The how and when to use liberalized diets can be tricky. Here’s a list of resources to come back to, whenever you’ve got questions.
What are liberalized diets?
Liberalized diets are ways to individualize a therapeutic diet when less restrictions are beneficial for your client.
Therapeutic diets are a key part of medical nutrition therapy. It is designed to support and improve specific medical conditions like kidney disease and diabetes. Because nutrition is all about individualization and customization. These therapeutic diets are also flexible enough to be liberalized as much or as little as each person needs.
Why is it important to liberalize therapeutic diets?
Limitations and restrictions are an inherent part of these types of diets. And at times this can be difficult or even counter productive to maintain despite an individual having certain diagnosis.
Therapeutic diets are key for health management, but there are times when a therapeutic diet or a more restrictive diet is not helping our patient successfully meet their nutritional needs.
Liberalized diets are common in long-term care and hospice settings, with older seniors and people with debilitating chronic conditions. Using liberalized diets as a way to improve their quality of life is a major reason to start one.
As a dietitian you might liberalize a therapeutic diet when the person in your care is:
- Has poor intake or are struggling to meeting their estimated nutritional needs
- Underweight or at high risk for malnutrition
- Improved quality of life
When we liberalize a diet, we’re looking at the individual and making an assessment about their ability to meet their estimated nutritional needs, healthfully manage their weight status and how necessary restrictions are based on their age and health conditions.
Liberalized Diets: Resources and Examples
There’s been a trend towards liberalizing diet orders in foodservice environments including hospitals and long-term care facilities. But you don’t have to be working in a facility like LTC to see the benefits of liberalized diets for your clients.
Keep reading for a list of places to find more information on how to and when to liberalize diets for different patients you’re caring for.
Older adults
Age can be a key factor when deciding whether or not to liberalize a diet for an older adult.
Assisting seniors in having adequate intake often means relaxing certain restrictions that may have limited access to their favorite foods. This might mean allowing them some potato chips on their low sodium diet. Or maybe enjoying a morning orange juice despite having diabetes and following a no concentrated sugar therapeutic diet plan.
Providing older adults liberalized diets can go a long way to helping them successfully meet their estimated nutritional needs.
Dysphagia
This is the only diet that has a hard and fast rule: NEVER liberalize this diet without a swallow evaluation first.
Because the only person who can upgrade a diet is a speech and language pathologist (the same person who can diagnose dysphagia), they are also the only one who can sign off on a liberalized dysphagia diet.
Even in the case of pleasure feeds for older adults, we have to be careful about those changes. Once a modified consistency diet has been added to a diet order, reach out to your speech and language pathologist for confirmation that a liberalized diet order is appropriate.
Cardiac diet
A cardiac diet is maybe the easiest therapeutic diet to liberalize.
As the name suggests, a cardiac diet is the go-to diet order for people with heart disease or heart failure. A liberalized cardiac diet typically goes from a low fat, low sodium diet order to a low sodium only diet. A change like this might happen when your client has a heart condition as well as concerns about low weight or poor intake.
Decide when to liberalize by starting to think about your patient’s weight status and their ability to meet their estimated nutritional needs.
Renal diet
Liberalized renal diets are less common, as kidney disease often requires a much tighter control of nutrients.
A renal diet plan are also the only therapeutic diet that has 2 parts: a diet without hemodialysis and a diet for hemodialysis. Though it’s uncommon to liberalize this diet, it doesn’t mean it doesn’t or shouldn’t happen. For each person with kidney concerns, the question often comes back to weight status, intake and an age appropriate decision around their diet needs.
Diet for type 2 diabetes
There’s a lot of room in a diabetic diet for liberalization.
Typically, the restrictions for a diabetic diet are decided based on a person’s blood sugar control. With increased glucose control comes a higher likelihood that a diet can, even in small amounts, be liberalized. The likelihood for a liberalized diabetic diet further increases as a person grows older and eating for pleasure begins to be prioritized over eating for controlled health.
Cancer
A therapeutic diet for cancer can be very layered and flexible, which means there’s a lot of room for liberalization.
It might be identified as a more variable neutropenic diet. It might also be a diet plan that encourages nutrient dense foods, and generally more of everything in order to help maintain weight status and support a person’s blood work. With concerns like anorexia, thrush and nausea limiting intake and raising the risk of significant weight loss, giving our client as many food options as possible is often key to successful treatment outcomes.
And That’s It!
Liberalizing a therapeutic diet doesn’t have to be tricky.
Bookmark this list and come back to it often, whenever you’ve got questions about easy the dietary restrictions for any of the people you’re caring for.
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