A nutritional rehabilitation program for persons with severe physical and developmental disabilities

Our purpose was to design and implement a nutritional rehabilitation program for persons with severe developmental disabilities who resided in a long-term-care facility or a group home. We used weight for height (WH) to classify residents of both facilities into three groups: group 1 (n=32), WH less than 5th percentile (Z scores < or = -1.650), goal=gain weight; group 2 (n=21), WH between the 5th and 85th percentile (Z scores ranging from -1.645 to +1.030), goal=maintain present rate of weight gain; and group 3 (n=8), WH greater than 85th percentile (Z scores > or = +1.036), goal=slow down rate of weight gain. The challenge in all groups was to bring about these changes without increasing the quantity of food (as assessed by 3-day food records) fed to the residents and to increase their fluid intake. For each subject, the project dietitian developed individualized menus that specified quantities and consistencies of food. Foodservice delivery was changed to a centralized system in the long-term-care facility to allow for closer control of the subjects' intake. A dietitian monitored the program with biweekly visits to the wards and frequent consultation with staff. Only a limited increase in fluid intake was noted; however, after 6 months of the program, the other goals were met. Our results suggest that nutritional rehabilitation of residents with developmental disabilities is enhanced by the involvement of a dietitian.