scholarly journals Improving the dietary intake of frail older people

2011 ◽  
Vol 70 (2) ◽  
pp. 263-267 ◽  
Author(s):  
W. S. Leslie
Keyword(s):  
Nutritional Status ◽  
Older People ◽  
Nutrition Knowledge ◽  
Screening Tools ◽  
Care Staff ◽  
Community Settings ◽  
Frail Older People ◽  
Population Subgroup ◽  
Poor Nutritional Status ◽  
And Training

As a population subgroup, older people are more vulnerable to malnutrition especially those who are institutionalised. Recognition of deteriorating or poor nutritional status is key in reversing the effects of undernutrition and reinforces the value of regular weight checks and/or the use of screening tools. Commercially produced supplements are often the first option used to address undernutrition in both acute and community settings. They can be expensive and, although regularly prescribed, have undergone only limited evaluation of their effectiveness in community settings. An alternative but less researched approach to improve the nutritional status of undernourished people is food fortification. This approach may be particularly useful for older people, given their often small appetites. The ability to eat independently has been significantly related to decreased risk of undernutrition. Assisting people who have difficulty feeding themselves independently should become a designated duty and may be crucial in optimising nutritional status. Lack of nutrition knowledge has been identified as the greatest barrier to the provision of good nutritional care. Education and training of care staff are pivotal for the success of any intervention to address undernutrition. The development of undernutrition is a multi-factorial process and a package of approaches may be required to prevent or treat undernutrition. Nutrition must be at the forefront of care if national care standards are to be met.

457 NUTRITION, SARCOPENIA AND FRAILTY

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii14-ii18
Author(s):  
W Du
Keyword(s):  
Nutritional Status ◽  
Older People ◽  
Significant Risk ◽  
Nutritional Intake ◽  
Frail Older People ◽  
Language Therapy ◽  
Frailty Status ◽  
Swallowing Problems ◽  
Prolonged Hospital ◽  
Poor Nutrition

Abstract   Many older people admitted to hospital are malnourished/at risk of malnourishment (30%), have swallowing problems (55%), are frail (25%), have sarcopenia (50%) or a combination of these. On admission to hospital frail older people are at significant risk of worsening nutritional status and prolonged hospital stay. Nutritional status should be identified, documented, food intake monitored and where appropriate they should be referred to the dietitian. The question remains, do staff recognise that frail older people may not eat their food increasing their risk of poor nutrition and outcome. Methods Older people admitted to a ‘Frailty’ Ward were directly observed during lunchtime by WD. The Minimal Eating Observation Form –Version II (MEOF-II) was used to document how much they ate. Frailty status (CFS), presence of Sarcopenia (Sarc-F) and whether a referral to dietetics or speech and language therapy (SLT) was completed. Results 39 patients were observed. Mean age was 82.38 years; median CFS 6 (3–8); median Sarc-F 4(0–9). Median MEOF II was 0 (0–5). Two patients were referred to dietetics and 4 to SLT. 7/40 (17,5%) were at high risk for undernutrition, a further 8/40(20%) were at moderate risk. 82% were severely frail, the remaining were mildly frail. 94% (16/17) exhibited sarcopenia. There was significant correlation between MEOF II and CFS (r = 0.4887, p = 0.00162); MEOFII and Sarc-F (r = 0.4395, p = 0.00512). There was correlation between CFS and Sarc-F (r = 0.80296, p < 0.00001). Only one (6%) was referred to the dietitian. Conclusion Frail older adults are often undernourished on admission to hospital. Nutritional intake is often poor with acute illness. Screening, observation and monitoring of nutritional intake should highlight concerns and needs for intervention. These study high lights that a significant number of older people are frail, fail to complete meals, are at significant risk of under nutrition, yet proactive intervention does not occur.

