Module 24. All about Food; Spending and Budgeting - … 24. All about Food; Spending and Budgeting...

HOMECARE AIDE WORKFORCE INITIATIVE (HAWI)

Trainer’s Manual—Page 24.1

Home Health Aide Training

Module 24. All about Food; Spending and Budgeting

Goals The goals of this module are to prepare participants to:

Assist clients to make healthy decisions about nutrition and diet.

Assist clients to plan and prepare their meals.

Assist clients to measure and record their weight.

Assist clients to eat.

Assist clients with budgeting and shopping.

Time 6 hours

Module 24. All About Food; Spending and Budgeting


Trainer’s Manual—4.2

Activities Teaching Methods Time

1. Eating for Health and Enjoyment Small-group work, large-group discussion, interactive presentation, and group presentations

2 hours and 10 minutes

2. Simple Modified Diets; Weighing a Client

Interactive presentation, large-group discussion, and pairs practice

1 hour and 5 minutes

3. Proper Food Storage and Safe Handling of Food

Interactive presentation 20 minutes

4. When Clients Need Assistance with Eating

Interactive presentation, demonstration, and pairs practice

65 minutes

5. The Role of the Home Health Aide in the Client’s Spending and Budgeting

Interactive presentation and small-group work and reporting

50 minutes

6. Shopping Tips: Ways to Make the Most Effective Use of the Client’s Finances

Small-group work and interactive presentation

30 minutes

Supplies Food samples (see Teaching Tools, Activity 1(b)—Sample Foods)

Measuring cups and spoons; plates, cups, and bowls; food scales (one for each of the five food groups, if possible)

Scales (for weighing a person)—both digital and non-digital

Individual-size puddings, spoons, and napkins

Assistive devices for eating (see section 7 in the Learner’s Book)

Teaching Tools, Activity 1(a)Mrs. Bertha Jackson

Teaching Tools, Activity 1(b)Sample Foods

Learner’s Book 1. Nutrition 2. MyPlate 3. Regular and Simple Modified Diets 4. Tips for Food Storage




5. Tips for Safe Food Handling 6. Helping Mrs. Jackson Get Ready to Eat 7. Assistive Devices for Eating 8. Basic Information about Budgets 9. Your Role in Assisting with Budgeting and Spending

10. Assisting Mrs. Jackson with Her Budget—Scenarios

11. Tips for Assisting Your Client in Following Their Budget 12. Guidelines for How to Handle Your Client’s Money

13. Recordkeeping

14. Shopping Tips: Food and Household Items

15. Shopping Tips: Other Purchases

Worksheets Worksheet 1. Food Likes and Dislikes

Worksheet 2. Assisting Mrs. Jackson with Her Budget

Skills Checklists Skills Checklist 1. Weighing a Client (DOH Procedure Checklist XII-31)

Skills Checklist 2. Helping Clients Eat (DOH Procedure Checklist XII-11)

Handouts Handout 1. Key Terms

Handout 2. Summary of Key Information

Advance Preparation Review all the training instructions and learner’s materials for this module. Note that icons are used to remind the trainer of the following:

When you are presenting or covering Key Content in the discussion. (Key Content is also addressed in the Learner’s Book and the handouts, but we use the “key” icon only when it is covered elsewhere in the learning process.)




When it is important to ask a particular question to get participants’ input.

When it is time to refer to the Learner’s Book.

When it is time to distribute a worksheet.

When it is time to distribute a skills checklist.

When it is time to distribute and discuss a handout. Copy all worksheets and handouts for participants. Prepare copies of the skills checklist. You will need one copy for each participant, to be collected and reused for subsequent trainings. Laminating the skills checklists will make them more durable and reusable. Gather all necessary supplies and equipment. Please note that the Key Content is meant to be background information for the trainer. DO NOT READ OUT LOUD TO PARTICIPANTS.

Activity 1. Eating for Health and Enjoyment

Teaching Tools, Activity 1(b)Sample Foods lists items needed for this activity. Either bring these items yourself, or ask participants a day ahead of time to choose one item from the list to contribute. Keep track of who is bringing in what item(s), so you can bring the other items to ensure that all the food groups are covered. Prepare the following flip chart pages:

“Learning Agenda” (Step 1)

“Food Likes and Dislikes” (Step 4)

“The Five Food Groups” (Step 9)

“The Five Food Groups and Daily Recommended Portions” (Step 10)

“Group Tasks for Meal Planning” (Step 12)

“One-Day Meal Plan” (Step 13)

Set up a workstation for each food group before class starts. Make sure each station has the necessary bowls, plates, cups, and measuring cups, as needed. The grain




group and protein (meat/beans) group each need a food scale (or you can ask participants to share one).

Activity 2. Simple Modified Diets; Weighing a Client

No advance preparation required. Activity 3. Proper Food Storage and Safe Handling of Food

No advance preparation required. Activity 4. When Clients Need Assistance with Eating

Buy a snack pudding for each participant, along with a few extras; bring enough plastic spoons and napkins for each participant. Prepare a flip chart page for “Mrs. Jackson’s Dining Experience” (Step 4). There is pairs practice in this activity and some participants may be ready to do return demonstrations. You need a skills checklist for each participant. Trainers should also be prepared with additional copies of the skills checklist to document return demonstrations. Gather a selection of adaptive devices for eating (see section 7 in the Learner’s Book).

Activity 5. The Role of the Home Health Aide in the Client’s Spending and Budgeting

No advance preparation required. Activity 6. Shopping Tips: Ways to Make the Most Effective Use of the Client’s Finances

No advance preparation required.




Activity 1. Eating for Health and Enjoyment 2 hours and 10 minutes

Learning Outcomes By the end of this activity, participants will be able to:

Explain how individual values and a person’s cultural upbringing affect a person’s relationship to food. List the five major food groups and identify foods within each group. State the amount of food that is appropriate in each food group per day.

Key Content When people are asked to describe what is unique about the culture they came from

or in which they were raised, food choices, meal preparation, and dining habits often enter into the conversation. What people eat and how they eat are integral parts of their culture. When home health aides help clients with meal preparation or eating, they are entering into the client’s culture.

Asking open-ended questions will help the home health aide know, understand, and respect the client’s food choices and preferences, cultural upbringing, and style of dining.

At the same time as they reflect culture and upbringing, food and nutrition are major factors in maintaining health.

Magazine articles are full of fad “diets” to help people lose weight. However, the word “diet” actually refers to the selection and quantity of food that people eat.

Everyone needs to eat a balance of foods from the five food groupsgrains, vegetables, fruits, dairy (milk), and protein (meat/beans). This is called a “regular diet.”




Activity Steps

PART A. ME AND MY FOOD [50 minutes]

Small-Group Work25 minutes 1. Introduce module. Post and review the “Learning Agenda.” Flip Chart

LEARNING AGENDA:

Everything about Eating; plus, Family Spending and Budgeting

What we eat and why

What’s a healthy diet?

What’s a simple, modified diet?

Helping clients to eat

Assisting with budgeting and shopping

How to handle the client’s money when shopping

Tips for shopping economically for food, clothes, and household items

2. Present the first bullet in Key Content. Note that, before participants learn how to help clients prepare and eat food, they will have a chance to explore their own cultural traditions around food. This exercise will help participants to recognize and honor the traditions of their clients.




3. Divide participants into five groups. Distribute Worksheet 1. Food Likes and Dislikes. Ask participants to spend 10 minutes discussing the questions on the worksheet as a group. Have them choose one person to write down their answers on his or her worksheet. That person will also be “the reporter” and share their group’s answers in the large-group discussion. To clarify the assignment, read through the worksheet, briefly answering the questions from your own perspective.

Teaching Tip If you have fewer than 10 participants, you can form fewer than five groups. You need to have at least two people in each group.

Large-Group Discussion25 minutes 4. Facilitate reporting back to the large group. Working with one question at a time,

invite the reporters to share their group’s responses to each question. Record the groups’ responses for each question on a flip chart page.

Flip Chart

FOOD LIKES AND DISLIKES

Foods eaten regularly

Favorite foods

Least favorite foods

Lessons about food

Teaching Tip To make this move more quickly, ask for only two responses from each group to each question. Each reporter can add to what previous groups reported, avoiding repetition. After you have heard answers to one question from all the groups, the reporters can add to the list, if they still have items that have not been reported.




