In order to determine whether more efficient diabetic management could be achieved by focused application of resources in a Hospital Based Home Care (HBHCJ program, a nonrandomized prospective intervention was made during 1995-1996 in the HBHC program of the New Orleans VA Medical Center. Greater flexibility in application of personnel resources appears to increase the benefits of the nutritional interventions. Even with focused interventions, it appeared that lack of compliance was often a barrier to improved diabetic control. Obstacles to improved diabetic management in this HBHC setting often were due not to lack of objective knowledge, but to patient and caregiver difficulties in accepting life-style changes. Nutritional intervention was particularly useful in improving patient skills at grocery shopping, and appears a useful strategy to motivate smoking cessation.
1. Stuck AE, Aronow HU, Steiner A, et al.A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. N Engl J Med.1995;333:1,184-1,189.
2.
2. Reuben DB, Greendale GA, Harrison GG. Nutrition screening in older persons. Journal of the American Geriatrics Society. 1995;43:415-425.
3.
3. Mazzoni C, Chylak N. Developing a standard of care for patients at risk for long-term hospitalization. J Am Diet Assoc.1994;95:1,415-1,418.
4.
4. Morley JE, Silver AJ. Nutritional issues in nursing home care. Ann Intern Med.1995;123:850-859.
5.
5. Gloth FM, Gunberg CM, Hollis BW, Haddad JG, Tobin JD. Vitamin D deficiency in homebound elderly persons. JAMA. 1995;274:1,683-1,686.
6.
6. Clark CM, Lee DA. Prevention and treatment of the complications of diabetes mellitus. N Engl J Med.1995;322:1,210-1,217.
7.
7. Ammerman AS, DeVellis BM, Haines PS, et al.Nutrition education for cardiovascular disease prevention among low income populations-description and pilot evaluation of a physician-based model. Patient Education and Counseling. 1992;19:5-18.
8.
8. Torkelson NS, Bazeley MA, Patterson SM. A diabetes cooking event. The Diabetes Educator. 1982;39-42.
9.
9. Dollahite J, Thompson C, McNew R. Patterns of food choices among Arkansans with less than a high school education. J of the Arkansas Medical Society. 1994;91:274-278.
10.
10. Moore SA. Educating the family and the patient about nutrition. Primary Care. 1994;21:69-83.
11.
11. Rifas E, Morris R, Grady R. Innovative approach to patient education. Nursing Outlook. 1984;42:214-216.
12.
12. Lindseth G. Nutrition preparation and the geriatric nurse. Western Journal of Nursing Research. 1994; 16:692-703.
13.
13. Melkus GD, Fain JA. Diabetes care concentration: A program of study for advanced practice nurses. Clinical Nurse Specialist. 1995;9:313-316.
14.
14. McDougall S. The effect of nutritional education on the shopping and eating habits of a small group of chronic schizophrenic patients living in the community. British J of Occupational Therapy. 1992;55:62-68.
15.
15. Jones-Nichols P. Cooking program promotes dignity through socialization, therapy. Provider. 1992;18:44.
16.
16. Cumming J, Jones A, Cumming M, Llewellyn G. It is possible: a process for teaching community living skills. The Australian Occupational Therapy Journal. 1992;39:35-38.
17.
17. Fernie GR, Griggs GT, Holliday PJ, Topper A. Increasing the accessibility of a conventional cooking range for wheelchair users. The American Journal of Occupational Therapy. 1994;48:463-466.
18.
18. Spooner B, Rudge G. Tasteful pictures. Nursing Times. 1993;89:34-36.
19.
19. Baum C, Edwards DF. Cognitive performance in senile dementia of the Alzheimer's type: The kitchen task assessment. The American Journal of Occupational Therapy. 1993;47:431-436.
20.
20. Gans KM, Levin S, Lasater TM, et al.Heart healthy cook-offs in home economics classes: An evaluation with junior high school students. Journal of School Health. 1990;60:99-102.
21.
21. Ling P, Green J. Something's cooking. Dietary Teaching. 1983;156:38-39.
22.
22. Arsenau DL, Mason AC, Wood OB, et al.A comparison of learning activity packages and classroom instruction for diet management of patients with non-insulin-dependent diabetes mellitus. The Diabetes Educator. 1994;20:509-514.
23.
23. Kupka-Schutt L, Mitchell ME. Positive effect of a nutritional instruction model on the dietary behavior of a selected group of elderly. Journal of Nutrition for the Elderly. 1992; 12:29-53.
24.
24. Sorensen G, Morris DM, Hunt MK, et al.Work-site nutritional intervention and employees' dietary habits: The Treadwell program. Am J Public Health. 1992;82:877-880.
25.
25. Lynde BD. Nutrition promotion for mature adults: A case study in peer education. Journal of Nutrition for the Elderly. 1992; 11:19-31.
26.
26. Pedersen AL, Lowry KR. A regional diabetes nutrition education program: Its effect on knowledge and eating behavior. The Diabetes Educator. 1992;18:416-419.
27.
27. Kristeller JL, Merriam PA, Ockene K, et al.Smoking intervention for cardiac patients: In search of more effective strategies. Cardiology. 1993;82:317-324.
28.
28. Orleans CT, Jepson C, Resch N. Rimer BK. Quitting motives and barriers among older smokers: The 1986 adult use of tobacco survey revisited. Cancer. 1994;74(7 Suppl):2,055-2,061.
29.
29. Stevens VJ, Severson H, Lichtenstein E, et al.Making the most of a teachable moment: A smokeless-tobacco cessation intervention in the dentist's office. Am J Public Health. 1995;85:231-235.
