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Lesley Carter: Nurses are key to preventing malnutrition in older people

More nursing care interventions and follow-up in the community after discharge from hospital would help older people avoid malnutrition and its disastrous spiral of ill health, says Age UK’s Lesley Carter

More nursing care interventions and follow-up in the community after discharge from hospital would help older people avoid malnutrition and its disastrous spiral of ill health, says Age UKs Lesley Carter

In a society more used to worrying about the health effects of obesity, its easy to overlook how serious malnutrition can be for older and more vulnerable people.

In the UK more than one million older people are believed to be at risk of malnutrition. The numbers could be even higher, because malnutrition is often not recognised or understood, particularly among those who are housebound, hard to engage with and isolated. That malnourished person could be someone in your street or that new admission.

The causes and consequences of malnutrition are often interlinked and can quickly lead to a relentless downward spiral of ill health. If society and health professionals

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More nursing care interventions and follow-up in the community after discharge from hospital would help older people avoid malnutrition and its disastrous spiral of ill health, says Age UK’s Lesley Carter


Picture: iStock

In a society more used to worrying about the health effects of obesity, it’s easy to overlook how serious malnutrition can be for older and more vulnerable people.

In the UK more than one million older people are believed to be at risk of malnutrition. The numbers could be even higher, because malnutrition is often not recognised or understood, particularly among those who are housebound, hard to engage with and isolated. That malnourished person could be someone in your street or that new admission.

The causes and consequences of malnutrition are often interlinked and can quickly lead to a relentless downward spiral of ill health. If society and health professionals continue to not recognise the risks of malnutrition there will be a profound impact on the health and social care needs of older people.

Treating someone who is malnourished is two to three times more expensive than for someone who is not.

Scale of the problem

A new report, State of the Nation: older people and malnutrition in the UK today, published by Age UK and the Malnutrition Task Force, highlights the scale of the problem and brings together information and evidence from across the system to give a clearer understanding of why this largely preventable and treatable condition is so widespread.

To unpick some of the reasons why older people start to not eat well and experience unintentional weight loss, we need to challenge the stereotypical notion that weight loss and ill health are a normal part of the ageing process.

We also need to understand and appreciate the impact of transitions in later life. Older people are more frequently becoming carers for the first time much later in life and are experiencing changes in life roles along with loss and long-term feelings of bereavement. They may feel lonely and isolated, become depressed, suffer from anxiety, lose their appetite, struggle with menu planning, shopping and cooking, and survive on buttered crackers.

Ensuring follow-up

Nurses, wherever they practice, are the key to understanding and highlighting this problem. We are well-placed to take the lead and ensure that in practical terms this preventable condition is tackled head on.

Most hospitals and care settings are now following NICE guidelines for nutritional screening during the admission assessment. However, there remains a challenge to get screening translated into nursing care interventions and ensure follow-up in the community after discharge.

We learned from a recent survey that 80% of patients were not followed up by their GP or anyone else about nutritional needs.

There is much positive practice out there. Community projects have a big role to play in addressing some of the social causes of preventable malnutrition. Nurses continuing to work locally across sectors and settings are helping to improve prevention and raise public and professional awareness.

Nurses using their vast amount of clinical skills and knowledge, along with validated tools and clinical guidance, can take the lead in raising awareness to tackle this preventable condition and help older people retain their independence and well-being.


Lesley Carter is a registered nurse, head of health influencing for Age UK and programme lead for the Malnutrition Task Force

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