Interdisciplinary Nutritional Management and Care for Older Adults by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030638924
Publisher: Springer International Publishing

Share understanding regarding older adults’ perspectives regarding the relationship between food and nutritional care.

Describe opportunities to improve the role of caregivers and the community in supporting patient motivation and adherence to nutritional care.

Explain the rationale and benefit of interdisciplinary teams in supporting positive nutrition-related behavior change in older adults.

10.1 Introduction

The nutritional status of older frail and hospitalized patients has been shown to be of high importance for general well-being and for their recovery. Patients at risk of malnutrition are known to have increased rates of infections and mortality. Nutritional risk also seems important for the degree of health and strength that patients recover after hospitalization [1, 2].

During the last years, guidelines have been developed to ensure the right care for patients at nutritional risk during hospitalization [3]. These guidelines consider screening for nutritional risk, nutrition plan, and monitoring as well as communication to other healthcare providers, when the patient still needs nutritional assistance at transferal between hospital departments or at discharge. A concrete division of tasks within the nutrition process has been shown important for good nutritional practice. Nurses play a significant role in nutritional care [4, 5].

Evidence suggests that approximately 30% of patients with nutritional risk are in hospitals, although estimates vary with differences in populations. More than half of these patients have a daily energy and protein intake of less than 75% of their needs, and up to 40% lose weight during hospitalization [6, 7]. The reasons for this insufficient food intake are multiple and complex. Insufficient knowledge of hospital staff about nutritional needs and a lack of attention to nutritional problems, especially among nurses, has been described [2, 7–10].

Some clinical controlled trials between specific patient groups have shown that active patient involvement in their own nutritional care and mentoring of patients could increase the patient’s energy intake [8, 10]. This is underlined by surveys which point out that patients have quite concrete expectations about their nutritional care, but do not seem to express them to staff [7, 8].

Of all older adults admitted to the acute setting, orthopedic patients have been shown to be among those most severely undernourished. The attention to nutritional aspects as part of patient care is undervalued and underdeveloped [11]. Creating strategies within which effective nutritional treatment can be achieved is vital. Effective management of nutrition for those at risk will speed recovery and reduce the incidence of secondary complications and mortality, reducing nursing workload in both hospitals and community settings [12].

Traditionally, nutrition has been a nursing responsibility, as caring for the patients’ basic needs [13]. Today, nutrition is an interdisciplinary field shared across several professions. Interdisciplinary and multimodal nutritional assistance facilitates the exploration of the barriers presented by the patient that prevent receipt of quality nutrition. The involvement of healthcare providers helps to identify these barriers and implement targeted practical and motivational solutions, offering a greater proportional increase in protein and energy intake and improved patient-reported experience measures [12, 14–16].

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