5. Explore some of the themes from the different groups. Ask participants:

Are there any foods listed that you never heard of? (If so, ask someone to explain what they are.)

(For Favorite Foods) What would you do if you were no longer able to eat your favorite foods?

(For Least Favorite Foods) What would you do if you went to someone’s house for dinner and the only foods served were those you don’t like?

Do the “lessons learned” from family and culture still hold true for you today? If not, how and why have your eating patterns changed?

6. Make transition to thinking about clients and food. Ask participants to think about

what they learned about Bertha Jackson from the module, Working with a Client Who Is Depressed (see Teaching Tip). Ask:

How might Mrs. Jackson answer the four questions on the worksheet?

What have you learned from this activity about food, food choices, and dining?

How does this apply to helping clients select, prepare, and eat their meals?

Teaching Tip Make sure to mention the importance of asking open-ended questions and active listening to learn about the client’s “food culture.” If you did not discuss Bertha Jackson earlier in this training, see Teaching Tools 1(a)—Bertha Jackson. Read the profile out loud—sounding tired and sad. Then ask participants to answer the questions in this step.




PART B. MYPLATE [1 hour and 20 minutes]

Interactive Presentation30 minutes 7. Define “nutrition.” Ask:

What does “nutrition” mean to you?

8. Discuss nutrition and nutrients. After several responses, review 1. Nutrition in the Learner’s Book.

9. Refer to 2. MyPlate in the Learner’s Book. Explain that, to help us think about the nutritional aspects of food, scientists have identified five major groups of foods that are necessary to keep the body healthy or growing. On a blank flip chart page, list the five food groups one at a time. After each one, ask for examples of foods from that group.

Flip Chart

FIVE FOOD GROUPS

Grains

Vegetables

Fruits

Dairy (Milk)

Protein

10. Discuss appropriate food quantities. After all the groups have been listed, post the prepared flip charge page with the guidelines for how much food from each category should be eaten by an average adult in one day. Note that these quantities—ounces of grains, cups of fruit—are not very familiar, so they will practice measuring out these quantities to get a better sense of what is recommended.




Flip Chart

THE FIVE FOOD GROUPS and DAILY RECOMMENDED PORTIONS:

Grains6 ounces

Vegetables2½ cups

Fruits2 cups

Milk3 cups

Protein5½ ounces

Small-Group Work20 minutes 11. Set up food table. Place the food that you and/or participants brought on a central

table.

12. Give instructions for small-group work. Explain that participants will work in the same groups as before. Assign one of the food categories to each group. Post the prepared flip chart page and explain the three tasks for each group. Give them 10 minutes to complete their tasks. Ask the groups to be sure that everyone gets a chance to practice weighing or measuring the food.

Flip Chart

GROUP TASKS FOR MEAL PLANNING:

1. Collect all the foods for your food group from the table

2. Measure out the total amount for one day (combine different foods, please!)

3. Suggest how to spread this out over the day’s meals and snacks




Teaching Tips If you have fewer than five groups, you may need to assign more than one food group to one or more of the groups. Or you can use one of the food groups as a demonstration, asking participants to guide you as you pick out the appropriate foods, select measuring devices and measure, and then think about how to spread the food out over a full day of meals and snacks. The extra time needed for this demonstration will be made up during the presentations, when there will be one less group presenting. Monitor the groups while they are working to answer any questions and to see that everyone is getting a chance to practice weighing and measuring.

Group Presentations and Large-Group Discussion30 minutes 13. Facilitate group presentations. Ask each group to show the amounts of food they

measured out to meet the daily requirements for their food group and to explain how they would include these amounts in a meal plan. Post the prepared flip chart page with the meals and list the foods and amounts suggested by each group.

Flip Chart

ONE-DAY MEAL PLAN:

BREAKFAST

SNACK

LUNCH

SNACK

DINNER




14. Discuss how to revise the meal plan. After each group has presented, ask participants to consider the “one-day meal plan” flip chart. Explain that this is very similar to the process that meal planners and dietitians follow to ensure a balanced diet. However, since each group worked on their own, some of the combinations might seem a bit odd. Ask participants to suggest (in the large group) how they might revise this meal plan.

Teaching Tip Remind participants that (a) different people have different preferences and (b) there are countless possibilities of food combinations that meet the daily recommendations.

15. Consider how people eat in the U.S. Ask participants if anyone in the room thinks he or she eats a well-balanced diet every day. Acknowledge that most people in the U.S. do not, and this has contributed to many diseases, including obesity, heart disease, liver diseases, high blood pressure, and diabetes. Ask participants:

Why do you think it is hard for people to eat a healthy diet all the time? Teaching Tip Some reasons are: we eat many of our foods on the run or in front of the TV, where we do not focus on portion control; high-fat foods are often cheaper; some neighborhoods lack fresh fruits and vegetables and they cost a lot of money; and we aren’t knowledgeable about good nutrition.

16. Remind participants about the importance of nutrition for home health aides, too. State that eating a balanced, nutritious diet is important for clients to remain healthy. It is equally important for home health aides to eat a well-balanced diet, because they need strength and energy to perform at their best.




Teaching Tools, Activity 1(a) Mrs. Bertha Jackson

I’m sure feeling tired today. I’m Bertha Jackson and I’m 80 years old. My mother lived until she was 105 years old. They say that means I’ll live long, too, but nowadays I don’t even know if I want to live that long. I was born in Georgia and most of my family still lives there. My husband, Lance, and I came up north soon after we got married. One of my nieces, Janice, lives up here. She’s the one who found this apartment for me. She was worried about me living in my big house all alone after Lance passed. I guess it was too much for meespecially with my heart condition. They call it congestive heart failureI call it getting old! Anyway, I couldn’t even climb the stairs anymore without getting out of breath, and Janice said I looked like I was losing weight. Now I have you aides to help me with cooking, but I just don’t feel like eating, not if it’s just me alone. Plus, they’ve got me on this new diet and all my food tastes “flat”—you know, it just doesn’t taste like anything.

I miss my friends and neighbors at my old house. My niece comes to see me when she can but the visits are always too short. I pretty much just stay in my room and think about the old days when I’d go back to Georgia to see my family—those great barbecues, Christmas, and the big card games that went on into the early morning hours. Or I just watch TV—whatever’s on. Even doing nothing makes me tired. Like now, I think I’ll go lie down.




Teaching Tools, Activity 1(b) Sample Foods (page 1 of 2)

Trainers can bring these foods to class, or ask participants to choose from this list and contribute foods themselves. If asking participants to bring foods, remember to make assignments ahead of time. Grains

2 bagels 2 tortillas Box of crackers Box or bag of cereal Container of cooked white or brown rice Loaf of your favorite type of bread

Vegetables

3 potatoes Bunch of celerywashed and cut up

Head of broccoliwashed and cut up

Head of lettucewashed

Small bag of carrotspeeled and cut up

Fruits 2 cans of peaches, or 3 fresh peaches 3 bananas 3 orangescut

Box of raisins Jar of applesauce Large bunch of grapeswashed




Teaching Tools, Activity 1(b) Sample Foods (page 2 of 2)

Dairy (Milk)

3 slices of cheese 3 small containers of plain yogurt Container of cottage cheese Small carton of milk

Protein (Meats, Eggs, Beans, and Nuts)

3 eggs Can of beans Jar of nuts Jar of peanut butter Large can of tuna fish Piece of boneless chickencooked




Activity 2. Simple Modified Diets; Weighing a Client

1 hour and 5 minutes Learning Outcomes By the end of this activity, participants will be able to:

List six simple modified diets. Explain the importance of respecting a client’s preferences with food. Demonstrate how to measure and record the client’s weight.

Key Content In addition to getting a balance of nutrients, many clients are advised to follow a

simple modified diet. This means that one feature of a regular diet is changed. The six simple modified diets are: soft foods, bland foods, low calorie, high calorie, low salt, and low fat.

Home health aides need to be prepared to help clients select and prepare foods that meet their dietary restrictions, at the same time as recognizing and honoring the client’s cultural traditions around eating and mealtime.

HHAs are sometimes asked to measure and record the client’s weight. They should

know how to do that with both digital and non-digital scales.




