Re: Section K

[Holly Sox, RN, RAC-C]

Well, actually, the intent of that passage was just to remind us that the problem still exists, despite the fact that interventions are making it less of a problem. Ideally, we should all be able eat a regular consistency diet.  If a problem exists (chewing, swallowing, sensory integration disorder, whatever) that makes it difficult to manage regular consistency food, then we try other approaches to make it easier. But, the problem still exists.   However, my interpretation of the original question was that the dietary manager felt that if someone was receiving a mechanically altered diet, then chewing problem should be automatically checked. And I just don't agree with that.    My child (5 yo) has a mild sensory integration problem that makes food choices VERY VERY challenging.  He gags on just about anything that is not mashed potato consistency.  He has perfect teeth, no difficulty chewing and no physical swallowing problem, although I guess the gagging would indicate some degree of swallowing problem.  At any rate, this child requires a mechanically altered diet in order to maintain some level of order and sanity for him and his parents.   You can rarely (if ever) get by with making assumptions in any area of medical practice. And certainly not on the MDS. You have to verify the reasons behind whatever treatments, medications, diet alterations, whatever, that your resident is receiving.  Just as you can't assume depression because someone is receiving an antidepressant.   Holly Holly F. Sox, RN, RAC-C  Clinical Editor, Careplans.com www.careplans.com [EMAIL PROTECTED] ----- Original Message ----- From: claudia farrell To: [EMAIL PROTECTED] Sent: Friday, February 20, 2004 11:34 PM Subject: Re: Section K Dawn you are correct. If the diet is changed/ Mech etc, then it is d/t a chewing or swallowing problem. On our state site for transmittals, this statement continues to be posted, around 2 years ago I believe in July. Not at work, so can't give exact date. I personally feel that if the diet is altered so that the resident doesn't experience difficulty w/eating their foods and the intervention worked---there is not a problem. Claudia >From: "dawn" <[EMAIL PROTECTED]> >Reply-To: [EMAIL PROTECTED] >To: <[EMAIL PROTECTED]> >Subject: Re: Section K >Date: Fri, 20 Feb 2004 21:31:24 -0500 > > >     I seem to recall a Q&A last year...maybe 2 years ago. You code chewing problem on MDS if on a mechanically altered diet, regardless. Anybody out there, please correct me...... Of course I keep all that at work. > >     dawn > > > >     ----- Original Message ----- >     From: Brenda Chance >     To: [EMAIL PROTECTED] >     Sent: Friday, February 20, 2004 10:59 AM >     Subject: RE: Section K > > >     Your director needs to talk with a speech therapist.  Mechanically altered diets include Mech Soft, Pureed, etc. and can be as much for swallowing problems as for chewing.  I would not code chewing unless there was a chewing problem.  This would be like assuming just because a resident has difficulty lying flat they have copd. > > > >     Brenda W. Chance, RN, RAC-C > >     MDS Coordinator > > > > > Get fast, reliable access with MSN 9 Dial-up. Click here for Special Offer! /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/