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Carly Lehmann
Intro to Dietetics
Carrie Hamady
December 3, 2014
Interview Reflection
Dietetics is a rapidly growing field with a high demand. Until recently, people did not
really know what a Dietitian was, or what they did; actually, there are still a lot of people who do
not know those answers. Whenever I tell someone my major, without fail, the first thing they say
is, What is that? Dietetics is becoming better known, but I think we still have some time before
dietitian is a household term. That is why when I was starting to realize Dietetics was the
major I wanted to pursue, I was happy to know that I have a cousin who is a Registered Dietitian
(RD). I think it is always nice when you are interested in something that someone else in your
family is interested in as well; that way you will always have someone to talk to and go to for
advice when you need it.
To start, I chose to interview my cousin because she is a Dietitian at a nursing home. I
currently work in an assisted living facility, so that is not much of a stretch from a nursing home;
but we do not have a full time Dietitian on site. Our Dietitian works at the main branch of our
facility and only makes monthly visits. So, even though I get to see what my boss does, who is a
Certified Dietary Manager (CDM), I wanted to learn more about what the actual Dietitian does in
a long-term care facility. I really wanted to see how much the CDM can do versus how much the
RD can do and I have learned that at work based on what I know my boss does not have the

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authority to do. Now, I know the differences in the CDM and the RD jobs, based on what I
learned from an RD. I was hoping to learn a little bit about the differences in job of the RD and
the Dietetic Technician, Registered (DTR), but her facility does not have one, and neither does
mine.
Nursing home Dietitians are becoming more prominent now due to the increase of people
going into them due to the baby boomer age group as they reach their later years. Nursing homes
held about 9% of Dietitians in 2012, and in the next eight years, the job outlook of Dietitians is
expected to increase by 21%, which is about 10% faster than average (1). According to the an
article in the Journal of the Academy of Nutrition and Dietetics, long-term care facilities
provide supportive social services for people who have functional limitations or chronic health
conditions and who need ongoing health care or assistance with normal activities of daily living
(2). The problem with long-term care facilities is that it is a pretty big change from living in your
own home for many years. Getting thrown into a new environment, meeting new people,
learning new routines--those things are not easy for anyone, let alone the elderly. Fortunately,
long-term care facilities are trying to change that to make their new living arrangements an easier
transition and more comfortable for them. A new guideline was released in 2010, the Minimum
Data Set 3.0 (MDS 3.0), which gives residents a voice in their daily routines. They get to help
plan their activities, their care, and their nutrition (3). Before the MDS 3.0, there was the MDS
2.0, which did not focus on individual needs, rather it focused on a one-size-fits all model (3). A
one-size-fits all model might be more convenient for the long-term care facility staff, but it does
not let the residents have the freedom that they have always had. It would be bad enough having
to leave your house for a nursing home, but to get there and not have any say over your daily
routine would be pretty unbearable.

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Furthermore, even though it is important to keep the residents happy, it is also important
to keep them healthy. There are two main goals when caring for the elderly: maintenance of
health and maintenance of quality of life (2). There are also two separate clinical guidelines to
ensure that residents are receiving the best care that they can. They are The Clinical Guide for
Nursing, Dietary, and Dietitian Staff and The Clinical Guide for Physicians, Pharmacists, and
Dietitians (4). The first guide is measured by clinical triggers, advanced directives, medical
conditions, hydration, laboratory parameters, environmental factors, nursing nutritional checklist,
interventions, and failure to improve (4). The second guide is measured by depression and mood
disorders, drugs, and irreversible causes (4). Under the MDS 3.0, it would seem that many of
these problems can be prevented or helped because residents take an active role in their care,
which lifts their moods, keeps their dignity, and makes them want to be more involved in daily
activities (3). Keeping residents happy is important because many of them do not have family
left to help with that, so keeping them involved is a good way to achieve this goal.
For my interview, I chose to interview Amy Wensinger, RD, LD. Amy earned her
Bachelors Degree from Miami University and she combined her internship with her Masters
Degree from Bowling Green State University. Amy currently works at Edgewood Manor in Port
Clinton, Ohio, which is part of Covenant Care. She started out as their dietary manager and then
moved up to being their RD; she has been there for the past 10 years. There are many
responsibilities that an RD has in a long-term care facility. A typical day for her includes
overseeing that the CDM is accomplishing all of her responsibilities and making sure that she is
doing her job effectively and efficiently. She performs audits as well as sanitary inspections to
make sure the kitchen and dining room are up to standards and code. Another extremely

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important aspect of her job is to evaluate new residents to help determine the type of diet they
should be on and to do the clinical paperwork pertaining to her evaluations.
I learned something pretty interesting while I was there that I started thinking about in
relation to my current job. Amy stated that they try to give their residents as much of a voice as
possible (due to the MDS 3.0) when determining their diets and she educates them so they
understand the risks of indulging in a diet that could potentially harm them. Since it is the end of
their lives, it is important for the elderly to be as happy as possible and being able to make their
own food choices is something that really does make them happy; which is something that I
know from my experiences of working in a long-term care facility, as well. I do not have
anything to do with the residents diets, so I do not know how much of a say our residents have
in their diets, but I know that we have several residents who are on mechanical soft diets and
need thickened liquids. I also know that very few of those residents are happy with that diet and
would take regular food in a heartbeat if they were given the chance. At the same time though, a
regular diet for someone who needs mechanical or puree could potentially kill them so it is more
important to enforce that rather than something like a diabetic diet because that can also be
controlled with medication to make up for the lack of appropriate diet.
As I stated earlier, Dietetics is a rapidly growing field with a 21% projected increase by
2022 as well as a projected increase of about 14,000 new available jobs (1). To obtain a job as a
Dietitian, you must at least hold and Bachelors Degree, have done an internship, and sat for and
passed the RD exam. Usually, once you have those things you can obtain a job without work
experience in the specific area you are applying to. Experience in other areas of Dietetics as well
as your internship are usually pretty sufficient. Nutritional interventions are important for
residents because many times depression sets in and they begin to withdraw from their daily

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routines. Interventions are fairly effective if they are started early enough and done routinely (2).
It is also important to have a loved one involved in the intervention to let the resident know that
it is in their best interest. Overall, Dietetics is a new profession that is becoming bigger and
bigger every day and it is exciting to be a part of it.

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References
1. Bureau of Labor Statistics. U.S. Department of Labor. Occupational Outlook Handbook,
2014-15 Edition. Dietitians and Nutritionists.
2. Dorner B, Niedert KC, Welch PK. Position of the American Dietetic Association:
Liberalized Diets for Older Adults in Long-Term Care. Journal of the Academy of
Nutrition and Dietetics. September 2002 Issue. Vol. 102 P. 1316-1323.
3. Thomsen B. Understanding Care Area Assessment. Todays Dietitian. November 2011
Issue. Vol. 13 No. 11 P. 12.
4. Ashmen W, Evans WJ, Morley JE, Thomas DR. Nutritional Management in Long-Term
Care: Development of a Clinical Guideline. Journal of Gerontology: Medical Sciences.
Published 2000, Vol. 55A No. 12 P. M725-M734.