Activity Steps Interactive Presentation30 minutes

1. Explain different types of diets. Refer to 3. Regular and Simple Modified Diets in the Learner’s Book. Describe the most common simple modified diets and the medical reasons for following each diet.

Large-Group Discussion20 minutes 2. Review Mrs. Jackson’s eating habits. Draw participants’ attention to Mrs.

Jackson’s relationship to food at the moment. Ask:

What do we know about Mrs. Jackson’s eating habits?

Teaching Tip From the client profile, they know that she has not been eating much, possibly due to depression, and has lost weight. She has a heart condition that may require a modified diet, and she states the food tastes “flat.”

3. Integrate discussions about nutrition and the social and emotional meanings of

eating. Note that participants should have concerns about Mrs. Jackson’s nutritional status, but they also need to consider the social and emotional meaning of eating for her, and her personal choices to eat what and when she wants to eat. Ask:

As a home health aide, what are your concerns about Mrs. Jackson’s nutrition and what might you do?

Teaching Tip In this discussion, balance the need for proper nutrition and Mrs. Jackson’s emotions. Some ideas are:

Find out what she likes and fix her favorite meals. Use spices/bring spices to the meals.




Eat with her. Listen to her to find out why she does not want to eat. Have food available for her to eat when she feels like it, not just at

mealtimes.

4. Review the home health aide’s role. Emphasize that no matter how much we want to help Mrs. Jackson regain her strength by eating a healthy meal, we cannot force her to eat, nor should we make her feel guilty or uncomfortable for not eating. If you become concerned about Mrs. Jackson’s weight, or if she regularly eats foods that are unhealthy for her, or if she does not eat at all, then it is time to call your supervisor to let him or her know about the situation. It is important for home health aides to encourage and provide nutritious and tasty meals and to do so in a way that honors the client’s long-standing preferences.

Interactive Presentation10 minutes

5. Review steps for weighing a client. Explain that sometimes they will be asked to help a client measure and record their weight. Ask participants the following question. Then distribute and review Skills Checklist 1. Weighing a Client.

What do you know about measuring a person’s weight?

6. Demonstrate how to measure weight. Talk about the different types of scales that are likely to be in a client’s home (i.e., digital and not digital). Ask for a volunteer to come up and get weighed by you. Follow the steps in the skills checklist. Explain what you’re doing as you’re doing it. Answer any questions.

Pairs Practice 5 minutes 7. Form pairs and give instructions. Ask participants to form pairs. Point out the

different scales in the room. Ask them to take turns weighing each other, following the steps in the checklist.




Activity 3. Proper Food Storage and Safe Handling of Food

20 minutes Learning Outcomes By the end of this activity, participants will be able to:

List three tips about proper food storage. List three tips about safe food handling.

Key Content

Storing food properly will make the food last longer. This also makes your client’s money stretch further.

Safe food handling is important in order to prevent the spread of germs. Germs can be

found on the food, on the preparation surface (table or counter), on the utensils, and on your hands. Germs from any of these sources can get into your client’s stomach and make him or her sick.

Activity Steps Interactive Presentation20 minutes 1. Assess participants’ understanding of food storage. Explain that the next topic is

“Proper Food Storage and Safe Handling of Food.” Ask participants:

Why do you think the home health aide should be concerned about food storage in the client’s home?




2. Explain the importance of proper food storage. Drawing from participants’ responses, explain that proper food storage will make food last longer, keep it from spoiling, and help stretch the client’s food budget. Refer to 4. Tips for Food Storage in the Learner’s Book.

3. Assess participants’ understanding of food handling. Ask participants:

Why do you think it is important to wash your hands and clean the area where you are preparing food for the client?

4. Explain the importance of safe food handling. Drawing from participants’ responses, explain that safe food handling is meant to keep germs from getting into the client’s food. Refer to 5. Tips for Safe Food Handling in the Learner’s Book.




Activity 4. When Clients Need Assistance with Eating

1 hour and 5 minutes

Learning Outcomes By the end of this activity, participants will be able to:

Identify non-nutritional factors that contribute to pleasant eating experiences. Demonstrate how to provide assistance during mealtimes.

Key Content Eating is not just for nutrition. Eating can also be a social event with emotional and

sensory elements of sharing, bonding, and just enjoying the experience. It fulfills many needs—physical, social, and even emotional. It is important to always be aware of this when assisting a client during mealtimes.

A pleasurable dining experience is not just about what kind of food is eaten or served. Food and the dining experience are pleasurable to people for many different reasons.

Home health aides are often asked to assist clients during mealtimes. For various reasons, clients may be limited in their ability to eat by themselves. They may be unable to move their hands or arms and manipulate utensils. Their hands/arms may tremble or shake. Or they may otherwise lack the strength to eat.

There are various ways a home health aide can assist a client to eat, from providing companionship to assisting with utensils. The emphasis should be on making mealtimes an enjoyable experience for the client. To properly prepare for assisting clients during meals, it is important to explore why we eat and why it isn’t just about putting food into our mouths.




Activity Steps

Interactive Presentation15 minutes 1. Introduce the activity. Explain that food has many purposes in our culture and, for

many people, nutrition and hunger aren’t the first things that come to mind when they think of eating! Explain that meetings, parties, social gatherings, and holidays are often centered on food. As noted earlier, how and what we eat are often significant identifiers of our culture, traditions, and beliefs.

2. Invite participants to share their positive food experiences. Ask:

What makes a dining experience pleasurable for you?

Teaching Tip Responses will likely be very personal, so affirm all responses. Ensure that the group touches on issues about the dining environment, aroma, temperature of food, food preferences, who may be there, who cooked the food, etc.

3. Invite participants to share their negative food experiences. Ask:

Have you ever had an unpleasant experience with food or dining? What made it unpleasant?

Teaching Tip: Ensure that the following things are mentioned: hair on the food, food that is cold when it is supposed to be hot, burning your tongue, not liking the company, odd smells.

4. Facilitate brainstorming. State that we know that Mrs. Jackson does not need

assistance with feeding during meals, but she is eating very little. And we also know that she can express her wishes and needs verbally. Ask participants to list questions that the home health aide can ask to help make her dining experience pleasurable. Help them word the questions to be open-ended as appropriate and write them on a flip chart page.



Trainer’s Manual—.24

Flip Chart

Mrs. Jackson’s Dining Experience

Teaching Tip Some questions may be: what kind of food do you like for breakfast, lunch, or dinner? What snacks do you like? Where do you prefer to eat? Are you allergic to anything? What’s your favorite food?

5. Invite participants to reflect on their own “dining” habits. Explain that preparing

someone to eat is an important part of a home health aide’s job. Ask participants:

If you are going to have dinner with friends or family, how do you prepare yourself?

6. Explain how to assist a client to prepare to eat. Refer to 6. Helping Mrs. Jackson Get Ready to Eat in the Learner’s Book. Note how participants’ responses (above) relate to each step. Note any of the information that was not covered in the discussion.

7. Explain how to help prepare a client to eat in bed. Note that when clients eat in bed, they also need to prepare for mealtimes. Review the steps in the second list on 5.

Demonstration—20 minutes 8. Explain the home health aide’s role in assisting with eating. After the home health

aide has prepared a client to eat, ensuring his or her dignity, it is time to assist the client in actually eating. Explain that most clients eat just like any other person, and eating can be a pleasurable or unpleasant experience. Home health aides have the role of assisting a client to have the most pleasurable dining experience possible each time they eat.




9. List specific tasks. Note that when a client is capable of feeding him- or herself, the

home health aide still may need to assist with tasks such as: providing a clothing protector, opening cartons, cutting the food into bite-size pieces, seasoning food, or other requests the client might have. If the client is not eating with others, checking in with the client about whether he or she wants company while eating (i.e., you) is also important.

10. Introduce demonstration. Explain that sometimes clients will need assistance being

fed, due to dementia, physical limitations, problems with swallowing that might be a result of a stroke, and so on. Explain that you are going to demonstrate how to help a client eat.

11. Set up demonstration. Ask for a volunteer to help you with the skills demonstration by joining you at the front of the room. Bring the pudding, spoon, napkin, plastic cup with water, and a clothing protector to the place where you will conduct the demonstration.

