Catherine has years of experience working with adults who have intellectual and developmental disabilities (IDD). She can provide nutrition support for individuals living in group homes, host homes, medical homes, residential facilities, or with families or caregivers. Individuals with IDD are at an increased risk for developing chronic diseases and obesity related to a poor diet. She offers a variety of services to help manage and prevent many health and weight issues. These include nutrition care plans, nutrition assessments, menus, recipes, meal plans, training classes, diet instructions, individual counseling, supermarket tours, and mealtime assistance plans. See Intellectual and Developmental Disabilities (IDD) for details.

Nutrition Care Plans

A Nutrition Care Plan is recommended for all individuals who are at risk for nutrition-related problems. A risk assessment may be completed to determine if a nutrition assessment is needed. The Nutrition Care Plan uses the Nutrition Care Process which includes the nutrition assessment, nutrition diagnosis, intervention plan, and nutrition monitoring/evaluation. A Nutrition Care Plan is recommended at least once per year for all individuals who are at moderate to high risk for nutritional problems.

Menus

A Four Week Menu Cycle can be prepared for your organization. Menus are designed to meet the USDA Dietary Guidelines for Americans with serving sizes for each menu item. Whole grains are emphasized and five or more servings of fruits and vegetables are included on daily menus. A variety of protein choices include lean beef and pork, fish, poultry, eggs, and beans. Low fat dairy foods are recommended on the Weight Control and Weight Maintenance Menus to reduce calories and fat. General modifications are included for the following diets: Pureed, Mechanical Soft, Low Lactose, and No Added Salt, or Low Sodium.

The Menu Cycle includes three calorie levels:

• 1200-1500 Calories (Weight Control)
• 1600-1800 Calories (Weight Maintenance)
• 1900-2200 Calories (Regular Diet)

Recipes

Recipes are included with the Four Week Menu Cycle and are provided for most entrees, side dishes, and desserts. Foods such as fruits and vegetables which only require simple preparation such as chopping, boiling, steaming or baking may not require a recipe. Most recipes are designed to be heart-healthy while retaining excellent flavors and textures if prepared as recommended.

Monday-Friday Lunch Box Menus

Menu items consists of foods which are easy to handle and carry in a lunch box. Entrees include sandwiches, wraps or roll-up sandwiches, and salads. Fruits and vegetables are also included along with a beverage and snack food. Although refrigeration may be needed, most foods should not require heating. These menus may not be appropriate for individuals who have difficulty chewing or who are on a mechanical soft or pureed diet.

Special Menus and Recipes

Special menus and recipes can be prepared for individuals who have multiple dietary restrictions.

Weekly Shopping List

A shopping list is available with the Four Week Menu Cycles to make meal planning and preparation easier.

Meal Plan System

Meal Plans with Sample Menus may serve as a good alternative to cycle menus and recipes. They are designed to make planning and preparing meals easier. Organizations which provide services to individuals living in a group home setting may benefit from the flexibility of the Meal Plan System. The Group Home Manager can choose the foods and recipes which are preferred by the residents without having to follow specific menus, recipes, and shopping lists. The Five Food Groups from the 2015-2020 Dietary Guidelines are used as a platform for food choices to ensure that meals are nutritionally adequate. Meal plans can be customized to meet the specific nutritional needs of each resident. As a general rule, each meal plan includes four different calorie levels:

• 1200-1500 Calories (Weight Control)
• 1600-1800 Calories (Weight Maintenance)
• 1900-2200 Calories (Regular)
• 2300-2600 Calories (High Calorie)

Snacks and beverages are also included with the Meal Plan System. The Meal Plans with Sample Menus should be used in conjunction with specific dietary recommendations which are usually found on the resident’s nutrition assessment or diet instruction. Since recipes are not provided, it is important that meals are prepared using heart healthy cooking guidelines which incorporate low sodium, low fat, healthy fats, and high fiber.

Diet Instructions

A diet instruction may be needed for individuals with medical conditions, developmental disorders, or weight issues which require modifications to their diet. The RDN will review the goals of the diet, tips on making food choices, and instructions on food preparation. A food list and sample meal plan may also be provided.

Nutrition Training Classes and Presentations

Nutrition training classes provide an opportunity for the RDN to review the nutritional goals for each client/resident with staff and caregivers. Classes may be presented to smaller groups such as in a group home or in a family setting but may also involve larger groups who may not work directly with the clients but need to be aware of their nutritional needs. In a group home setting, a training class may include going over the nutrition assessment, nutrition diagnosis, nutrition intervention plan, diet instructions, and meal plans. Since several individuals with a variety of nutritional needs live together, it is important for the RDN to be able to explain and demonstrate how to best meet the needs of everyone.

Training classes may also be needed on a variety of topics commonly seen in the IDD population such as obesity, overweight, heart disease, gastrointestinal disorders, and dysphagia. These classes may be presented to larger groups of people working in the organization. Nutrition education may include cooking classes, appropriate portion sizes, and reading food labels. Nutrition Training Classes are customized to meet the needs of your organization and the residents/clients who are being served.

Nutrition Training and Counseling for Individuals with IDD

Individual counseling or training may be beneficial for people with mild to moderate MR or those who can understand basic nutrition principles such as food groups and portions. It is important for the RDN and those who work with these individuals to have realistic approaches which emphasize small steps as significant in reaching their goals. Nutrition education typically includes low literacy materials and resources to facilitate learning. Visual teaching tools such as pictures of foods with appropriate portions, assistive devices, and computer-aided systems can also be used. Improved retention can be achieved by teaching simple concepts and by allowing the individual to demonstrate what he/she has learned.

Supermarket Tours

Choosing healthy foods for individuals with a variety of nutritional needs can be a challenge, especially when you are on a budget. The RDN can help you discover how to get the most nutrition for your food dollar, which foods to always have on hand, and foods to limit. Shopping Tours are individualized to meet the needs of your family, group home or facility. A typical tour will take about one hour and may include meal planning, smart store navigation, reading labels, understanding health claims, and tips on choosing fresh produce, fish, meats, and poultry.

Meal Time Assistance Plans

A Meal Time Assistance Plan is an individualized educational procedure designed to provide optimal assistance for individuals with feeding problems. Health history, dietary needs, positioning, communication, and adaptive equipment are all considerations when developing a plan. The RDN will work with other team members to evaluate and formulate a plan which meets the needs of each person.