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

Abstract

Aim To explore malnutrition screening practices by dietitians working with community dwelling older adults in Australia. Methods A descriptive cross‐sectional online survey of dietitians providing dietetic care to older adults (aged ≥65 years) was conducted in November to December 2014 using a three‐part 25‐item questionnaire with scaled, closed and open‐ended questions. Results One hundred and thirty‐three community dietitians participated in the survey. Seventy‐seven percent of them reported malnutrition screening was conducted in the workplace and this was highest in government organisations. The majority of dietitians (75%) reported a screening tool was used and the Malnutrition Screening Tool was most commonly used. Independent of level of experience, the majority of dietitians considered malnutrition screening important and agreed with the need for routine screening. Sixty‐six percent of dietitians reported that clients screened and found to be at risk of malnutrition frequently refused nutrition assessment. Conclusion Reported malnutrition screening practices varied considerably across all organisations and states. Although routine screening for malnutrition risk is recommended, refusal for nutritional assessment after positive screening is common and requires further investigation. It is not clear how the term ‘malnutrition’ is perceived by the elderly and further investigation into their perceptions would be useful, particularly as offer for nutrition care is frequently declined.

The role of the dietitian in the management of malnutrition in the elderly: A systematic review of current practices

“…Ten studies relating to the connection between the setting and the role of the dietitian were categorised into the first theme . All studies revolved, in different care settings, around the extent to which screening instruments are used and around the practices that resulted from this screening.…”

“…The same applies to organisational type (e.g. government, private, not for profit); screening practices differ per organisational type …”

“…Second, ad hoc referral to dietitians also exists . For patients to be referred, dietitians are often dependent on sufficient and effective screening for malnutrition by other health professionals.…”

Disease‐related malnutrition in the twenty‐first century: From best evidence to best practice

“…Accepting malnutrition as an inevitable outcome of old age and/or disease Prioritising medical treatment over nutritional support Figure 1 Expressed barriers to nutrition screening. 16, [23][24][25][26] Editorial as 25% of the care provided being unnecessary or potentially harmful. 39,40 Organisational culture, or 'how things are done here', is defined by leadership support, communication, teamwork and conflict resolution.…”

National survey in elderly care on the process of adopting a new regulation aiming to prevent and treat malnutrition in Sweden

“…In Sweden, as in many other countries, malnutrition or risk thereof is a pronounced problem in elderly care, (Bell, Tamura, Masaki, & Amella, 2013;Törmä, Winblad, Cederholm, & Saletti, 2013). Due to malnutrition's multi-faceted etiology (Craven, Pelly, Lovell, Ferguson, & Isenring, 2016;Söderström et al, 2013) it is assumed that the adoption of this new regulation would be a complex task to undertake. On its introduction, national authorities addressed local political committees, heads of organisations and CMNs in each municipality (National Board of Health & Welfare, 2014).…”