12. Conduct demonstration. Follow the steps in Skills Checklist 1. Helping Clients Eat, and feed the pudding to the volunteer (pretending that you have a variety of food items available). Demonstrate good communication skills while feeding. Explain the steps and take questions.

13. Highlight key points on skills checklist. Distribute Skills Checklist 2. Helping Clients Eat. Give participants a few minutes to review. Then ask:

How do you ensure the client’s safety while eating?

How can you make eating easier and more pleasurable for a client who has difficulty swallowing?

14. Discuss the assistive devices for eating. Refer to 7. Assistive Devices for Eating in the Learner’s Book. Show samples of the different devices. Pass the utensils around for participants to feel how the grip is different.




Pairs Practice30 minutes

15. Set up practice pairs. Ask participants to form pairs for skills practice. Distribute the snack (pudding), spoons, napkins, and cups of water to each participant, explaining that they will take turns and experience both feeding and being fed. Remind participants to follow the steps on Skills Checklist 1 and to remember to use their communication skills. Allow the participants 10 minutes for one participant to feed his or her partner; then ask them to switch and take another 10 minutes for practice. Remind participants that the trainer(s) will be moving around the room to monitor how participants are doing, to answer questions, and to provide additional instructions as necessary. They will also be able to observe return demonstations when pairs think they are ready.

Teaching Tip Some participants may be ready to do their return demonstration during this pairs practice. Use copies of the skills checklist to document their return demonstration. Then give feedback following the return demonstration. If a participant’s performance is not satisfactory, encourage him or her to practice more, and to do another return demonstration at a later time.

16. Facilitate debriefing. Ask participants:

How did it feel to assist another person to eat?

How did it feel to have someone assist you to eat?

How can you apply this experience to your work with clients?




Activity 5. The Role of the Home Health Aide in the Client’s Spending and Budgeting


Define what a budget is and describe its purpose in financial planning. Describe the two possible financial roles of the home health aide. Accurately record the expenditures for which the home health aide is responsible.

Key Content

A budget is a plan that helps a client (or the client’s whole family) to keep spending within certain limits. Budgeting is important because it can help the client meet financial goals.

The home health aide may assist with the client’s budgeting and spending in two ways:

By teaching the client how to budget his or her money effectively and spend it carefully

By assisting with shopping

It is important that the client take as much responsibility as possible for their budget. The home health aide can assist them in doing this by:

Involving the client in making choices and decisions

Honoring the values and preferences of the client




There are certain guidelines that the home health aide should follow when handling the client’s money:

Do not use the client’s money for personal purchases.

Keep personal money separate from the client’s money.

Keep all receipts.

Give all change to the client immediately. It is very important for the home health aide to keep records of all purchases that he

or she makes for the client. This protects the client, the home health aide, and the agency. Records should be simple, current, accurate, easy to read, and readily available. The records should include:

The date

The amount of money and whether it was cash or a check

The items that were purchased and the cost of each item

The signatures of the home health aide and the client

Activity Steps Interactive Presentation—10 minutes 1. Define “budget” and invite participants to share their experiences. Start by

explaining that a budget is a plan that helps a person or family to keep spending within certain limits. Explain that having a budget can help to avoid some kinds of financial difficulties. Ask participants :

What financial difficulties do you think a budget might help someone avoid? Listen to participants’ answers. Then explain that a budget can also help a client to reach certain financial goals. Ask participants:

What financial goals do you think a budget might help someone reach?

Teaching Tip: If participants have a hard time answering these questions, you may want to share your own responses. For example, you could say that having a budget could help someone avoid running out of money before the next paycheck, or




not having enough money left to pay a bill, or getting into debt. Having a budget could also help someone save money for an important goal, like buying a new winter coat.

2. Review the Learner’s Book. After listening to participants’ responses, refer to 8. Basic Information about Budgets in the Learner’s Book and review with participants.

3. Introduce the two financial assistance roles of the home health aide. Explain that the home health aide may assist a client or a client’s family with their budgeting and spending in two ways. Refer to 9. Your Role in Assisting with Budgeting and Spending in the Learner’s Book. Review 9 with participants and answer any questions.

4. Discuss the first financial assistance role. Explain that most clients manage their own spending and finances. In some cases, however, a client may no longer be able to do so. When this happens, the local Department of Social Services will assume financial responsibility for the client or for the client’s family. A case manager from the Department of Social Services will develop a budget with the client. The role of the home health aide is to assist the client in following the budget.

Small-Group Work and Reporting—25 minutes

5. Introduce small-group activity. Divide participants into four groups. Refer to 10. Assisting Mrs. Jackson with Her Budget—Scenarios in the Learner’s Book. Read the opening paragraph with participants, and remind participants that Mrs. Jackson is the client that they met earlier. Assign one scenario to each small group.

Distribute Worksheet 2. Assisting Mrs. Jackson with Her Budget. Explain that they will have 10 minutes to read the scenario that they have been assigned and to decide as a group what they would do or say to assist Mrs. Jackson. Ask if they have any questions.




6. Debrief response from first small group. After 10 minutes, ask the small group that was assigned the first situation to describe the situation to the whole group and then to share with the group what they would do or say to assist Mrs. Jackson.

7. Debrief responses from the second, third, and fourth groups. At the end, refer to 11. Tips for Assisting Your Client in Following Their Budget in the Learner’s Book.

Interactive Presentation—15 minutes

8. Explore client’s feelings about getting assistance with financial tasks. Begin by

asking participants:

How do you think you might feel if you had to give your money to someone else to do your shopping for you?

Validate participants’ responses, and then explain that many clients feel anxious about giving their money to a home health aide. It can make them feel powerless, or worried about being taken advantage of. This is one reason why it is so important to follow certain guidelines when handling a client’s money. Following these guidelines can help the client to feel more trust and confidence. These guidelines also protect the home health aide and the agency in case there is ever a question about how the home health aide spent the client’s money.

9. Discuss Learner’s Book. Refer to 12. Guidelines for How to Handle Your Client’s Money and 13. Recordkeeping in the Learner’s Book and review them with participants. When reviewing 12, be sure to explain that there may occasionally be an emergency when a client needs to purchase something but does not have immediate access to their money to buy it. (For example, a diabetic client may need to eat something before they take insulin.) In these emergencies, the home health aide should call the agency. The agency may allow the home health aide to use their own money to purchase something for the client, and then the home health aide will be reimbursed. When you finish reviewing 12 and 13, answer any questions.




Activity 6. Shopping Tips: Ways to Make the Most Effective Use of the Client’s Finances


Name seven ways of shopping effectively for food and household supplies. List ways in which best values can be found when shopping for clothes. Describe guidelines for buying appliances and household items.

Key Content

When assisting with shopping, the home health aide should follow certain shopping

tips in order to spend their client’s money as wisely as possible. Some tips to follow when shopping for food include:

Make a list with the client, and buy only what is on the list.

Look for coupons and discounts; note “last day of purchase.”

Check unit prices for the best deals.

Buy foods that are in season and that the client prefers.

Buy generic foods if the client is willing.

Buy in bulk if it is practical.

Use government supplemental programs.

Activity Steps Small-Group Work—15 minutes

1. Form small groups and give instructions. Assign participants to groups of three or

four people. After they are in their groups, ask them to imagine that they are going grocery shopping together. Then ask them to spend five minutes answering this question:




What shopping tips will help you to spend your money as wisely as possible? Explain that you would like them to write their ideas down with a marker on a piece of flip chart paper. Ask if there are any questions, and then ask them to begin.

2. Debrief small-group discussion. After five minutes, ask the small groups to read their flip charts and share the tips that they brainstormed with each other. Note that they already know a lot about how to save money when they are shopping for groceries. Then point out that when they are shopping for a client, it is even more important to make careful choices about what to purchase. Review 14. Shopping Tips: Food and Household Items in the Learner’s Book. Review with participants. Ask if there are any questions.

Interactive Presentation—15 minutes

3. Refer to Learner’s Book. Explain that there are also tips to keep in mind when making other kinds of purchases for clients. Refer to 15. Shopping Tips: Other Purchases in the Learner’s Book. Ask if there are any questions.

4. Review key concepts from this activity. Ask participants the following questions:

Why is it important to help your client follow a budget?

Why is it important to keep records of what you purchase for your client?

