Additional materials were added to the gastrointestinal (GI) section including the addition of the FODMAP diet and Ostomy guidelines. Other additions include Neutropenic precautions, 2015-2020 USDA dietary guidelines and updates to the diabetes section to include injectables and glycemic crisis.

This manual is a culmination of research and the expertise of medical professionals brought together in a useful diet manual for extended care facilities such as nursing homes, assisted living facilities, and rest homes. The guidelines for diet modifications provided in this manual are based on the needs of the older population and are supported by the latest in nutrition research. All information in this manual has been researched and is supported by current reference material on nutrition and diet therapy.

In addition, this manual provides guidelines for culture change dining program supportive of the national movement to create a more home-like environment for residents living in extended care facilities. Feeding the extended care resident presents with special considerations including risk of malnutrition, age-related diseases and polypharmacy. It is the belief of Dietitians of New England (DONE) that diet remains an important tool in maintaining nutritional status while preventing diet-related exacerbation of chronic disease such as congestive heart failure, hypertension, and hyperglycemia. It is also important that the dining atmosphere is conducive to eating with soft pleasant music and encouraged socialization. For this reason we have created a “healthier” house diet using the 2015-2020 Healthy American Guidelines, as well as guidelines to create a more home-like dining program. By providing a healthy house diet, we able to reduced the number of therapeutic diets necessary for extended care residents. The goals are to maximize the number of residents offered the House menu and have a warm inviting dining program.