Eating strategies – a qualitative study of how frail, home-dwelling older people in Denmark develop strategies to form meaningful eating situations

2017 ◽  
Vol 39 (3) ◽  
pp. 590-608 ◽  
Author(s):  
TENNA JENSEN ◽  
LIV GRØNNOW ◽  
ASTRID PERNILLE JESPERSEN
Keyword(s):  
Nutritional Status ◽  
Older People ◽  
Participant Observation ◽  
Public Institutions ◽  
Frail Older People ◽  
Structured Interviews ◽  
Public Care ◽  
Older Men And Women ◽  
Insight Into

ABSTRACTThis article analyses the strategies that frail, home-dwelling older people who receive food from public institutions develop and use during eating situations, to gain an insight into how older people mobilise resources in relation to eating. The analysis is based on semi-structured interviews and participant observation sessions with 25 home-dwelling frail older men and women, aged 72–101, who live in Copenhagen and receive food from the municipality. Like healthier older people, frail older Danes develop and use strategies to create acceptable eating situations. The strategies are linked to the arrangement of the eating situation, their former lives and experience with food and eating, and their perception of their own body. The focus on strategies enables insights into how frail older people manage to mobilise resources to create meaningful eating situations. However, even though they mobilise resources to create and maintain eating strategies, these are not all equally appropriate with regards to supporting a healthy nutritional status. The eating strategies used by frail older people and the resources they entail are key to their experience with eating. Focusing on these strategies is useful when developing public care initiatives as this will precipitate an awareness of the resources of this group and how these are activated and contribute to or detract from a healthy nutritional status and a high quality of life.

Oral care help to maintain nutritional status in frail older people

2010 ◽  
Vol 51 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Yasunori Sumi ◽  
Nobuyoshi Ozawa ◽  
Hiroko Miura ◽  
Yukihiro Michiwaki ◽  
Osami Umemura
Keyword(s):  
Nutritional Status ◽  
Older People ◽  
Oral Care ◽  
Frail Older People

scholarly journals Case management for integrated care of frail older people in community settings

2018 ◽  
Author(s):  
Euan Sadler ◽  
Zarnie Khadjesari ◽  
Alexandra Ziemann ◽  
Katie Sheehan ◽  
Julie Whitney ◽  
...  
Keyword(s):  
Case Management ◽  
Older People ◽  
Integrated Care ◽  
Community Settings ◽  
Frail Older People

scholarly journals Developing a model of short-term integrated palliative and supportive care for frail older people in community settings: perspectives of older people, carers and other key stakeholders

2016 ◽  
Vol 45 (6) ◽  
pp. 863-873 ◽  
Author(s):  
Anna E. Bone ◽  
Myfanwy Morgan ◽  
Matthew Maddocks ◽  
Katherine E. Sleeman ◽  
Juliet Wright ◽  
...  
Keyword(s):  
Older People ◽  
Supportive Care ◽  
Community Settings ◽  
Frail Older People ◽  
Short Term ◽  
Key Stakeholders

scholarly journals Predicting Malnutrition Risk with Data from Routinely Measured Clinical Biochemical Diagnostic Tests in Free-Living Older Populations

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1883
Author(s):  
Saskia P. M. Truijen ◽  
Richard P. G. Hayhoe ◽  
Lee Hooper ◽  
Inez Schoenmakers ◽  
Alastair Forbes ◽  
...  
Keyword(s):  
Early Detection ◽  
Nutritional Status ◽  
Diagnostic Test ◽  
Test Data ◽  
Diagnostic Tests ◽  
Micronutrient Deficiency ◽  
Screening Tools ◽  
Free Living ◽  
Poor Nutritional Status ◽  
Older Populations

Malnutrition (undernutrition) in older adults is often not diagnosed before its adverse consequences have occurred, despite the existence of established screening tools. As a potential method of early detection, we examined whether readily available and routinely measured clinical biochemical diagnostic test data could predict poor nutritional status. We combined 2008–2017 data of 1518 free-living individuals ≥50 years from the United Kingdom National Diet and Nutrition Survey (NDNS) and used logistic regression to determine associations between routine biochemical diagnostic test data, micronutrient deficiency biomarkers, and established malnutrition indicators (components of screening tools) in a three-step validation process. A prediction model was created to determine how effectively routine biochemical diagnostic tests and established malnutrition indicators predicted poor nutritional status (defined by ≥1 micronutrient deficiency in blood of vitamins B6, B12 and C; selenium; or zinc). Significant predictors of poor nutritional status were low concentrations of total cholesterol, haemoglobin, HbA1c, ferritin and vitamin D status, and high concentrations of C-reactive protein; except for HbA1c, these were also associated with established malnutrition indicators. Additional validation was provided by the significant association of established malnutrition indicators (low protein, fruit/vegetable and fluid intake) with biochemically defined poor nutritional status. The prediction model (including biochemical tests, established malnutrition indicators and covariates) showed an AUC of 0.79 (95% CI: 0.76–0.81), sensitivity of 66.0% and specificity of 78.1%. Clinical routine biochemical diagnostic test data have the potential to facilitate early detection of malnutrition risk in free-living older populations. However, further validation in different settings and against established malnutrition screening tools is warranted.