What are three ways you can save money when you shop for your client?

5. Wrap up the activity. Ask participants if they have any questions.

6. Summarize the module. Distribute and review Handout 1. Key Terms and Handout 2. Summary of Key Information. Ask participants if they have any questions.


Learner’s Book—Page 24.1

Learner’s Book

Module 24. All about Food; Spending and

Budgeting Activity 1. Eating for Health and Enjoyment 1. Nutrition 2. MyPlate 3. Regular and Simple Modified Diets 4. Tips for Food Storage 5. Tips for Safe Food Handling Skills Checklist 1. Weighing a Client Activity 2. When Clients Need Assistance with Eating 6. Helping Mrs. Jackson Get Ready to Eat Skills Checklist 2. Helping Clients Eat 7. Assistive Devices for Eating




Activity 3. The Role of the Home Health Aide in the Client’s Spending and Budgeting 8. Basic Information about Budgets 9. Your Role in Assisting with Budgeting and Spending 10. Assisting Mrs. Jackson with Her Budget—Scenarios 11. Tips for Assisting Your Client in Following Their Budget 12. Guidelines for How to Handle Your Client’s Money 13. Recordkeeping Activity 4. Shopping Tips: Ways to Make the Most Effective Use of the Client’s Finances 14. Shopping Tips: Food and Household Items 15. Shopping Tips: Other Purchases




1. Nutrition Page 1 of 3

What is nutrition? Nutrition is how the body uses food to grow and stay healthy. Nutrients are the basic elements of food that the body needs to be healthy. Nutritious is what we call foods that have lots of nutrients, and are good for the body. Nutrients Water: The most important nutrient! A person can live only a few days without water!

Function: help digest food, get rid of wastes, and keep a steady body temperature (through sweating).

Sources: the fluids we drink (examples: water, juice, milk, coffee, tea); some foods (examples: soup, celery, lettuce, apples).

Amount needed: 64 ounces of water each day (8 cups). We need to keep a “fluid balance” between the water that goes

into our bodies and the water that goes out. Water goes out when we urinate, sweat, have bowel movements, or vomit.

Dehydration is when the body does not have enough fluids. Causes: when body water is lost and not replaced. Examples: sickness (vomiting, diarrhea); too much sweating; or not drinking enough waer. Dehydration can lead to very serious health problems, including death.





Carbohydrates: The energy source for the body!

Function: provide “fuel” for body heat and energy Also provide fiber, which the body needs for regular bowel

movements. Sources: bread, cereals, rice, potatoes, pasta, vegetables, and fruits

(starches, or “complex carbohydrates”). Sources: foods that are high in sugar—desserts, syrups, and jellies

(“simple carbohydrates”). Complex carbohydrates are better for the body than simple

carbohydrates. “Grains” are all foods made from wheat, rice, oats, cornmeal, or

barley. These are plants that grow in nature. “Whole grain” foods have more of the original plant in them and are more nutritious (better for our bodies) than “refined grains.”

Proteins: The body’s building blocks.

Functions: to build and repair body tissues Sources: meats, beans, fish, eggs, milk, soy, and nuts Amount needed: depends on the person’s size, age, level of activity,

and health

Fats: How the body stores energy. Function: provide insulation (warmth); protects internal organs;

carry nutrients. Sources: meat, fish, eggs, nuts, milk, butter, and oils Polyunsaturated fats: corn, soy, safflower, and sunflower oils Saturated fats: meat, butter, coconut oil, and peanut oil

Polyunsaturated fats are better for us than saturated fats.





Vitamins:

Functions: help with growth; help the body to use other nutrients Vitamin A: skin, bone growth Vitamin B: helps nervous and digestive systems Vitamin C: helps in healing and keeping blood vessels strong Vitamin D: strengthens bones and teeth Vitamin E: helps in healing and energy

Different vitamins are found in different foods. That’s why we need a variety of foods in our diets.

Minerals: Functions: strengthen some body parts; help the body to use other

nutrients Calcium: strong bones and teeth; blood clotting; muscle

contraction Potassium: heart function Iron: helps body cells to use oxygen Sodium: keeps normal balance of water throughout the body

Minerals are also found in different foods. So we need to eat a variety of foods in our diets.




2. MyPlate Page 1 of 2

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choose MyPlate10 tips to a great plate

Making food choices for a healthy lifestyle can be as simple as using these 10 Tips. Use the ideas in this list to balance your calories, to choose foods to eat more often, and to cut back on foods to eat less often.

United StatesDepartment of Agriculture Center for Nutrition Policy and Promotion Go to www.ChooseMyPlate.gov for more information.

10 tips

Nutrition Education Series

DG TipSheet No. 1

June 2011USDA is an equal opportunity

provider and employer.

balance calories Find out how many calories YOU need for a day asafirststepinmanagingyourweight.Gotowww.ChooseMyPlate.govtofindyourcalorielevel.Beingphysicallyactivealsohelpsyoubalancecalories.

enjoy your food, but eat less Take the time to fully enjoy yourfoodasyoueatit.Eatingtoo fast or when your attention is elsewheremayleadtoeatingtoomanycalories.Payattentiontohungerandfullnesscuesbefore,during,andaftermeals.Usethemtorecognizewhentoeatandwhenyou’vehadenough.

avoidoversizedportions Useasmallerplate,bowl,andglass.Portionout foodsbeforeyoueat.Wheneatingout,chooseasmallersizeoption,shareadish,ortakehomepartofyour meal.

foods to eat more often Eatmorevegetables,fruits,wholegrains,andfat-free or1%milkanddairyproducts.Thesefoodshavethenutrients you need for health—includingpotassium,calcium,vitaminD,andfiber.Makethemthebasis for meals and snacks.

makehalfyourplate fruitsandvegetables Choosered,orange,anddark-greenvegetablesliketomatoes,sweetpotatoes,andbroccoli,alongwithothervegetablesforyourmeals.Addfruittomealsaspartofmain or side dishes or as dessert.

switchtofat-freeor low-fat(1%)milkTheyhavethesameamountofcalcium and other essential nutrients as whole milk, but fewer calories and less saturated fat.

makehalfyourgrainswholegrainsToeatmorewholegrains,substituteawhole-grainproductforarefinedproduct—suchaseatingwhole-wheat bread instead of white bread or brown rice instead of white rice.

foods to eat less oftenCutbackonfoodshighinsolidfats,addedsugars, and salt. They include cakes, cookies, ice cream, candies,sweeteneddrinks,pizza,andfattymeatslikeribs,sausages,bacon,andhotdogs.Usethesefoodsasoccasionaltreats,noteverydayfoods.

comparesodiuminfoods Use the Nutrition Facts label tochooselowersodiumversionsoffoodslikesoup,bread,andfrozenmeals. Select canned foods labeled“low sodium,” ”reduced sodium,” or “no salt added.”

drinkwaterinsteadofsugarydrinks Cutcaloriesbydrinkingwaterorunsweetened beverages.Soda,energydrinks,andsportsdrinksareamajorsourceofaddedsugar,andcalories,inAmericandiets.




3. Regular and Simple Modified Diets

Page 1 of 2

A regular diet can be changed to fit the needs of different people. A simple modified diet has just one change from a regular diet. Simple modified diets are: soft, bland, high-calorie, low-calorie, low-salt, or low-fat. Mrs. BradleyRegular diet

“Because I don’t have any health problems, I can pretty much eat what I like. Of course, I don’t overdo the fatty foods. And I make sure to eat lots of fruits and vegetables each day. Eating the right servings from the food groups gives me what I need to stay healthy.”

Mr. HuntSoft diet

“Ever since my surgery, I’ve had trouble eating. So I need soft foods that are easy to chew, swallow, and digest. I can have foods from every group. But they need to be strained, chopped, or ground up first. I stay away from foods with a lot of fiber, like seeds.”

Mrs. AtkinsBland diet

“With my history of ulcers, I need to eat foods that are easy to digest. All the food groups are fine for me. But I’m supposed to stay away from foods with lots of fiber or spices. And I can’t have coffee or alcohol.”

Mr. WangHigh-calorie diet

“I need to gain back the weight I lost during chemo and build up my strength. I can have foods from any group. I just need to make sure they have lots of nutrients and calories. I get a milk shake for my snack each day.”




