Food for thought

Physio staff are well placed to spot when older patients are malnourished, says Kate Bennett.

Obesity regularly hits the headlines but malnutrition in older people is often overlooked, despite the fact that it seems to be increasing. People are admitted to hospital or referred to community services for many reasons, such as falls, illness, frailty and ‘acopia’ but malnutrition is often not recognised as a contributory factor. 
People become malnourished for a number of reasons, including diminishing availability of community provision services, being unable to get to the shops and loss of appetite through lack of activity. Additionally, mental health issues involving loss, bereavement, social isolation and loneliness are considered key causes for malnutrition in the older population.
Physiotherapists are well-placed to recognise malnutrition and take appropriate action. In the community team we ask about appetite and fluid intake as a standard part of our assessment, along with asking about whether or not the person is able to prepare food and go to the shops or use the internet. 
We are all also trained to use and interpret the Malnutrition Universal Screening Tool (MUST) and our concerns are referred on to the person’s GP, district nurses or community matrons. 
We can also provide information about community lunch clubs and other initiatives for those who suffer from loneliness, which can affect their eating patterns. Equipment can also be provided and kitchen tasks practised if necessary. Patients can be weighed regularly at home in order to monitor weight loss or gain.
Malnutrition on the ward is more difficult to recognise and address, despite patients being weighed regularly and having easier access to food and drink in this setting. Dietitians are an invaluable but often scarce resource for advice and intervention, but there are various ways in which food and drinks can be fortified for patients. 
Ensuring that patients who need assistance are fed can also have a huge impact. Too often, barely touched plates are removed with the assumption that the patient isn’t hungry. 
Malnutrition is increasingly common and we all have a role to play in recognising it and getting the patient back to health.
  • Kate Bennett is the chair of Agile

Further reading

Agile, is the professional network for physios working with older people.  Here is a recent parliamentary report on this topic.

Kate Bennett Chair of Agile

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