Our services

Nutrition and Dietetics - Specialty areas - Stroke and neurological conditions

Overview

Neurological conditions are conditions of the central and peripheral nervous system. Stroke is a type of neurological condition in which blood supply to part of the brain is cut off, causing cells to become damaged. This damage can affect how the body works including movement, communication, swallow and how much we are able to eat.

There are more than 600 other neurologic diseases. Major types include Huntington's disease and muscular dystrophy, spina bifida, Degenerative diseases where nerve cells are damaged or die, such as Parkinson's disease and Alzheimer's disease, injuries to the spinal cord and brain, seizure disorders, such as epilepsy, infections, such as meningitis.

This Trust has a National Spinal Injuries Centre (NSIC) located at Stoke Mandeville Hospital. For more information please follow this link.

Services provided

Patients with neurological conditions may be seen by dietitians in various settings including inpatient wards (depending on reason for admission) and in community settings.

The Specialist Stroke Unit is based at Wycombe Hospital. This unit includes a hyper acute stroke unit and a rehabilitation ward.

Nutritional support

Malnutrition and dehydration are common after stroke and are associated with a slower rate of recovery.

All patients known to be at high risk of malnutrition should be referred to the Dietitian. The Dietitian will look at the best way to support nutrition including menu planning, snacks and other food items, and nutritional supplements as required see managing malnutrition section for more information.

Swallowing difficulties

Many patients experience swallowing difficulties after stroke. They may be recommended to have altered texture diets by the Speech and Language Therapists, e.g. soft or puree meals, thickened drinks etc. The Dietitians work closely with the Speech and Language Therapists to support patients to meet their nutrition needs on such dietary recommendations.

Artificial feeding

Patients who are unable to meet their nutrition needs due to swallowing difficulties may be considered for tube feeding, either for short term or long-term management. The Dietitian works closely with the Trust Nutrition Nurse Specialist who will advise on the best route of nutrition for these patients see managing malnutrition section.

Rehabilitation

The Dietitian may support patients in the rehabilitation phase to focus on healthy eating and weight management or maintaining a healthy weight. This may include menu planning, cooking tips, and recipe ideas to support achieving a healthy lifestyle to reduce the risk of strokes in the future.

Ongoing support

Some patients who require further input from the dietetic team after they are discharged from hospital may be followed up by Community Dietitians in a clinic setting, in their own homes, or in Community Hospital or Care home/Nursing home settings.

Referral information

When a patient is admitted with a stroke, the nursing staff will refer them to the Dietitian if they are at risk of malnutrition or if there is another specific reason that they need to be seen.

If a patient requires ongoing support after discharge this maybe through hospital clinics of Community Dietitians using the appropriate referral form, see contact us page.

Research and audit (summary of projects and outcomes)

The Stroke Specialist Unit at Wycombe Hospital is involved in the Royal College of Physicians SSNAP audit which is used as a national performance measure on the service we provide our stroke patients. The unit is currently in the top 7% of stroke services in England, Wales and Northern Ireland. The team work hard to assess the performance of various aspects of our service throughout the therapies, nursing and medical care. The Dietitians work hard to make sure all patients are screened for malnutrition and the correct nutrition care pathways are in place.