3. Regular and Simple Modified Diets

Page 2 of 2 Mrs. SimmsLow-calorie diet

“I have diabetes, and I need to lose weight. So my doctor says I have to cut calories. I can have food from all the groups. I just eat less sweet or fatty foods. Skim milk, yogurt, fruits, vegetables, and lean meats are all great. But I really limit fried foods, chips, soft drinks, and cheese.”

Mr. PerezLow-salt diet

“Salt makes my blood pressure worse. So I’ve cut back a lot on foods with sodium in them. Every food group is OK. But I need to stay away from salty foods like bacon, canned soups, and crackers.”

Mrs. VernLow-fat diet

“Because my liver doesn’t work well, I have trouble digesting fat. The doctor has me on a low-fat diet. Now I have jello instead of ice cream for my night snack. And during the day, I have some fruit instead of cookies.”




4. Tips for Food Storage

Storing food properly will make the food last longer. This also makes your client’s money stretch further. Here are important tips for storing food properly so that it doesn’t spoil.

As soon as you get back from shopping, put meat, fish, and poultry in the refrigerator. If the food is loose or wrapped in paper, put it in a clean plastic bag first.

Store dry foods in covered containers. Use older purchases first. (Store separate from cleaning supplies.)

DO NOT store food beneath the plumbing (under the sink).

Refrigerate eggs, milk products, margarine, cooking oils, salad dressings, and mayonnaise.

DO NOT refrigerate fresh fruit until it becomes ripe.

Keep the refrigerator and freezer units in good working order. The refrigerator temperature should be at 36°F to 40°F. The freezer temperature should be at 0°F.

Cover all cooked food and write the date on the cover before putting it in the refrigerator.

Use frozen foods within six months after you buy them. Don’t thaw frozen food on the counter at room temperature.




5. Tips for Safe Food Handling

Page 1 of 2

Safe food handling is important in order to prevent the spread of germs. Germs can be found on the food, on the preparation surface (table or counter), on the utensils, and on your hands. Germs from any of these sources can get into your client’s stomach and make him or her sick. Follow these tips to keep foods safe from germs:

Wear clean clothes and/or an apron.

Always wash your hands before handling food.

Wear gloves if you have a cut or infection on your hands.

Never cough or sneeze around food.

Clean and sanitize your work space before and after preparing food.

Use clean dish towels and dishcloths.

Use hot water and soap to wash utensils.

Never taste and stir food with the same spoon.

Put warm foods (leftovers) in the refrigerator immediately.

DO NOT use damaged cans with bulging lids.

Do not eat raw eggs. NEVER use cracked eggs. NEVER undercook

eggs.




5. Tips for Safe Food Handling

Page 2 of 2

Use cooked meat, poultry, fish, and baked dishes within three to four

days after cooking.

DO NOT use foods that have become moldy.

Keep hot foods hot (above 140°F) for serving.

Keep cold foods cold (below 40°F) for serving.

Keep the refrigerator clean.

Use food within the recommended time (on the label).

DO NOT refreeze food.




6. Helping Mrs. Jackson Get Ready to Eat

Eating is more than just the food. For many people, it is one of the most important events of the day. Whether clients eat with others or alone, it’s smart to plan ahead to make the meal as enjoyable as possible. Read how you can help your clients get ready to eat. Today Mrs. Jackson will be eating with other people. Follow these steps to help her get ready:

1. Help her wash her hands and face, brush her hair, and put on make-up. This helps her feel good about the way she looks.

2. Help her use the toilet, commode, or bedpan. 3. Make sure she has her dentures. 4. If you will be with her during the meal, help her tuck a napkin into her

blouse, if needed. Today Mrs. Jackson is not feeling well and will be eating alone in her bed. Follow these steps to help her get ready:

1. Make sure her sheets and blankets are clean. Fluff and turn her pillow. 2. Help her sit up. 3. Place the tray on her lap or on a bed table, if she has one. 4. Help tuck a napkin into her shirt, if needed. 5. Make sure she can call for you if she needs you. Or, see if she would

like you to stay while she eats.




7. Assistive Devices for Eating

These devices make it easier for the client to feed him- or herself:

Angled forks and spoonsfor limited wrist or arm movement

Easy-grip large-handled forks, spoons, and knives

Sipper cup

Plates with high lipsto keep food on plate

Snap-on food guardto keep food on plate




8. Basic Information about Budgets A budget is a plan that helps a client (or the client’s whole family) to keep spending within certain limits. Budgeting is important because it can help the client meet financial goals. In order to create a budget, the client will need to carefully estimate:

Their expected income

Their expected expenses

Any profit (left over money after expenses are paid) or loss (any expenses not covered by income)

Some clients may have a case manager who works with them to create a budget. This budget will be based on:

The client’s income

The client’s values and preferences

The client’s spending habits in the past




9. Your Role in Assisting with Budgeting and Spending The home health aide may play two financial assistance roles in the client’s home:

1.) To teach the client (and/or the client’s family) how to budget his or her money effectively and spend it carefully

2.) To assist with shopping, purchasing, and banking




10. Assisting Mrs. Jackson with Her Budget—Scenarios

Mrs. Jackson has a budget so that she can control her spending. Your role is to assist her in following her budget. When you assist her, you want to honor her values and preferences as much as possible. You also want to encourage her to take as much responsibility as she can for managing her own budget. Read the situations below, and then decide what you would do or say to assist Mrs. Jackson.

1. Imagine that Mrs. Jackson has asked you to go to the drugstore to buy her a beauty cream that she just saw advertized on TV. This beauty cream costs $25 and it is not in her budget.

2. Imagine that Mrs. Jackson has asked you to buy shampoo, but you

notice that there are two unopened bottles of shampoo in the bathroom cabinet.

3. Imagine that Mrs. Jackson really likes a particular brand of orange juice

and she has asked you to buy a gallon of it for her, but you have a coupon for your favorite brand of apple juice.

4. Imagine that you have made a grocery list with Mrs. Jackson, and you

have tried to estimate how much it will cost to buy everything on her list. You estimate that it will cost $50, but Mrs. Jackson has given you only $25, because that is what is in her budget.




11. Tips for Assisting Your Client in Following Their Budget You can make suggestions, but encourage your client to make the decisions.

If the client asks you to buy something that is not in their budget, you may suggest that they talk this over with their case manager to see if it’s a purchase that they can really afford.

Before purchasing an item for a client, look to see if the client already has that item in the home. If they do, suggest that the item may not need to be purchased at that time.

When there are choices to be made, include your client in making them.

If you think you know a cheaper alternative to something the client wants, ask the client’s opinion before you purchase it. Do not buy something just because it is on sale.

Encourage the client to take responsibility for their budget as much as possible.

Remember that you are shopping for your client, not for yourself.

Keep their values and preferences in mind instead of your own.




12. Guidelines for How to Handle Your Client’s Money It is very important that you keep a record of everything that you buy for a client. This will help the client feel confident that you are spending their money wisely and according to their wishes. It will also protect you and your agency. Here are some things to keep in mind to help you keep track of what you spend for your client. Never use your client’s bank card.

If the client needs to withdraw cash from their bank account, you can go to the bank with the client. However, the client has to do the transaction by themselves, or with the help of “customer service.”

Never use your client’s money (or their family’s money) to buy your own things.

Even if you plan on paying it back right away, this is considered stealing. You could lose your job.

Keep your own money separate.

This will help you avoid getting confused. Keep all receipts.

Be sure to show the receipts to your client, and then save them in a box or a notebook.

Give the client (or the family) all of their change immediately.

Be sure to give them all change, even if it is only a few pennies. Also, give it to them as soon as you return from shopping so that you don’t forget.




13. Recordkeeping

You should keep a written record of everything you buy for your client. This will help avoid confusion or misunderstanding. It will also protect you, your client, and the agency. Your records should be:

Simple

Current

Accurate

Easy to read

Easy to find

Your records should include:

The date the client gave you the money


The things you bought, and the cost of each thing

The exact amount of change

Your signature and the client’s signature




14. Shopping Tips: Food and Household Items Preparing to shop:

1. Make a list with your client, and stick to the list when you are shopping.

2. Shop in stores that offer the most value for the most items.

3. Look for coupons and discounts.

4. Don’t shop when you are hungry. What to buy:

5. Buy fresh fruits and vegetables that are in season.

6. Buy day-old bread, if your client agrees.

7. Check unit prices for the best buys.

8. Buy food in large quantities if the client can afford to and it’s practical.

9. Be aware of the “last date of purchase” or expiration date.

10. Avoid “health foods.”

11. Buy generic products if your client is willing. How to pay:

12. Use government programs:

Food stamps

WIC coupons

Surplus foods Remember: Keep your client’s values and preferences in mind when you shop.




