Undernutrition is a form of ‘malnutrition’, which simply means ‘poor nutrition’. It affects 10-15% of people over 65 years of age. A person can become undernourished when they don’t eat enough of the right foods to keep them healthy. Undernutrition has serious consequences because the body isn’t getting the right nutrition to work properly. Some consequences of undernutrition include reduced ability to fight infections, reduced mobility, increased risk of falls, poor wound healing and more frequent GP visits and hospital admissions. Undernutrition is not well recognised or treated in the community.
In view of this, we have worked in collaboration with the Patients Association to develop the "Patients Association Nutrition Checklist", which was launched in December 2018. Due to its simplicity and ease of use, the Patients Association Nutrition Checklist can be used in the early identification of undernutrition due to having the ability to highlight 'clinical concern' which could then act as a prompt to screen using a validated screening tool such as the Malnutrition Universal Screening Tool (MUST') (NICE clinical guideline 32 states that in the community, 'screening' should be carried out on initial registration to a GP practice, at other clinic opportunities and wherever there is a 'clinical concern', e.g. unintentional weight loss or poor appetite).
We have piloted the Patients Association Nutrition Checklist with domiciliary care, Southampton Fire Service, and the voluntary sector. A report from our pilot with Southampton Fire Service and Age UK Southampton can be downloaded from the 'resources' section.
We also carried out a research project in 2018 to validate the Patients Association Nutrition Checklist against 'MUST'. The Patients Association Nutrition Checklist was shown to have 'moderate' agreement with 'MUST'. A project report, along with poster and oral communication presented at the BAPEN 2018 conference can be downloaded from the 'resources' section. We have recently submitted this research as an academic paper to the Journal of Human Nutrition and Dietetics.
The Patients Association Nutrition Checklist is available in two formats: one specifically aimed at patients themselves to complete (the 'patient version'), whilst the other is a version for volunteers, carers and professionals to complete (the 'staff version'). Wessex AHSN has particularly been involved in the development of the staff version. This version consists of two parts:
Section A - consists of four key questions to focus discussions around weight, unintentional weight loss and loss of appetite. These are the four questions which has been validated against 'MUST', and can be used to identify if someone is likely to be undernourished. Because these specific questions have been validated, the wording of these questions must remain unchanged.
Section B - to be used with people identified as likely to be at of undernutrition from using Section A. Section B consists of additional questions to focus on the reasons for the increased risk of undernutrition, and provide a framework for giving basic advice and signposting to services that can provide support. It has space for you to write down any specific advice given and recommendations made, along with a section to write down any follow up plans.
To download either version of the Patients Association Nutrition Checklist, please visit the Patients Association website.