September 3 Post - Yes, you can be too thin

We at Ostrich would like to offer our thanks to Margit Physant from The Malnutrition Task Force for writing this blog about how malnutrition can seriously damage an older person’s health. She also explores how care services should tackle the growing problem.

The Duchess of Windsor once said that “you can never be too rich or too thin”. Now I haven’t had the luxury of testing the first part of that quote, but the latter I completely disagree with; you can be too thin!

Malnutrition – in the sense of undernutrition - refers to low bodyweight with or without recent weight loss and it is still with us. Malnutrition can affect anyone at any age and is more common than the media portrays. You hear stories of a growing overweight population but little about malnutrition. What’s more, malnutrition is particularly common in the elderly with over a million people aged above 65 affected.

However, it is important to remember that malnutrition (however common it is) is not a normal part of growing old. Older people suffering with malnutrition will suffer with serious health risks and are more susceptible to serious infections and diseases while also suffering from physical difficulties. They are more likely to be admitted to hospital (about one third of older patients are malnourished or at risk when they are admitted to hospital). Once they get ill, they take longer to recover and have to stay in hospital for longer. Nobody wants that!

Helping to prevent malnutrition

The good news is that many malnutrition cases can be prevented.

The first thing is to recognise that someone is at risk. For a start, they may look thin. It should be noted that overweight people can also be at risk of malnutrition if they have recently lost weight without intending to. Loose clothes, belts and jewellery can be signs of weight loss as can poorly fitting dentures.

Health professionals carry out tests to assess whether someone is at risk of malnutrition. The MUST - Malnutrition Universal Screening Tool – is often used. It is based on height and weight and can be carried out by anyone.

Some older people who are found to be at risk of malnutrition simply need to eat more, but others need professional help. If an older relative or friend is malnourished, it is best to discuss this with their GP so any underlying medical conditions can be ruled out. Older people who find it difficult to swallow may need referral to a SALT – a Speech and Language Therapist.

There are many factors that contribute to older people becoming malnourished such as not being able to afford as much food as they need, difficulties in shopping and cooking, having a poor appetite and little interest in food, and illness. This also means that people need different kinds of help. They may need benefit advice if money is tight or practical help with shopping or cooking.  They may need cooked meals provided at home or the opportunity to eat in company. People with memory problems such as dementia or Alzheimer’s disease may need reminding or cues to eat. Age UK may offer services in your area that can be of help.

Tackling malnutrition

If you would like more information and suggestions for people not eating and drinking enough, you can check out The Dairy Council. They have produced a range useful materials. The materials can be downloaded and printed copies are available free of charge on The Dairy Council website.

All older people should get all the food and drink they like when they want it. This should be possible for people who are already receiving social care. Unfortunately, in reality this is the case for only 2:3 (64%) for older people who receive social care either in their own home or in a care home according to the latest Adult Social Care survey. If you want to see what the situation is in your local authority, you can find the information on the government’s website.

The Malnutrition Task Force was set up about a year ago to combat malnutrition in later life.  We are an independent group of experts from a range of sectors across the country. Including health, social care and local government. We were set up to make sure that malnutrition is made aware in all care services and community support services. We’ve worked extremely hard to identify good practises and how to implement these in care settings.

To email Margit please contact: [email protected]

The Malnutrition Task Force is also on Twitter: @MalnutritionTF