Learning you are “at risk”: seniors’ experiences of nutrition risk screening

Abstract

Nutrition risk screening can help identify community-dwelling older adults who may benefit from nutrition education and interventions to improve food intake. Research has shown, however, that older adults who are found ''at risk'' through nutrition screening commonly do not see themselves at risk, and many do not follow through with accessing recommended nutrition services. Thus, the purpose of this qualitative study was to examine older adults' experiences of learning they were at risk through nutrition screening and to identify what influenced their perspectives and responses to their screening results. Face-to-face interviews were conducted with 22 older adults who had screened at risk (SCREEN II Ó scores \ 54) through a nutrition screening process conducted by mail. Participants received their screening results in a personalized letter before the interview, along with some recommendations to help improve food intake and decrease their nutrition risk. Interviews were transcribed and analyzed for themes. When participants reflected about receiving their screening results, some described feeling surprised or even upset by the message that they were at increased risk, whereas others felt unconcerned or reacted with heightened attentiveness to their nutrition. They also began to rationalize their screening score and found ways to explain away their risk. The message that they were at increased risk was poorly understood and not well received because it contradicted their perspective: they felt they were doing the right things, they saw room for improvement rather than seeing themselves at risk, and they tended to make comparisons that helped support the view that they were not truly at risk. Further, even though participants saw room for improvement, they described barriers to change and commonly felt that the recommendations were more applicable for others than themselves. Strategies to improve communication of nutrition screening results and recommendations are discussed to help seniors better understand their risk and take steps to improve their nutrition.

Malnutrition screening of older adults in the community setting: Practices reported by Australian dietitians

“…Similarly, assessment refusal has been reported in other Australian studies, with the reasons also unclear . However, an investigation of Canadian community living seniors regarding malnutrition risk found that many who were classified at risk did not understand what being at risk meant or did not view themselves at risk . The study's researchers suggested the term ‘at risk’ may be confusing and perceived negatively .…”

“…13,32 However, an investigation of Canadian community living seniors regarding malnutrition risk found that many who were classified at risk did not understand what being at risk meant or did not view themselves at risk. 33 The study's researchers suggested the term 'at risk' may be confusing and perceived negatively. 33 It is not clear how the term 'malnutrition' is perceived by the elderly and further investigation into their perceptions is required.…”

“…33 The study's researchers suggested the term 'at risk' may be confusing and perceived negatively. 33 It is not clear how the term 'malnutrition' is perceived by the elderly and further investigation into their perceptions is required.…”

Nutri-eSCREEN®: descriptive analysis of a self-management site for older adults (50+ years)

“…For example, font was made larger and bolding removed in some areas to promote readability and the SCREENII score was removed, as this was not readily interpretable or meaningful to the older adult users. Prior work with older adults, identified that 'risk' terminology was not well understood and could be inflammatory [24]. Thus with the removal of the score, concepts of 'where you are doing well' and 'where you can improve' were used to build the tailored messaging.…”

The European Journal of Ageing in the European Year for Active Ageing

“…As a contrast to all the statistical evidence from survey and demographic data reported in the articles described so far, this issue includes one report from a qualitative study of people's responses to being notified that their pattern of nutrition holds health risks (Reimer et al 2012). The European Journal of Ageing receives an increasing number of submissions based on qualitative studies.…”