15. Shopping Tips: Other Purchases Shopping Tips: Drugs and Medicines

1. Try to substitute generic drugs when they are cheaper, but be aware that some prescriptions need to be filled with a particular brand name.

2. Store medications in their original containers, with the label on.

Shopping Tips: Clothing

1. Keep in mind what your client needs and wants.

2. Do comparison shopping.

3. Shop at the beginning of the season for the best selection, and at the end of the season for the best bargains.

4. Beware of damaged merchandise.

Shopping Tips: Appliances and Household Items

1. Consider your client’s preferences for color, type, or brand.

2. Select practical items.

3. Know the stores you shop in.

4. Make sure discount houses are what they claim to be.

5. Evaluate product advertisements and warranties.



Handouts

Handout 1. Key Terms Page 1 of 3

Budget [8]

A budget is a plan that helps a client (or the client’s whole family) to keep spending within certain limits.

Carbohydrates [1]

A nutrient that provides energy for the body. Carbohydrates are found in starches (bread, rice, grains, pasta), fruits, vegetables, and sugar.

Dehydration [1]

When the body does not have enough fluids.

Fats [1]

Nutrients that are found in meat, fish, eggs, nuts, milk, butter, and oils. Fats are stored in the body to provide insulation (warmth), protect internal organs, and store energy.

Grains [1]

Wheat, rice, oats, cornmeal, or barley. “Whole grain” foods have more of the original plant in them and are more nutritious (better for our bodies) than “refined grains.”

Minerals [1]

Minerals are nutrients that strengthen some body parts and help the body to use other nutrients. ■ Calcium: supports strong bones and teeth; blood clotting; muscle

contraction ■ Potassium: supports heart function ■ Iron: helps body cells to use oxygen ■ Sodium: keeps normal balance of water throughout the body



Handouts


MyPlate [2]

There are five food groups: grains, fruits, vegetables, protein (meat or beans), and dairy (milk). Eating from all five food groups will give a person all the nutrients they need to stay healthy. “MyPlate” is a picture that shows the right amount of each food group for a healthy meal.

Nutrients [1]

The basic elements of food that the body needs to be healthy. Nutrition [1]

How the body uses food to grow and stay healthy. Polyunsaturated fats [1]

These are fats found in corn, soy, safflower, and sunflower oils. These are better for the body than saturated fats.

Proteins [1]

Nutrients that help the body to build and repair body tissues. Proteins are found in meats, beans, fish, eggs, milk, soy, and nuts.

Regular diet [3] This is a balance of foods to help a healthy person to stay healthy. MyPlate (see Handout 2) shows how much foods should come from each food group, for a regular diet.

Saturated fats [1]

These are fats found in meat, butter, coconut oil, and peanut oil.



Handouts


Simple modified diets [3]

This is when a regular diet is changed in just one area. Examples of simple modified diets are: soft diet, bland diet, high-calorie diet, low-calorie diet, low-salt diet, or low-fat diet.

Vitamins [1]

Vitamins are nutrients that help with growth and help the body to use other nutrients. ■ Vitamin A: supports the skin and bone growth ■ Vitamin B: helps nervous and digestive systems ■ Vitamin C: helps in healing and keeping blood vessels strong ■ Vitamin D: strengthens bones and teeth ■ Vitamin E: helps in healing and energy



Handouts

Handout 2. Summary of Key Information Page 1 of 7

Nutrition is how the body uses food to grow and stay healthy. Nutrients are the basic elements of food that the body needs to be healthy. Nutrients include water, carbohydrates, proteins, fats, vitamins, and minerals. Each type of nutrient plays a different role in the body. All of them are important.

There are five food groups: grains, fruits, vegetables, protein (meat or beans), and dairy (milk). Eating from all five food groups will give a person the nutrients they need to stay healthy. “MyPlate” is a picture that shows the right amount of each food group for a healthy meal. Other tips for a regular healthy diet are:

o Eat less food and stay away from “over-sized” servings. o Half of “our plates” should be fruits and vegetables. o Half of the grains we eat should be whole grains. o Reduce the amount of sodium (salt) we eat. o Drink water instead of sugary drinks.

“MyPlate” shows a regular diet. This is what is needed for people who are

already healthy to stay healthy. A person who is not healthy can be helped by changes in their diet. A simple modified diet has just one change from a regular diet. Simple modified diets are:

o Soft diet: foods from every food group, but they are strained, chopped, or ground up first. This is for clients who need food that is easy to chew, swallow, and digest.

o Bland diet: food from every food group, but avoid spices, coffee, or alcohol.

o High-calorie diet: food from every food group, but increase the amount a client eats. This is for clients who need to gain weight.

o Low-calorie diet: food from every food group, but decrease the amount a client eats—especially fatty and sugary foods. This is for clients who need to lose weight.



Handouts


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1 switch to fat-free or low-fat (1%) milk They have the same amount of calcium and other essential nutrients as whole milk, but fewer calories and less saturated fat.

make half your grains whole grains To eat more whole grains, substitute a whole-grain product for a refined product—such as eating whole-wheat bread instead of white bread or brown rice instead of white rice.

foods to eat less often Cut back on foods high in solid fats, added sugars, and salt. They include cakes, cookies, ice cream, candies, sweetened drinks, pizza, and fatty meats like ribs, sausages, bacon, and hot dogs. Use these foods as occasional treats, not everyday foods.

compare sodium in foods Use the Nutrition Facts label to choose lower sodium versions of foods like soup, bread, and frozen meals. Select canned foods labeled“low sodium,” ”reduced sodium,” or “no salt added.”

drink water instead of sugary drinks Cut calories by drinking water or unsweetened beverages. Soda, energy drinks, and sports drinks are a major source of added sugar, and calories, in American diets.

balance calories Find out how many calories YOU need for a day as a first step in managing your weight. Go to www.ChooseMyPlate.gov to find your calorie level. Being physically active also helps you balance calories.

enjoy your food, but eat less Take the time to fully enjoy your food as you eat it. Eating too fast or when your attention is elsewhere may lead to eating toomany calories. Pay attention to hunger and fullness cues before, during, and after meals. Use them to recognize when to eat and when you’ve had enough.

avoid oversized portions Use a smaller plate, bowl, and glass. Portion out foods before you eat. When eating out, choose a smaller size option, share a dish, or take home part of your meal.

foods to eat more often Eat more vegetables, fruits, whole grains, and fat-free or 1% milk and dairy products. These foods have the nutrients you need for health—including potassium, calcium, vitamin D, and fiber. Make them thebasis for meals and snacks.

make half your plate fruits and vegetables Choose red, orange, and dark-green vegetables like tomatoes, sweet potatoes, and broccoli, along with other vegetables for your meals. Add fruit to meals as part of main or side dishes or as dessert.

choose MyPlate10 tips to a great plate

Making food choices for a healthy lifestyle can be as simple as using these 10 Tips. Use the ideas in this list to balance your calories, to choose foods to eat more often, and to cut back on foods to eat less often.

United StatesDepartment of Agriculture Center for Nutrition Policy and Promotion Go to www.ChooseMyPlate.gov for more information.

10 tips

Nutrition Education Series

DG TipSheet No. 1

June 2011USDA is an equal opportunity

provider and employer.



Handouts


Simple modified diets (continued):

o Low-sodium (salt) diet: foods from every food group, but avoid salty foods like bacon, canned soups, and some crackers. This is for clients with high blood pressure.

o Low-fat diet: cut down on foods with fat. This is for clients who have trouble digesting fat.

Proper food storage will make the food last longer. This also makes your client’s money stretch further. Tips include:

o Keep meat, fish, poultry, eggs, and milk products in the refrigerator. Store salad dressings and mayonnaise in the refrigerator after opening.

o Store dry foods in covered containers. o Cover all cooked food and write the date on the cover before putting

it in the refrigerator. o Use frozen foods within six months after you buy them. Don’t thaw

frozen food on the counter at room temperature.

