Raising the Issue of Malnutrition E-Learning

 

 

Welcome Food Train Eat Well Age Well's Raising the Issue of Malnutrition E-Learning.

Eat Well Age Well, as part of the Scottish charity Food Train, is a national project funded by the Scottish Government which aims to contribute to the improved prevention, identification, and treatment of malnutrition among older people in Scotland.

This training has been developed as an e-learning version of our Raising the Issue of Malnutrition training and is suited for anyone who works with, or cares for older people. The training aims to increase your knowledge and understanding of malnutrition in older people, how to recognise it, and what you can do about it.

The training is made up of 8 videos along with written information and activities. The training takes around 1 hour to complete and you can work through each section at your own pace. If you need to you can save your progress at anytime and return to complete it later.

The videos included in this training were developed in partnership with NHS Tayside and Dundee Health and Social Care Partnership. 

 

Training Contents

 

1. What is Malnutrition?

2. Causes of Malnutrition

3. Signs and Symptoms of Malnutrition

4. Case Study: How does someone become malnourished?

5. Dehydration

6. Screening for Malnutrition

7. Dietary Advice for Older People

8. The Eat Well Guide

9. How Much is Enough?

10. Food First Advice

11. Nourishing Drinks

12. Resources

 

Should you need any help with this training please contact eatwellagewell@thefoodtrain.co.uk

 

 

What is Malnutrition?

Malnutrition occurs when a person's diet does not meet their nutritional needs. 

Ageing puts us at risk of becoming malnourished. As we get older we are more likely to experience changes in our lifestyle, health and wellbeing, and functional ability. This in turn can make it difficult to access and eat a well balanced diet leading to malnutrition

Malnutrition is often a silent and hidden issue and will regularly go unnoticed until there is a visible impact on the health and wellbeing of an older person.

Watch the video below to learn some key facts and figures about malnutrition. 

Video length - 2mins 46 secs

Activity

Take a few minutes and note down any factors you think might stop an older person from getting enough to eat and put them at risk of malnutrition. The answers will be provided in the next section.

 

 

 

Video References

Malnutrition Task Force: State of the Nation Report

BAPEN: The cost of malnutrition in England and potential cost savings from nutritional interventions

Causes of Malnutrition

There are a number of barriers which may impact an older person’s ability to access food and eat well. It is important to consider the full picture when discussing food, appetite, and weight loss with an older person

The video below provides some examples of the causes of malnutrition as well as what can happen to an older person if they start to lose weight and become malnourished. 

 

Video length: 6mins 47 secs 

There are many consequences of malnutrition that can impact the quality of life of an older person. Early identification and treatment of malnutrition is key as most cases of malnutrition can be helped with simple, straight forward advice. If you notice a difference in what food someone is eating or buying, it is important to consider what barriers they may be facing and how you can support them to overcome them.

 

 

Activity 

There are many signs and symptoms that you can look out for that can help you notice if an older person is at risk of malnutrition. Take a few minutes and note down some signs and symptoms that could tell you if someone is at risk.

Symptoms of Malnutrition

Malnutrition often goes undetected and untreated as there is poor awareness of the signs and symptoms. Many older people themselves believe that losing weight or having a smaller appetite is a normal part of aging when it is in fact a myth. Keeping an eye out for the signs and symptoms of malnutrition is an important part of prevention. The video below will explain some common signs and symptoms you may see if an older person is at risk of malnutrition.

Video length: 3mins 46secs

Useful Links

POSTER - How to spot if someone is underweight

Case Study: How Does Someone Become Malnourished?

As we have seen malnutrition can be caused by a number of different factors. In this video Katherine Sideway, a specialist Dietitian in NHS Tayside gives an example of how an older person can become malnourished, what the potential consequences are, how we can help to support an older person to eat well.

Video Length: 7mins 19secs

Dehydration

Dehydration often goes hand in hand with malnutrition and older people are at a higher risk of becoming dehydrated. Dehydration can cause serious health issues, so it is important to encourage people to drink plenty throughout the day and to keep an eye out for any potential signs and symptoms.  

 

Watch the video below to learn more about dehydration

 

Video length: 4mins 6secs

Screening for Malnutrition

It is important to identify those at risk of malnutrition as early as possible and there are several tools available to help you.

The Patient’s Association Nutrition Checklist is a simple and easy to use tool that has been adopted by many organisations across Scotland to help them identify older people who are at risk of malnutrition. The video below provides more information about how to use the checklist.

Video length: 2mins 19secs

Once you have used the checklist to identify if someone who is at risk of malnutrition you can then provide them appropriate advice and support. Before giving advice, it is important to consider if there are any “Red Flags”. Red flags are any concerns that may require input from a health professional such as

·         Pain when chewing and swallowing.

·         Changes in bowel habit.

·         Pain after eating.

·         Rapid weight loss over a few weeks.

