Goals should be measurable, attainable, specific, and client-centered. How do you
measure success against a vague goal of “gain weight by eating better”? Is “eating
better” achieved by adding butter to foods to increase calories or by substituting 1%
milk for whole milk because it is heart-healthy? Is a 1-pound weight gain in 1 monthacceptable or is 1 pound/week preferable? Is 1 pound/week attainable if the client has
accelerated metabolism and catabolism caused by third-degree burns?
Client-centered goals place the focus on the client not the health care provider; they
specify where the client is heading. Whenever possible, give the client the opportunity
to actively participate in goal setting, even if the client’s perception of need differs from
yours. In matters that do not involve life or death, it is best to first address the client’s
concerns. Your primary consideration may be the patient’s significant weight loss during
the last 6 months of chemotherapy; the patient’s major concern may be fatigue. The
two issues are undoubtedly related but your effectiveness as a change agent is greater if
you approach the problem from the client’s perspective. Commitment to achieving the
goal is greatly increased when the client “owns” the goal.
Keep in mind that the goal for all clients is to maintain or restore optimal nutritional
status using foods they like and tolerate as appropriate. If possible, additional
short-term goals may be to alleviate symptoms or side effects of disease or treatments
and to prevent complications or recurrences if appropriate. After short-term goals are
met, attention can center on promoting healthy eating to reduce the risk of chronic
diet-related diseases such as obesity, diabetes, hypertension, and atherosclerosis.