By: Lexi Dakin
Starting out as a new-grad dietitian working independently in long-term care can be intimidating and overwhelming at first. You feel this pressure to follow the guidelines exactly as written since they’re backed by evidence, it feels safe and that’s what we’re taught to do. During school you’re focused on retaining as much information as you can and learning everything there is to know about being a dietitian. Every textbook you memorize, every exam you write and every assignment you complete, it becomes easy to lose sight of one of the most important lessons you’ll learn in this profession: people are not textbooks.
As students, we learn the foundations of dietetic practice; how to identify nutrition problems, prioritize goals, implement interventions, monitor progress and so on. When I first started working as a dietitian in long-term care, I wanted to follow everything I learned in school step by step, especially when faced with one of the most common issues in LTC: malnutrition. Automatically, I would want to assess their level of malnutrition, identify the nutrition problem and create the “perfect” nutrition plan. Deviating from what you’re taught or from what feels like the “best” clinical answer can feel risky, almost like you’re doing something wrong. But I quickly learned that the most meaningful progress often happened when I put down my pen and paper and simply listened.
Sometimes treating malnutrition doesn’t always look like the standard interventions such as high-protein/high-energy foods. Sometimes it’s about what the resident is missing and what they truly need. A homemade meal. A childhood favourite snack. Or even something as simple as a cookie for breakfast if that’s what they were used to their whole life because it brings them comfort, joy, and a sense of normalcy. A nutrition plan can be clinically perfect on paper, but if a resident doesn’t want to follow it, it can be practically useless. Honouring food preferences, traditions, and routines doesn’t just support physical health but it supports emotional well-being, which is just as important. By allowing residents to continue their traditions, we’re prioritising intake, comfort and autonomy.
Imagine moving into an unfamiliar place, surrounded by unfamiliar people, expected to adapt to a new routine every day. One of the few comforts you might rely on is food you love that brings back memories and makes you feel more at home. In LTC, residents are often trying new foods and eating alongside people they don’t know. So, it’s our job as healthcare professionals support residents by offering a dining experience that feels comforting, safe, and enjoyable.
The skills and education we learn in school are still very important. They provide the foundation of our practice and essential knowledge. But they don’t capture feelings, beliefs, values, or the deep personal meaning food holds. They don’t capture the individuality that nutrition care requires.
Being a dietitian has empowered me not only to use my clinical skills, but also to connect with people on a deeper level and meet them where they are. One of my favourite parts of this profession is learning about people’s food habits, how everyone eats differently, how food ties into culture, tradition, and identity. Applying our knowledge in real life means recognizing that we’re working with real people, with real emotions, memories, values, and lived experiences. Residents are not case studies, and they don’t always need a textbook answer. They need someone who listens, cares, and wants to help improve their lives.
As dietitians, we’re trained to know what we should do based on guidelines, clinical tools, and best practices. Those tools are essential for assessment, documentation, and safety. But our role isn’t to replace decision-making, it’s to support it.
I’m not saying we should abandon clinical judgment or give residents whatever they ask for at all times. Rather, it’s about listening to what they’re missing, understanding what they’re willing to do, and using our expertise to guide them toward choices that are realistic, meaningful, and beneficial in the long run.