As the rapid spread of COVID-19 across the world continues to dominate the headlines, the pandemic has very quickly altered how we go about our daily lives. The Government and public health services are now asking us to take unprecedented steps to protect ourselves and those around us.
The situation surrounding this new and unique coronavirus is changing on a daily basis and is likely to continue for some time. It’s understandable that over the coming weeks and months our clients are likely to have concerns about staying well. As dietitians, we are able to provide reassurance and practical support.
This article offers top tips for supporting our clients to stay healthy.
Following a healthy diet is one of the best tools we can employ to stay well.
Encourage clients to stick to their normal routine as much as possible – encourage them to eat three regular meals per day, consume at least five portions of fruit or vegetables per day, and include plenty of wholegrains, pulses and lean protein in their diet.
You could explain the link between nutrition and immunity, emphasising the importance of consuming a diverse range of vitamins and minerals from a balanced diet. It’s important to reiterate that the term “immune-boosting” is misleading and that there are no “quick fix” pills or supplements that will suddenly help.
Assess how likely your client is to comfort eat in times of worry, boredom, or stress. If appropriate, you may wish to discuss alternative strategies for how they can alleviate these feelings without turning to unhealthy snacks. Healthier coping mechanisms might include yoga, meditation or talking to others.
Ask clients about any issues they may be experiencing with regards to accessing food. Social distancing measures and self-isolation combined with limited mobility, reduced transportation or financial difficulties may mean it’s more difficult to access food. Whilst it’s important to avoid panic buying, you might like to encourage clients to stock up on cupboard essentials.
Suitable foods may include:
- Tinned fish/vegetables
- Dried pasta and rice
- Jars of pasta sauces
- Canned soup
- Breakfast cereals
- Frozen fish/meat/vegetables
- Nuts/seeds/nut butters
- Dried fruit
It may be necessary to explore creative ways for clients to create healthy dishes that fit with their needs and preferences, advising on suitable swaps for any unavailable items. Discuss ways to preserve perishable food like fruits and vegetables, such as batch cooking and freezing portions to be reheated and eaten at a later date.
Finally, you may wish to explore options for accessing food in the event that they are unable to leave the house – online delivery services, the support of family, friends, or neighbours, or community schemes can be helpful.
If experiencing disruption to their usual daily routine, clients may not be consuming as much fluid as they normally would. Encourage consumption of at least 8 - 10 cups of fluid per day, and remind clients of strategies to assess their hydration status. This could include paying attention to their thirst levels, urine colour, and looking out for other symptoms of dehydration (i.e. reduced concentration and headaches).
If it’s safe to do so, clients should try to get some daily exercise. While attending the gym or workout classes is not recommended, there are alternative ways of exercising whilst practicing social distancing. You could suggest going for a run or taking a walk, doing a cardio or bodyweight workout in the garden if they have one, or following an online yoga or stretching video.
Ideally, we should encourage clients to get outdoors to ensure they are getting some daily sunlight exposure. This may not always be possible, and if sunlight exposure is limited, ensure that they are taking a daily 10mcg vitamin D supplement.
As well as promoting exercise, impress on clients the importance of also getting sufficient rest, as this will also contribute to their overall wellbeing.
As well as encouraging clients to take care of their physical health by following all advice issued by the Government and paying attention to their nutrition, hydration, and activity levels, it is vital to remind them of the importance of protecting their mental health.
The mental health charity Mind has produced some advice and information, including practical steps that clients may find useful if they are feeling anxious about coronavirus or isolated by social distancing measures. During consultations, check in with your clients to see how they are feeling, and signpost them to appropriate support if required.
Ask yourself if it is possible to deliver consultations remotely. There are multiple platforms available through which you can carry out online consultations, including Zoom, Skype, and Doxy.me. Telephone consultations are also an option for clients who do not have internet access or aren’t particularly tech-savvy.
Remember that you can use an online scheduling platform such as Nutrium to allow clients to schedule virtual appointments with you.
The Nutrium mobile app also allows you to deliver all of your nutritional recommendations to clients and enables you to follow-up to check on their progress. You could also set up a billing platform such as Halaxy to invoice clients and store your clients’ records securely. Ensure that any platforms which you use are compliant with your country’s data protection laws.
If face to face contact is unavoidable, you can take the follow steps to protect yourself and your clients:
- Ask all clients prior to the consultation if they are displaying any symptoms associated with COVID-19, and refuse to see any who are.
- Ensure you are practicing and modelling good hand hygiene in front of clients, encouraging them to do the same.
- Think about positioning consultation room furniture in order to ensure a distance of at least 1.5 metres between you and the patient.
- Open doors for clients to minimise the number of surfaces they come into contact with.
The guidelines relating to COVID-19 are constantly evolving. Be sure to keep up-to-date with the latest advice from your country’s government and public health bodies, and reinforce the healthcare messages being given to your clients.