Malnutrition week runs from the 4th-8th of October with the theme “Malnutrition is everybody’s business”.  A truer statement has never been said! Malnutrition impacts more than just the individual, it can impact their family, the aged care facility and the healthcare system. It is therefore everyone’s responsibility to recognise the risk factors for malnutrition and address them as soon as possible to prevent it from occurring.  Outlined in this article are some of the common risk factors. 

Incontinence

It may come as a surprise that incontinence can have a negative impact on nutrition. Some residents may intentionally restrict their intake of food and fluids to avoid having an accident. Staff can support residents by:

  • Having a regular toileting schedule that doesn’t overlap with meals.
  • Ensuring continence aids are well fitted to maintain resident dignity. 
  • Providing encouragement and assistance at meals. 

Decreased Appetite

It is important to recognise when a resident’s appetite has changed. Have they stopped snacking? Do they no longer enjoy favourite foods? Medications, irregular sleep and hospitalisations are just some of the things that can disrupt a person’s appetite. Some strategies to address a poor appetite include:

  • Offering food and a milk based drink with morning tea, afternoon tea and supper.
  • Offering meal alternatives such as sandwiches or double dessert.
  • Serving drinks after meals to prevent residents from “filling up”.
  • Offering dessert after the main meal is completed. 

Increased Requirements

Are your residents eating well yet losing weight? This can be a sign that they have increased nutrition requirements. Wandering, pressure injuries/wounds and infections can all increase a person’s protein and energy needs. Ways to meet increased requirements include:

  • Encouraging residents to eat the meat/protein portion of their meal first.
  • Providing nourishing fluids such as juice, cordial, milk and soft drink.
  • Fortifying meals with milk powder, butter, cheese and cream.
  • Offering fortified milkshakes 

Difficulty Chewing or Swallowing

It’s no surprise that problems with chewing and swallowing can greatly impact a resident’s intake. This can be due to pain or discomfort caused by eating, fear of choking or increased effort and time required at meal times. Strategies to address chewing and swallowing problems include:

  • Regular oral hygiene to maintain good oral health.
  • Ensuring residents are wearing their dentures and that they fit well (adhesive may be required).
  • Sending a referral to the speech pathologist if you notice any problems with swallowing. 

Eg. Coughing at meals, wet sounding voice, resident complains of food “getting stuck”.

Dementia
Dementia can impact nutrition in several ways including residents forgetting to eat, forgetting how to eat and not recognising thirst/hunger. Ways to support nutrition in residents with dementia include:

  • Redirecting residents to the dining room and explaining that it’s time to eat.
  • Minimising distractions in the dining room such as loud music/TV.
  • Offering finger foods such as point sandwiches, cheese cubes or ice-cream in a cone.
  • Ensuring meals are well presented and are a suitable texture for the resident.

There are many different reasons for malnutrition and it is important that everyone looks out for risk factors. If you recognise that any of your residents are at risk of malnutrition, send through a referral to your Plena Healthcare dietitian