Written by Registered Dietitian, Magdalena Kot
Under-nutrition in older people has many faces. With implications of the pandemic and recent lockdown, we can observe shielding and isolation becoming the main challenge in the 65+ population as numbers shows that 93% of those at risk of malnutrition live in the community.
As a dietitian working with Ageing Well Team, my role is to assess nutritional status and barriers to good nutrition for those identified with high risk of 2 or above on MUST screening tool (Malnutrition Universal Screening Tool) that is used nationally.
Having a good chat about eating patterns, access to food and hydration, many elders do not want to, in their own words, ‘make a fuss’. It’s through these conversations we realise how making connections becomes important part of our job. Loneliness plays a huge part in preventing people from eating. Low mood often leads to low appetite and decreased intake. With RITs teams in community – RITs being Rapid Response Team – we’re able to make a difference not only by adapting living conditions, but also improving quality of life by adding connection to the multidisciplinary mix.
It is paramount for my service to be able to identify the level of independence of the individual and support network available. Based on my assessment, I make recommendations and, where appropriate, signpost to meals on wheels services and give advice on food fortification and oral nutritional supplementation. I work with patients, family members and carers to facilitate and implement nutritional care plans.
Implementing easy food fortification techniques can make a huge difference in increasing uptake of calories and protein, helping to maintain weight and prevent lean body mass loss which, if paired with appropriate exercise and mobility levels, can prevent progression of frailty. Connecting and engaging people in conversation also benefits their mental health which in return can improve their oral intake.
For an easy to make and nutritious milkshake, you can blend glass of milk with a scoop of creamy ice cream and some berries, adding couple of spoons of honey for a sweeter taste if needed. With a good range of plant-based milks, yoghurts and ice creams it is possible to fortify foods for those with lactose intolerance, allergy to cow’s milk protein or those following vegetarian or vegan diets.
During first three months of pandemic I have observed huge engagement from community services, voluntary sector and local city councils to provide food parcels for most vulnerable.
Whilst socially distanced deliveries were made, connection and support remained, bringing hope and comfort to those shielding at home. So, if you feel that your loved one is at risk of under-nutrition please have a chat about it and check your local services or community engagement projects to find some help and support. It is there for you.
Magdalena Kot is a Registered Dietitian practising in an acute setting in West Midlands. She is involved in the supporting Ageing Well Team as part of ‘Front Door’ initiative facilitating services for elderly population and preventing unnecessary hospital admissions.
Follow Magdalena on Twitter: @MagdalenaKotRD