Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 35; no. 3; pp. 692 - 698
• Main Authors: Hedman, S, Nydahl, M, Faxén-Irving, G
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2016
• Subjects: Aged; Aged, 80 and over; Appropriate diet; Combined Modality Therapy; Diet Records; Dietetics - manpower; Dietetics - methods; Elder Nutritional Physiological Phenomena; Feeding and Eating Disorders - diagnosis; Feeding and Eating Disorders - diet therapy; Feeding and Eating Disorders - therapy; Female; Food prescription; Food, Nutrition and Dietetics; Gastroenterology and Hepatology; Geriatric Assessment; Geriatric patients; Healthy Diet; Hospitals, University; Humans; Kostvetenskap; Male; Malnutrition - diagnosis; Malnutrition - epidemiology; Malnutrition - etiology; Malnutrition - prevention & control; Medicin och hälsovetenskap; Mini Nutritional Assessment; Nutrition Assessment; Nutritional Status; Nutritional Support; Patient Compliance; Portion Size; Precision Medicine; Prevalence; Risk; Sweden - epidemiology; Portion size; Mini nutritional assessment; Food prescription; Geriatric patients; Appropriate diet
• ISSN: 0261-5614; 1532-1983; 1532-1983
• DOI: 10.1016/j.clnu.2015.04.018

Summary Background & aims Malnutrition is a well-recognized problem in geriatric patients. Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients. The objective of this study was to investigate routines regarding dietary prescriptions and monitoring of food intake in geriatric patients and to see how well the prescribed diet conforms to the patients' nutritional status and ability to eat. A further aim was to identify the most common reasons and factors interacting with patients not finishing a complete meal. Methods This study combines two methods using both qualitative and quantitative analysis. Patients (n = 43; 82.5 ± 7.5 yrs; 60% females) at four geriatric wards performed a two-day dietary record, assisted by a dietician. Nurses and assistant nurses at each ward participated in a semi-structured interview regarding prescription of diets and portion size for the patients. Results The prescribed diet differed significantly (P < 0.01) from a diet based upon the patient's nutritional status and ability to eat. Only 30% of the patients were prescribed an energy-enriched diet in contrast to 60% that was in need of it. The most common reason for not finishing the meal was lack of appetite. Diet prescription for the patient was based upon information about eating difficulties identified in the Mini Nutritional Assessment-Short Form (MNA-SF) at admission and the type of diet that was prescribed on a previous ward. Monitoring of the patients' food intake was described as a continuous process discussed daily between the staff. Conclusion Patients' nutritional status and to what extent they were able to eat a complete meal was not routinely considered when prescribing food and monitoring food intake in this study. By making use of this information the diet could be tailored to the patients' needs, thereby improving their nutritional treatment.