Safe food handling prevents the spread of germs. Germs can be found on

the food, on the preparation surface (table or counter), on the utensils, and on your hands. Follow these tips:

o Always wash your hands before handling food. o Wear clean clothes and/or an apron. o Wear gloves if you have a cut or infection on your hands. o Never cough or sneeze around food. o Clean and sanitize your work space before and after preparing food. o Use clean dish towels and dishcloths. o Use hot water and soap to wash utensils. o Never taste and stir food with the same spoon.



Handouts


Page 5 of 7

Safe food handling (continued): o Do not eat raw eggs. NEVER use cracked eggs. NEVER undercook

eggs. o Use cooked meat, poultry, fish, and baked dishes within three to four

days after cooking. o DO NOT use foods that have become moldy. o Keep hot foods hot and cold foods cold for serving. o Keep the refrigerator clean.

Eating is more than just the food. For many people, it is one of the most

important events of the day. Whether clients eat with others or alone, it’s smart to plan ahead to make the meal as enjoyable as possible.

o When the client is eating with others, help him or her to get clean, get dressed, and use the toilet ahead of time.

o When the client is eating alone and in bed, help him or her to sit up in bed and get comfortable. Place a tray on her lap or on a bed table. See if he or she wants you to stay while he or she eats.

Assistive devices for eating can make it easier for clients to feed themselves. These include:

o Angled forks and spoonsfor limited wrist or arm movement o Easy-grip large-handled forks, spoons, and knives o Sipper cup

o Plates with high lipsto keep food on plate

o Snap-on food guardto keep food on plate



Handouts


Page 6 of 7 Budgeting is important because it can help the client meet financial goals.

In order to create a budget, the client will need to carefully estimate their income and their expenses. This will tell them what is left after expenses are paid, or what expenses are not covered by their income.

The home health aide can play two roles in assisting with the client’s budget:

o Teach the client (and/or the client’s family) how to budget his or her money effectively and spend it carefully

o Assist with shopping, purchasing, and banking Here are some tips for assisting your client to follow their budget:

o You can make suggestions, but encourage your client to make the decisions.

o When there are choices to be made, include your client in making them.

o Remember that you are shopping for your client, not for yourself.

When you are using your client’s money, your client needs to feel

confident that you are spending their money wisely and according to their wishes. Here are some tips:

o Keep a record of everything that you buy for a client. o Never use your client’s bank card. o Never use your client’s money (or their family’s money) to buy your

own things. o Keep your own money separate. o Keep all receipts. o Give the client (or the family) all of their change immediately. o When possible, use checks instead of cash.



Handouts


Page 7 of 7 Record-keeping: You should keep a written record of everything you buy

for your client. Record-keeping helps to avoid confusion or misunderstanding. It will also protect you, your client, and the agency.

o Your records should be:

Simple

Current

Accurate

Easy to read

Easy to find

o Your records should include:

The date the client gave you the money


The things you bought, and the cost of each thing

The exact amount of change

Your signature and the client’s signature

Shopping tips for food:

o Make a list with your client, and stick to the list when you are shopping.

o Buy fresh fruits and vegetables that are in season.

o Check unit prices for the best buys.

o Buy generic products if your client is willing.

o Remember: Keep your client’s values and preferences in mind when you shop.



Worksheets

Worksheet 1. Food Likes and Dislikes

Different people can have very different taste in food. Talk with your group about your likes and dislikes.

1. Which foods do you and your family eat every week? Why do you eat them so often?

2. Which foods do you like the most? Why?

3. Which foods do you like the least? Why?

4. What did you learn about food and eating while you were growing up?



Worksheets


Page 1 of 2

Mrs. Jackson has a budget so that she can control her spending. Your role is to assist her in following her budget. When you assist her, you want to honor her values and preferences as much as possible. You also want to encourage her to take as much responsibility as she can for managing her own budget. Read the situations below, and then decide what you would do or say to assist Mrs. Jackson.

1. Imagine that Mrs. Jackson has asked you to go to the drugstore to buy her a beauty cream that she just saw advertised on TV. This beauty cream costs $25 and it is not in her budget. What would you do or say? __________________________________________________________________

__________________________________________________________________

__________________________________________________________________

2. Imagine that Mrs. Jackson has asked you to buy shampoo, but you notice that

there are two unopened bottles of shampoo in the bathroom cabinet. What would you do or say? __________________________________________________________________

__________________________________________________________________

__________________________________________________________________



Worksheets


Page 2 of 2

3. Imagine that Mrs. Jackson really likes a particular brand of orange juice and she

has asked you to buy a gallon of it for her, but you have a coupon for your favorite brand of apple juice.

What would you do or say? __________________________________________________________________

__________________________________________________________________

__________________________________________________________________

4. Imagine that you have made a grocery list with Mrs. Jackson, and you have tried

to estimate how much it will cost to buy everything on her list. You estimate that it will cost $50, but Mrs. Jackson has given you only $25, because that is what is in her budget. What would you do or say? __________________________________________________________________

__________________________________________________________________

__________________________________________________________________



Skills Checklists

Skills Checklist 1. Weighing a Client Get ready. 1. Explain to the client that you will be weighing them. 2. Wash your hands. 3. Gather the equipment you will need. 4. Put on gloves, as needed. 5. Check that the scale is set at “0.” Adjust if needed. Weigh the client. 6. Assist the client onto the scale. 7. Provide support while the client steadies him- or herself. 8. Note the weight. If you are using a scale with a needle and dial, wait until the

dial stops moving. 9. Observe for any problems the client has while you are weighing them, such

as not being able to stand on the scale. 10. Assist the client off the scale. Clean up and ORR. 11. Record the weight. 12. Report any changes in condition or behavior (such as a gain or loss of more

than five pounds or client concerns about weight). 13. Store the equipment in a safe place.



Skills Checklists

Skills Checklist 2. Helping Clients Eat

Page 1 of 2

Get ready 1. Wash hands. 2. Gather equipment and supplies. 3. Put on gloves, as needed. Prepare the client to eat 4. Prepare the client to eat as described in section 6 of the Learner’s Book. 5. Determine if the client would like to eat at the table or in bed. 6. Make sure the client has the food required by the care plan. 7. Provide the client with a clothing protector, if needed. 8. Cut up food into bite-size pieces, if necessary. 9. Arrange the food attractively on the plate.

10. Open any cartons or containers that would be difficult for the client to open.

11. Talk to the client about what food is there, and ask if the client needs additional assistance.

12. If the client needs assistance with feeding, follow steps 13–25. Assist the client to eat 13. Provide privacy if appropriate. 14. Before feeding client, ensure he or she is in an upright sitting position and

has a clothing protector.

15. Sit at client’s eye level. 16. Ensure that food is not too hot. Stir to cool. 17. If you are assisting a client who is visually impaired, explain where the food

is located on the plate, and what is on the spoon or fork. 18. If you are assisting a client who has facial weakness or is paralyzed on one

side, bring the food to the strong side. 19. Offer the client fluid to moisten the mouth and to ease swallowing. Use

straws or a training cup for fluids. Continue to offer fluids throughout the meal every three or four bites.

20. Alternate types of food offered, allowing for client preferences.



Skills Checklists

Skills Checklist 2. Helping Clients Eat

Page 2 of 2

21. Offer the food in bite-size pieces from the tip of a half-filled spoon or a fork. Use spoons and forks gently.

22. Make sure client’s mouth is empty before next bite of food or sip of beverage is offered.

23. Talk to client while feeding him or her. 24. Wipe food from client’s mouth and hands as necessary. 25. Encourage client to finish the meal, but do not force food. Assist the client to clean up 26. When finished eating, wipe mouth and remove food. 27. Remove clothing protector and dispose of in proper container. 28. When the meal is complete, provide opportunity for client to wash hands and

face. Assist as necessary. Clean up and ORR 29. Record fluid intake and uneaten food as required by the care plan. 30. Clean up eating area as needed. 31. Wash hands.

Module 24. All about Food; Spending and Budgeting - … 24. All about Food; Spending and Budgeting...

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