This is not an exhaustive list, and you should always use your own judgement in these situations. If you do not feel safe to give advice or feel that a person requires further support, then encourage them to visit the relevant health professional to discuss these issues.

Later on in this training there is information on some simple first line advice that you can give an older person who is at risk of malnutrition.

Think about how you could use the checklist in your organisation or with older people in your own life. 

If you would like more information or support with using the checklist within your organisation, please get in touch with us at eatwellagewell@thefoodtrain.co.uk

 

 

Useful Links

Patients Association Nutrition Checklist

Dietary Advice for Older People

Diet plays a significant role in our health as we age, and it is important to encourage all older people to eat well.

Well-nourished older people tend to 

·         Live more independently

·         Have better mobility

·         Have less falls

·         Be better able to complete day-to-day activities

·         Get sick less often

·         Require less prescription medications

 

Before discussing specific advice for those at risk of malnutrition, we will first look at what is recommended as a healthy diet for older people. 

The Eat Well Guide

The Eat Well Guide is a good starting point when helping people to eat well. It is a resource developed to give a general idea of what a balanced diet looks like. The Eat Well Guide was developed for all ages and is therefore not specific to older people. Older people who are fit and well with no concerns around poor appetite or weight loss should aim to follow the Eat Well Guide as much as possible. Older people who have specific health concerns (e.g. diabetes) or who have been advised to follow a specific diet should consult the relevant health professional before making any major changes to their diet.

The Eat Well Guide splits foods into 5 sections, click the blue dots below to find out more about each section.

How Much is Enough?

The graphics below will give you some information on dietary recommendations and portion sizes for older people.

Further Resources

The British Dietetic Association have produced a resource to support older people to eat, drink and age well which you may also find useful when working with older people. It can be accessed here.

Eat Well Age Well's Eat Well: A guide for older people in Scotland was produced in partnership with Age Scotland and provides more information about eating well as we age. It can be accessed here.

Food First Advice 

When an older person is at risk of malnutrition it is likely that they are struggling to eat enough, have a poor appetite or have lost weight. Offering small, easy to manage suggestions is often enough to help stimulate their appetite and enable them to eat more.

It is important to address any barriers to eating and drinking that may be in place as well as giving advice on what foods to eat. For example, if someone is struggling to hold cutlery or chew food then you should encourage them to speak with their GP or Dentist for support and advice.

Food first advice is person specific advice that aims to increase the nutritional content of the food that an older person is eating. This makes it easier for an older person to eat more and stimulate their appetite without being put off their food. Food first advice is designed to be nutrient dense and followed for a short period of time. Food first advice can be stopped once the person’s appetite has returned and/or they have stopped losing weight or have regained any weight lost. The videos below offers further explanation as well as examples of advice and support you can give to help support someone at risk of malnutrition. 

Video length: 6mins 46 secs

It is important to remember that older people who are malnourished still require a varied diet, and while adding extra fat and sugar is an easy way to increase calories, focusing only on increasing calories with higher fat and sugar foods can often lead to older people missing out on other important nutrients that they need. Therefore, when giving food first advice, try to give a range of examples the person can try making sure to include foods high in protein, fibre, vitamins, and minerals. One example of how you can fortify a meal is shown below. Click on the ingredients to see how they can enhance the meal. 

Further Support

Our booklet Staying Well and Nourished in Later Life gives more examples of food fortification and tips for improving intake when a persons appetite is poor. It can be accessed here: Staying Well and Nourished in Later Life

 

Our Eat Well Age Well advice line is a freephone advice line ran by Food Train's Dietitian and can provide further advice around eating well to older people or those who work with or care for the. The advice line is open Mondays, Wednesdays, and Thursdays, 9am-4pm. 0131 447 8151 

Nourishing Drinks

Fortified drinks such as milkshakes are another great way to boost extra nourishment. The video below gives some examples of how to make a nourishing drink.

Video length: 3mins 47secs

Resources

We have a number of resources available to help support you to give advice to older people.

 
Eat Well: A Guide for Older People in Scotland is a booklet which gives advice to older people around healthy eating as they age. 

Staying Well and Nourished in Later Life is booklet which gives food first advice as well as ideas of nutrient dense meals, snacks and drinks that an older person can try.

BDA Malnutrition Factsheet is a short resource produced by the British Dietetic Association to provide information on malnutrition as well as ideas for food first advice.

The Eat Well Age Well Advice Line is a freephone advice line ran by Food Train's Dietitian and can provide further advice around eating well to older people or those who work with or care for the. The advice line is open Mondays, Wednesdays, and Thursdays, 9am-4pm. 0131 447 8151

Training complete!

Thank you for taking the time to complete this training, we hope it’s been informative and helpful. Please take the time to fill out our post training questionnaire.

If you have any questions you can email Jen at jen.grant@foodtrain.co.uk