NICE guidelines issued over care of elderly
22/02/2006
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The National Institute for Health and Clinical Excellence (NICE) have issued guidelines for doctors and nurses to recognise malnutrition in the elderly.
The guidelines, developed in collaboration with the National Collaborating Centre for Acute Care state that all hospital patients should be routinely screened for malnutrition and offered specialist nutritional support if required.
Up to 40% of hospital patients are thought to be at risk.
A report by the British Association for Parenteral and Enteral Nutrition published in December estimated that malnutrition costs the NHS £7.3bn a year.
The effects of malnutrition include impaired immune responses; reduced muscle strength and fatigue; breathing difficulties; impaired wound healing; apathy; depression and self-neglect.
Testing for malnutrition is already mandatory in Scotland and NICE is calling for the guidelines to be extended to England and Wales.
The problem is particularly serious among the elderly. It is thought more than 10% of people aged over 65, and up to 60% of pensioners who are admitted to hospital are malnourished.
The NICE guidelines recommend that all hospital and care home patients should be weighed and measured on admission, and all outpatients should be checked at their first clinic appointment.
Checks should be repeated weekly for inpatients, and where there is clinical concern for outpatients, say the guidelines. It also recommends that nutrition support be considered for people at risk of malnutrition - such as those who have eaten little or nothing for more than five days, or who are unable to take in nutrients properly.
All acute hospitals are advised to employ at least one specialist nutrition support nurse.
"As people become ill or have chaotic lifestyles, they are less able both to take in the foods they need and to absorb them. Attention needs to be paid both to physically helping people eat and to ensuring the food they swallow is appropriate for their requirements and presented in a way which encourages appetite," said Client Support Manager Sarah Head.
"It is heartening to see an influential body such as NICE emphasising the importance of recognising and acting upon signs of malnutrition - something patient representatives have been calling on the NHS to address for the past decade and longer."
The guidelines have also been welcomed by organisations such as Help the Aged.
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