Back in March 2013 I wrote a blog about the need for good nutritional care as people age. Whilst awareness of malnutrition in older age has increased in the last decade there is still much work to be done to address what is a preventable and treatable condition. In simple terms it is not normal to get thinner as we age and there is much that can be done in adulthood and for older people specifically to raise awareness and understanding and ensure that people get the screening and treatment they need. For the past year the ILC-UK has been a member of the Malnutrition Task Force (MTF) , an independent group of experts across Health, Social Care and Local government united to address the problem of malnutrition in older people.
Whilst it is true that malnutrition can result from ill health or disease, it can also result from wholly preventable causes. These include low income (to heat or to eat?), physical mobility to reach shops or cook for oneself, a reduction in appetite perhaps due to depression or bereavement and a lack of awareness of malnutrition. Part of the problem is language. Focus groups run by the MTF in the UK found that the term malnutrition was irrelevant to older people outside of reference to the developing world. They did not equate their experiences or those of their peers as being related to malnutrition. However all could identify with weight loss, lack of appetite, reduced interest in food or difficulties shopping, either for themselves or their friends or those they cared for. As a result of these findings the Task Force aims to raise awareness among older people their friends and families and have teamed up with the Dairy Council  for their ‘bring it back’ campaign which highlights the importance of regular meals and snacks.
In addition we aim to actively influence behaviours across the NHS, residential care and in the community, to create long lasting change in the way malnutrition is highlighted, identified and treated. We have created implementation and best practice guides on preventing malnutrition in local communities, hospitals, care homes and food and beverage providers as no matter where an older person is they deserve 24 hour access to good nutrition and hydration care.
Mini guides support these publications to provide information for those just getting started on addressing malnutrition in their area and a cost evidence review (soon to be published and written by the ILC-UK) provides the economic background individuals and organisations need to demonstrate the urgency with which we need to address malnutrition as well as highlighting how savings can be achieved and the success of local community initiatives in preventing malnutrition.
Key to changing both attitudes and the system are best practice and increased understanding.
Best practice revolves around five main principles:
- Raising awareness to prevent and treat malnutrition and dehydration through education to older people, their families and front line staff
- Working together within teams, across organisational boundaries and across communities
- Identifying malnutrition in the individual and prevalence within organisations and across local communities
- Personalising care, support and treatment for every individual
- Monitoring and evaluating the individual and the processes in place to address malnutrition.
More importantly it is about talking to older people about food and wellbeing more than nutrition. We do not eat nutrients we eat, enjoy and involve ourselves in food. Part of the problem for those living at home is the isolationist way that care has developed meaning many mealtimes are spent alone. We all eat better when in company and food is more enjoyable when shared. By raising awareness and by changing attitudes and practices within the health and social care sector we can begin to effect long lasting change and ensure good food, nutrition and hydration are embedded as principles of good care and well-being.
 Malnutrition Task Force www.malnutritiontaskforce.org.uk
 Dairy Council www.milk.co.uk/consumers
There are a number of guides for professionals available on the Malnutrition Task Force site http://www.malnutritiontaskforce.org.uk/resources.html