Raising Awareness of Undernutrition. Annemarie Aburrow, Dietitian Reducing Undernutrition Conference 17 th November 2016

Transcription

1 Raising Awareness of Undernutrition Annemarie Aburrow, Dietitian Reducing Undernutrition Conference 17 th November 2016

2 Session Aim: To provide an awareness of the issue of malnutrition, and provide staff with the skills in identifying the people at risk (potential signs of malnutrition), and how to provide appropriate support

3 Training topics Healthy ageing & good nutrition Definition & prevalence of malnutrition Causes & consequences of malnutrition. Where to go if concerned What you can do to support someone at risk? Signs of malnutrition Awareness materials available

4 Why the concern over nutrition in older people? Growing population of older people Increasing needs Role of nutrition in maintaining health Preventing malnutrition through treating nutritional issues Undernutrition is less well-known, less recognised problem Most older people live at home in the community How to access older people: importance of your role

5 Location of older people

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7 Healthy ageing & good nutrition Objectives: Explain why good nutrition is important for older people Identify health conditions which can be affected by nutrition Be able to state the key food groups and identify some key health messages for older people

8 Healthy Ageing

9 What is good nutrition?

10 Definition & prevalence of malnutrition Objectives: Be able to state the prevalence of malnutrition in older people and that the majority of people at risk of malnutrition are living in the community Explain the term malnutrition in simple language

11 What if someone is not getting good nutrition? Which of these represents malnutrition?

12 What if someone is not getting good nutrition? May become malnourished due to undernutrition (not getting enough of a nutrient) Or malnourished due to an excess, e.g. obesity For the purpose of this session, we will be discussing the undernutrition form of malnutrition Summary: Imbalance between what we eat and drink and what our body needs

13 Malnutrition in the Community 93% of malnourished individuals live in the community Affects around 3 million people Prevalence varies according to setting Vulnerable groups are at higher risk

14 % malnourished Malnutrition increases with age (Illustrated using care home data) y 70-80y 80-90y <90y Age Prevalence of malnutrition increased according to age categories (Parsons et al. 2009)

15 (Parsons et al., 2009) Malnutrition risk & health condition

16 Common health problems for older people

17 Causes & consequences of malnutrition Where to go if concerned Objectives: Be able to identify causes of malnutrition (including factors affecting food intake) Be able to identify consequences of malnutrition Know the most appropriate healthcare professionals to signpost to if concerned about someone

18 Causes of malnutrition & Factors affecting food intake

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20 Where to go if concerned about malnutrition: In small groups, discuss - Where do you currently go for nutrition advice? - Where (or who) would you advise an older person with concerns about malnutrition to go?

21 Where to go if concerned about malnutrition An example showing where to advise someone to go if concerned. This may vary depending on your area or locality

22 Why should we be concerned about malnutrition?

23 Malnutrition: Does it matter?

24 Malnutrition: Does it matter? COSTLY - malnutrition in England costs > 19billion (Elia 2015) 50% of this was spent on those aged over 65 years (with 40% of this being spent on care home residents) Under-recognised and under-treated across care settings (Elia 2003)

25 Signs of malnutrition Objectives: Be able to identify signs of malnutrition Be able to identify visual signs of weight loss

26 Signs of malnutrition & Signs of weight loss

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28 Malnutrition warning signs Social signs: Loss of interest in activities / routines Absence at clubs / activities Withdrawal

29 Malnutrition warning signs Other signs:

30 Signs of unexpected weight loss

31 What you can do to support someone at risk? Objectives: Be able to identify simple ways of supporting people at risk of malnutrition (nourishing drinks, nourishing snacks, food fortification)

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33 Nourishing Drinks

34 Snacks Equivalent to 4 biscuits (140kcal) Fairy cake Slice malt loaf ½ scone & jam Handful dried fruit Packet of crisps Jam tart Scoop of ice cream Crumpet with butter Pot of custard or rice pudding Medium sausage roll 1 plain biscuit = 35Kcal

35 Snacks Equivalent to 6 biscuits (210kcal) Slice sponge cake Bakewell tart Mince pie Doughnut Thick & creamy yoghurt Mini pork pie Pot of trifle Individual cheesecake Rich chocolate mousse Toasted tea cake 1 plain biscuit = 35Kcal

36 Snacks Equivalent to 8 biscuits (280kcal) 2 crackers with butter & cheese Large handful of peanuts Danish pastry Croissant with jam Large glass whole milk & 2 chocolate digestives 2 slices malt loaf ½ scone with jam and cream Pork pie & 3 cocktail sausages Chocolate bar 1 plain biscuit = 35Kcal

37 What can you do? Fortifying foods Adding calories without significantly increasing portion size Some examples

38 What can you do? Fortifying food ideas Make fortified milk : Mix 4 tbsp skimmed milk powder with 1 pint of whole milk

39 A note about pre-existing medical conditions If the person you are talking to has diabetes: - Exercise caution around advising sugary foods and drinks - Focus on fortifying foods with fat and protein instead Signpost the older person to their Practice Nurse who will be able to provide advice tailored to diabetes if needed (they may then suggest a referral to a Dietitian who can advise more fully on specific individual requirements) If you are concerned around any other medical conditions, such as high cholesterol or dementia, signpost the older person to their Practice Nurse or GP

40 Practical ways to support people Recognising the signs of malnutrition early, and offering appropriate support Addressing causes of malnutrition If appropriate, consider having a conversation about what they ve had to eat

41 Awareness materials available Objectives: Be familiar with malnutrition awareness materials available from the Wessex AHSN and the Dairy Council

42 Resources OPEN Resources Posters for use in any public areas Leaflets suitable for general public / family members OPEN website: Dairy Council Resources Bring it Back Leaflets and Postcard sets Dairy Council website: Order or download online from:

43 Objectives: Recap Can you now do the following?: Explain why good nutrition is important for older people Identify: - causes of malnutrition - consequences of malnutrition - signs of malnutrition - simple ways of supporting people with malnutrition Know the most appropriate healthcare professionals to signpost to Be familiar with malnutrition awareness materials