Practical Guidance to Help Identify and Combat Malnutrition in Frail Older People

10 May 2013

Prof Paul Knight is President of the BGS and is Director of Medical Education and Consultant Physician at the Royal Infirmary, Glasgow. The issue of malnutrition has been brought into sharp focus by the Francis report, where harrowing witness accounts highlighted how patients suffer when patient nutrition and assistance with feeding is not given adequate priority.  However, as geriatricians, we have long recognised the importance that adequate intake of food and fluid plays in gold-standard patient care. Over the last 18 months or so I have been involved with the Malnutrition Task Force (MTF).  This is a multidisciplinary group hosted by AGE UK and involving participants from across health and social care, including staff involved in hospital and care home catering. Malnutrition is a well recognised issue in older people, particularly the oldest and the most frail, and especially those who are admitted acutely to hospitals or who reside in care homes. It is thought that poor nutrition and hydration prolong hospital stay and contribute to worsening frailty. Many organisations have drawn attention to the problems of poor nutrition over a number of years. The MTF set out not to duplicate this work but to provide practical assistance to care teams through the provision of case histories and tools for assessment and treatment.  Recognising that malnutrition often starts in the community, we have produced three guides covering the community, care homes and hospitals.  These contain important insights for the following groups:

  • health and social commissioners, who need to recognise that the malnourished do less well in terms of health and functional status over time. Health and social services incur unnecessary additional costs when the condition goes unrecognised and untreated.
  • both professional and informal carers, who need to recognise the important role they play in establishing and maintaining nutritional intake in frail older patients.
  • geriatricians, who need to be confident that they know how to assess, how to plan interventions along with their teams and how to monitor outcomes for patients who are malnourished

The guides can be downloaded here. The task force hopes that you might find them useful in addressing issues around poor nutrition and hydration and give you some practical hints to improve care. *The task force received unrestricted financial grants from commercial partners - apetito, Nutricia and also from WRVS and Age UK . Nutricia and apetito have been observers on the group but have not influenced the guide writing

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