Visit from Dietician

Discussed overnight feed alarm and alternate methods of feeding. The bolus method was deemed inappropriate posing more problems than it solved. It was noted that the overnight feed was not the only thing to change in the last 2 years as Rachael's condition has declined. Discussed postural pain/pressure sores. Claire was unable to help but did say extra protein could make a difference. Discussed choking occurances and Rachael said choking can happen at all times and increasingly. The amount of feed Rachael was taken deemed fine and incontinence overnight was also discussed. Advised of current weight and said will be re-weighed again by Dr E on 19/01/11. Concluded no issues with feed. Discussed bowel and bladder movements. Claire advised to continue taking lots of fluids. Concurred that balancing incontinence and constipation is difficult and agreed to err on the side of incontinence.