Improving Nutrition for Older Persons Project
Step 1: Screening
Screening is done to identify clients who are at risk of malnutrition.
Screening for malnutrition
Three simple questions about appetite and recent weight loss will be asked to rate clients’ risk of malnutrition.
Appetite
A loss of appetite might occur because of:
- episodes of nausea and vomiting
- chewing or swallowing difficulties
- side-effects of certain medications
- taste alterations
- a particular disease state
- stress, worry and/or anxiety.
Maintaining a normal level of food intake can be difficult in the presence of a loss of appetite.
Poor food intake over an extended period of time will result in poor nutrition.
Weight loss
Poor nutrition can lead to weight loss. When a client loses weight it is often a sign that vital body tissue such as muscle has decreased, as well as body fat.
A loss of muscle tissue can weaken the body as well as weaken the immune system. Such changes can make clients more susceptible to falls, infections and poor wound healing.
Step 2: Home visit by the D.A.H.T. nutritionist
Home visits by the D.A.H.T. nutritionist
It is important for clients experiencing difficulties with eating to obtain expert help. An improvement in a client's nutritional state will help to build strength. The risk of falls and ill health will be less likely and better wound healing should occur.
Clients identified as having malnutrition will be offered a home visit by the D.A.H.T. nutritionist.
Clinical assessment
The nutritionist will do a physical examination (of the face, shoulders, abdomen, back, arm and leg) to check for changes in muscle and fat. The purpose of this is to work out the level of malnutrition.
Malnutrition can be rated as mild, moderate or severe. A score (PG-SGA Score) will be given and this will be checked by the Nutritionist from time to time to measure improvements in the client's health & well being.
Nutritional guidance & education
The nutritionist will provide guidance to improve the nutritional quality of the diet. If necessary, nutritional supplements will be recommended. These may be in the form of home-made, high-energy drinks, additions to meals and/or specially purchased products.
Meal plans and shopping hints, along with other advice, will be provided. These details will be discussed with family and carers as appropriate.
Goals
The nutritionist and client will discuss goals and an action plan will be designed to help stop further weight loss.
One of the goals will be to measure an improvement in the clinical test result of malnutrition (the nutritionist's PG-SGA score).