From the time I began my undergraduate degree in nutrition, I had a clear goal in mind to become a clinical dietitian in a hospital. I was determined to pursue my dietetic internship placement in this setting to acquire the essential skills needed for a future career as a hospital dietitian.

Upon finding out that I had been placed in a long-term care home for my clinical internship, I was discouraged and felt that I would not be gaining the clinical skills required to achieve my goal. Nutrition in the end stages of life was not a particular interest of mine, and I was unclear about the role of a dietitian in a long-term care home.

Within the first few weeks of my placement, my mindset completely shifted. I quickly realised just how essential dietitians are in this setting and the massive impact they have on residents’ lives. Simultaneously, I began to realise just how rewarding it can be to work with a patient population whose time on earth is limited and how privileged I was to be able to positively impact others during such a cherished period of life.

As I came to learn, nutrition plays a unique role in the lives of older individuals. After a lifetime of eating and drinking, this population has memories, emotions, and a sense of comfort attached to foods and beverages. (2) With a deeper meaning behind nourishment, older generations require nutritional care that is personalised, culturally sensitive and considerate of their unique life experiences. (3) Dietitians in this setting not only provide expertise in dietary management but also help to create a supportive environment that honours choice and dignity. (4)

For this reason, the goal of nutrition in long-term care looks a little different than it does in other clinical settings. Residents in long-term care typically do not return to their previous homes and often live with health conditions that are either incurable or are inappropriate to treat in the end stages of life. Thus, a balance must be maintained between medical nutrition interventions that slow decline and preserving quality of life through the enjoyment of food and beverages. (2)

Naturally, achieving this balance presents many unique challenges, requiring dietitians to continuously apply problem-solving skills, adhere to principles of best practice and collaborate with other members of the multidisciplinary team. Throughout my time working alongside the care home’s dietitian, I was able to help navigate many challenging situations that arose.

We encountered residents struggling with low appetite and weight maintenance, resistance towards texture-modified diets and fluids, and the need to address the diverse dietary requirements of each individual. Every new obstacle provided me with insight into different approaches that could be used and enhanced my ability to adapt in difficult situations.

While my role as a dietetic intern constantly challenged me, it also offered countless rewarding moments where I felt that I was making a positive difference. Some of the moments where I truly felt my impact included optimising a resident’s enteral feeding regiment to promote weight gain, designing a customised menu to accommodate a resident’s unique food preferences, and regulating a resident’s bowel function after many weeks of challenges.

Even something as simple as ordering a resident’s favourite food item or providing an assistive device to allow for independent eating was incredibly rewarding, knowing how much of a difference these changes were making in their lives. No matter how big or small my contribution, residents were grateful for my time and energy spent trying to improve their health status and their overall experience in long-term care. In turn, this fuelled my motivation to continue to make a meaningful impact through food and nutrition.

After many months as a dietetic intern, I left my placement with a new outlook on nutrition in long-term care and a new career goal. I realised how fulfilled, challenged and driven my work made me feel, and how eager I was to continue making a positive impact in this setting.

This experience exposed me to an unfamiliar area of dietetics and broadened my perspective on the diverse career opportunities available to dietitians. I learned to remain flexible with my goals and to stay open to new opportunities, as you never know what direction this could lead you.

I would encourage current or prospective dietetic interns to remain open to experiences that may initially seem outside of their original plans and to embrace new challenges that push them out of their comfort zone. From my experience so far, discovering your unique area of interest in dietetics is not always a straightforward journey, but the rewards are well worth the effort.