42 | Nursing in Practice | Autumn 2022

HOW TO

Registered nurse and Age UK Malnutrition Task Force lead Lesley Carter explains how to identify and prevent malnutrition in older people in the community

Malnutrition in older people is not an inevitable part of ageing or illness . It is a serious condition and both a cause and consequence of ill health that , in most cases , is preventable . Being malnourished leads to increased morbidity and reduced health-related quality of life , for example due to poor wound healing . It also puts older people at increased risk of admission and longer stays in hospital . However , many of us simply accept weight loss as a part of ageing so the signs of malnutrition can often go unnoticed until they have had a negative impact on a person ’ s health or wellbeing . ¹

The fact that so many people are now living into late old age should be a cause for celebration . However , living longer means nothing if you are not living well , and poor nutrition is a key factor affecting quality of life .

Furthermore , the failure to prevent malnutrition is costly for the NHS and social services . One study found the total health and social care costs for an individual who is malnourished are around three times those of someone who is not (£ 7,408 compared with £ 2,417 per year ). ² Addressing the causes of malnutrition – and dehydration – is vital at a time when we all need to take the pressure off health and social care .

Malnutrition is preventable There are three main reasons for malnutrition :

• Medical factors . Diseases such as cancer or chronic

liver disease can lead to malnutrition , and will require highly specialist support .

• Physical factors . These include arthritis and other causes of limited mobility , sight loss , acute and chronic pain , dentition and oral health problems , chewing and swallowing difficulties .

• Social factors . These are possibly the most complex , difficult to diagnose and tricky to solve , and include low income , isolation or bereavement .

Disease-related malnutrition should usually be picked up and managed by the patient ’ s specialist hospital team . This article will focus on preventable malnutrition for older people in the community , which is usually related to physical or social risk factors , as significant numbers of at-risk older people live in their own homes or in care homes .

In a society encouraged to worry more about the health effects of obesity , it ’ s easy to overlook how serious malnutrition can be for older and more vulnerable people . Public health messages and policy are preoccupied with reducing levels of obesity , so weight loss has come to be seen as desirable .

More needs to be done to ensure that the public and health and care staff understand the risks of unintentional weight loss . Staff working in the community should be able to give clear and helpful advice to older people and their families .

Living longer means nothing if you are not living well , and poor nutrition is a key factor affecting quality of life

ALAMY