What is the interdisciplinary role of dietitians, dieticians and nutritionists in geriatric residences? Where and when is it necessary to cross over from one's individual task to a team collaboration of a higher level? From the drafting of a cyclical departmental diet to the difficult choice of special menus, from the presence of diabetic guests to those with intolerances, from the control of compliance with the rules to the risk of contamination... These are just some of the ways that the figures of dietician, dietician and nutritionist travel in the Nursing Home, evaluating and intervening on nutrition, in the awareness of the characteristics of dementias and the respective behaviors that follow, as well as the involutive pathologies related to the neuro decay -motor of the elderly. What improperly, in the jargon, is called as "Rest home", is a source of request for the figure of dietitians, dieticians and nutritionists, who despite being essential, is facing extremely delicate situations, which require complex choices, risking the opposition and making it essential the interdisciplinary support of the team. The professional, too often perceived as "alone", or on the contrary overloaded with work, can rely on the trace that already belongs to his core competence, as support for a solid and irreproachable compensatory, habilitative and rehabilitative path, which pursues the objective of increase the patient's skills, resources and satisfaction to the utmost, sharing the ideal in the care team. This manual aims to provide an ideal perspective, starting from the problem that in the current decade represents the first cause of death of the institutionalized elderly, providing a structured path that starts from a correct food management towards the full awareness of the causes and the consequences of fasting. We start from a practical example: in the Nursing Home (in the jargon called "Retirement home") we find that a patient refuses the meal, understood as food, hydration and / or therapy; it seems that he does not want to take anything by mouth. The team takes charge of the case, discussing it: every professional figure finds that the patient has not changed on his performance, compared to before the event. In fact, the doctor guarantees that there is no pathological worsening, the nurse and the healthcare-worker guarantee that the evidence of health and care has not been aggravated, the psychologist that the mood is identical to himself, as well as the Physiotherapist for the motor skills, the speech therapist for those related to swallowing, and educator, rehabilitation technician and occupational therapist say that the life of the person in the department has not changed. It is clear that the ritual tasks of every element of the personnel, even if carried out with excellence, are insufficient to cope with this treatment. Thus continuing, the problem of malnutrition and dehydration quickly becomes vital and seemingly unsolvable. The need therefore becomes that of an interdisciplinary team (and not only multidisciplinary, a dimension described above) in which the professional dietician / dietician / nutritionist plays a crucial role. The importance of a method that investigates the causes of food refusal and offers rehabilitative pathways to accepting the meal, designed to intervene on fasting in a structured way, lies in the timeliness and clarity of the roles. Through this treatment, the professional will knowingly take part in the identification of the causes of rejection of the meal in the Nursing Home and not, through complete cataloging of the same with respective hypotheses of intervention to prevent, treat and rehabilitate malnutrition. The transversal task of the professional dietician / dietician / nutritionist now becomes, therefore, of great importance in the rehabilitation process, indispensable in its specific activities, in order to achieve the result.

Over the past thirty years, there have been dramatic changes in the treatment of eating disorders. With the realization that such disorders typically involve complex biophysical symptoms, the focus of client care has been on the use of the interdisciplinary teams and multifaceted treatment therapies. While the team approach holds high promise for improved treatment, its effectiveness requires that team members have a mutual understanding of the role of each professional within the team. This study assesses the level of understanding among other professionals of an interdisciplinary team, of the role of the dietician and the medical nutrition therapy she/he provides. Secondly, the study assesses the degree of improved knowledge achieved through a nutrition-focused workshop. A study group was selected, consisting of eight mental health care professionals, including therapists, counselors, and social workers. Participants' baseline knowledge was assessed through a pre-test and improvement was measured by a post-test administered after the workshop. Descriptive statistics were used to analyze the pre and post-test results. The overall mean increase in the individual test scores was twenty-nine percent. However, even though overall knowledge of the subjects was increased, the improvement was not uniform across the full range of topics. Questions relating to referral criteria and role significance showed the most improvement. Areas relating to the dietician's responsibilities and mode of treatment utilized showed a fairly positive improvement. But, in areas relating to referral, boundary issues, and duration of therapy, participants' scores only modestly increased. The overall results of this study suggest that a nutrition-based workshop provided to members of an interdisciplinary team can be an effective strategy for delivering quality care to individuals with eating disorders. Mixed performance of the participants in some critical areas suggest that more formalized nutrition education should be incorporated into the education and training of other professionals.