scholarly journals Inter-Relationships between Frailty, Sarcopenia, Undernutrition and Dysphagia in Older People Who Are Admitted to Acute Frailty and Medical Wards: Is There an Older Adult Quartet?

Geriatrics ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. 41
Author(s):  
David Smithard ◽  
Dharinee Hansjee ◽  
Darrien Henry ◽  
Laura Mitchell ◽  
Arjun Sabaharwal ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Older People ◽  
Older Adult ◽  
Screening Tools ◽  
Morbidity And Mortality ◽  
Nutritional Risk ◽  
Convenience Sample ◽  
The Mean ◽  
Medical Wards ◽  
Frailty Score

Introduction: With increasing age the prevalence of frailty, sarcopenia, undernutrition and dysphagia increases. These are all independent markers of outcome. This study explores the prevalence of these four and explores relationships between them. Methods: A convenience sample of 122 patients admitted to acute medical and frailty wards were recruited. Each was assessed using appropriate screening tools; Clinical Frailty Score (CFS) for frailty, SARC-F for sarcopenia, Nutritional Risk Tool (NRT) for nutritional status and 4QT for dysphagia. Results: The mean age of the participants was 80.53 years (65–99 years), and 50.37% (68) were female. Overall, 111 of the 122 (91.0%) reported the presence of at least one of the quartet. The median CFS was 5 (1–9), with 84 patients (68.9%) having a score of ≥5 (moderate or severely frail); The median SARC-F was 5 (0–10), with 64 patients (52.5%) having a score of ≥5; The median NRT was 0 (0–8) and 33 patients (27.0%) scored ≥ 1. A total of 77 patients (63.1%) reported no difficulty with swallowing/dysphagia (4QT ≥ 1) and 29 (23.7%) had only one factor. Sixteen patients (13.1%) had all four. There was a significant correlation between nutritional status and dysphagia, but not with frailty or sarcopenia. There were significant correlations between frailty and both sarcopenia and dysphagia. Conclusions: In our sample of acute medical and frailty ward patients, there was a much higher prevalence than expected (91%) of either: frailty, sarcopenia, undernutrition or dysphagia. The prevalence of all four was present in 13% of patients. We suggest that frailty, sarcopenia, nutritional risk and dysphagia comprise an “Older Adult Quartet”. Further study is required to investigate the effect of the “Older Adult Quartet” on morbidity and mortality.

scholarly journals Quality of care for frail older adults

2018 ◽  
Vol 30 (9) ◽  
pp. 1255-1257
Author(s):  
Kirsten Moore
Keyword(s):  
Older People ◽  
Quality Care ◽  
Well Being ◽  
Home Care Services ◽  
Nursing Home Care ◽  
Care Staff ◽  
Frail Older People ◽  
Care Services ◽  
Home Based ◽  
Societal Changes

Our successes in improving life expectancy has led to increased years of life lived with multimorbidity and dementia with increased support needs. Much of the support given to frail older people is provided by family and informal support networks with significant impact on their physical, psychological, and financial well-being. Demographic and societal changes are reducing the capacity of family to offer this care. Formal home-based, center-based, and long-term/residential/nursing home care services are predominately provided by untrained care staff working under supervision from nursing staff. Difficulties recruiting and retaining these staff is leading to major challenges to meeting the needs of older people (Chenoweth et al., 2010). This volume contains a number of studies focusing on ways to improve care provided by these services for frail older people. The approach underpinning these papers and many perspectives of good quality care for older people is the need to be person-centered where the older person identifies their own goals for care and assessment of need, employing a holistic and strength-based approach incorporating their interests, values, and capacities (Vernooij-Dassen and Moniz-Cook, 2016).

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