other nutrients. Each vegetable contains different amounts of these nutrients so it's important to choose a variety of vegetables each day!

Foods in the Vegetable Group

Any vegetable or 100% vegetable juice is in the Vegetable Group:

Fruit Group

Key Message

Focus on fruits

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Fruits provide vitamins A and C, potassium, and fiber. The amount of these nutrients in each fruit variety varies. For example, strawberries, oranges and grapefruits are excellent sources of vitamin C, while cantaloupe and apricots are excellent sources of vitamin A. Eat a variety to get the vitamin A, vitamin C, and fiber needed daily. All fruits are naturally low in fat.

Fiber helps promote regular digestion and may reduce the risk for certain cancers and heart disease.

Foods in the Fruit Group

Any fruit or 100% fruit juice is in the Fruit Group.

Canned fruits, such as applesauce, fruit cocktail, apricots and pineapple.

Milk Group

Key Message

Get your calcium-rich foods

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Milk Group foods like milk, cheese and yogurt together provide calcium and eight other essential nutrients, including protein, phosphorous, vitamins A, D and B12, riboflavin, niacin, and potassium. Dairy foods contribute three of the five nutrients that the 2005 Dietary Guidelines identified as low in children's diets — calcium, potassium and magnesium.

Foods in the Milk Group

Some foods are made from milk, but we can't count on them to get the large amount of calcium we need. These Extra Foods are in the "Others" category and include:

Meat Group

Key Message

Go lean with protein

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The Meat Group contains foods from both plants and animals. Meat Group foods provide protein and iron, as well as B vitamins, vitamin E, zinc, and magnesium.

Foods in the Meat Group

Foods in the Meat Group include:

Bacon is not in the Meat Group because it primarily provides fat, not protein and iron, the key nutrients for this group.