Eight years of nutrition intervention for a young person with an acquired brain injury

Abstract

AbstractThis case is about a 38‐year‐old man with an acquired brain injury (ABI). It is a qualitative analysis of eight years of nutrition intervention by a private dietetic practitioner in a nursing home setting. For the eight years of nutrition intervention, enteral formula met all his nutrition requirements. Optimal goal weight was reached and stable eight years after the initial injury. In the early postacute period, energy requirements were 16 MJ/day for a goal weight of 70 kg. Today, energy requirements are less than 7 MJ/day to maintain weight at or below 80 kg. Over the eight years, the dietitian reviewed the client 40 times and adjusted the regimen 12 times. Each review was one hour long; monthly reviews for the first four years, then bimonthly. Weight was the main clinical outcome directing nutrition decisions. No gross nutrient deficiencies were incurred. No pressure sores developed. Reflux resolved with changes to medication, enteral formula and regimen. One episode of aspiration pneumonia was recorded. Based on this case study, we recommend nutrition planning for postacute care include a two‐hour initial assessment, then one‐hour monthly review for the first 12–24 months. Weight should be recorded monthly, and routine biochemistry bimonthly with six‐monthly nutrition‐specific measures of trace elements, micronutrients, blood glucose, serum lipids, iron studies and protein markers. Long‐term nutrition intervention for ABI is a mostly unexplored, challenging and growing area of dietetics. This case study provides preliminary information for developing long‐term enteral nutrition services to people with an ABI.