By Shantika Bhat, VG Intern

Shantika Bhat is interested in neurological diseases and how to care for patients. She interviewed Cathy Conway, a registered dietitian who works with patients who have developmental and intellectual disabilities. 

Playing the role

Something that always comes up in the medical field is that fear of preconceived notions of a doctor’s role. Some patients will be scared that the doctor will be telling them what to do or that the doctor doesn’t want to listen to them. Oftentimes it’s not talked about how intimating a title can be for patients and so Cathy wants to break down those feelings by playing her role in a manner that’s focused on active listening.

“It is really important to respect an individual and hear what they are saying,” says Conway.

As a registered dietitian she gets patients all the time who will believe that she will be telling them what to eat and what not to do, however, she doesn’t. She listens and asks them “What do you think?”

“I call it peeling an onion. You want to get to the real issue by asking the questions and repeating what my patients tell me.” For example, Conway had a patient who had Type 2 Diabetes and their A1C was high. Conway asked the patient questions and made the patient realize what they were doing that wasn’t healthy without directly saying it. I learned from Conway that making your patients realize what they did wrong is more effective than telling them what they did wrong. At the end of the day it’s the patients who make the decision so you have to make sure they realize what they need to fix.

Working with Intellectual and Developmental patients: Patient-Centered Care

I thought when working with patients who have intellectual disability that health professionals would need extra training. My perception has changed a little bit after talking with Conway. I went into this thinking that there must be extra training for many disabilities; however, Conway says she learned the most from experience over time. I knew that with a spectrum of all of these disabilities that a training will not be enough for you to be able to provide the best care for them. It is all case by case which is why Conway treats her patients using Patient Centered Care. The Institute of Medicine’s article Crossing the Quality Chasm: A New Health System for the 21st Century defines patient–centered care as “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.”

“You can’t put everyone in a box,” says Conway.

Active listening is so important because it helps to really connect to the patient so that the dietitian or doctor can help them best. Active Listening is a technique used to connect and engage the speaker and listen in conversations. Conway recommends that everyone going into the healthcare field learn Patient-Centered care and active listening.

 Diets

Conway advocates for diversity and trying something new. In New York they passed Bill S1471A/A4072, which requires hospitals to make plant-based meals and snacks containing no animal products or by-products that are nutritionally equivalent to other menu items available to those that request them. The bill also requires hospitals to list the plant-based options on all written materials and menus. One of Conway’s patients was in the hospital for a week and got to try the menu with these foods he wouldn’t have tried elsewhere. And now this patient orders plant-based foods such as quinoa on a regular basis on his outings.

“You should try different foods so that new foods can be added to your regular diet. The more exposure the better,” said Conway

For information that may be helpful to food services, see: https://www.vrg.org/fsupdate/index.htm