Ruth, 82 years old, was placed in a nursing home due to her family's inability to meet her increasing health care needs in the late stages of Alzheimer's disease

Ruth, 82 years old, was placed in a nursing home due to her family's inability to meet her increasing health care needs in the late stages of Alzheimer's disease. This was a very difficult decision for the family, especially for her husband, 85-year-old Dale. Ruth had been on a diet for diabetes at home, but now is refusing almost all meals and fluids. Her family has been asked to decide on their plan for provision of tube feeding and IV fluids should this become necessary. In the meantime, the dietary department is doing their best to offer foods to Ruth that she used to like, within the guidelines of a diet for diabetes. Ruth is completely unable to feed herself with utensils and she gets agitated when placed in the dining room with the other residents. She has been losing weight over the past two months since her admission. Dale is new to using warfarin medication to control blood clots. Listed below is Dale's 48-hour recall with his vitamin K levels indicated (data from the USDA nutrient data laboratory online).

Questions:

1. What is the therapeutic benefit of a diet (e.g., for diabetes) when an elderly person is in long-term care? 
2. Should Ruth be required to follow a diet for diabetes at this time? Will she be compliant?
3. What nutrition interventions might be helpful for Ruth at this time? 
4. Is Dale meeting his DRI for vitamin K on each day? 
5. What advice do you have for him regarding his vitamin K intake over these two days?