Publish date: 5 December 2024
The Ealing Community Nutrition Support Dietetic team is asking NHS staff and teams to do their part to tackle malnutrition amongst patients, particularly those in care homes, by doing three simple things: ask, look and listen.
The team says this is particularly important because patients can often downplay how little they are eating.
“A visual assessment can flag issues such as hiding food, leaving food, reduced muscle mass and strength etc. Listening is also vital - they may make a small comment that hints at a bigger problem eg they don't want to get up in the night could mean they are limiting their fluid intake. By doing this we can build a good rapport and improve the overall understanding of the patient in order to achieve a complete assessment with a holistic approach,” says Nicola Christie, Community Specialist Dietitian.
But what exactly does ask, look and listen mean?
Ask – If you know somebody who may be vulnerable because they have health problems, because they are older or perhaps because they are isolated, don’t be afraid to ask them if they are eating and drinking okay. Don’t be afraid to ask about somebody’s appetite or ability to prepare food and drink, it could make all the difference and help you stop malnutrition in its tracks.
Look – Always be on the lookout for tell-tale signs of unplanned weight loss such as looser clothing, loose belts or rings or dentures. And remember you won’t always see weight loss so keep your eyes open for other signs like empty fridges and cupboards, local shops that have closed, or reluctance to travel or leave home.
Listen – Listen carefully to what somebody is telling you about their life. It may not be about eating and drinking directly, but is it about feeling tired, feeling worried because they are unwell, feeling lonely, or losing interest in things that usually give them enjoyment? Practice active listening and think about how the way somebody is feeling generally may affect how they are able to look after themselves.
The team, comprising Dietitians and Nutrition Practitioners Vicky Nikodimova, Vimbai Tendengu and Anusha Gunawardena, is part of the Ealing Community Partners, and they’re on a mission to make sure all staff know how to identify, manage and treat malnutrition.
with stalls at various sites
They recently marked Malnutrition Awareness Week by hosting a series of stands at community and inpatient sites, including Mattock Lane Health Centre, Acton Health Centre, Featherstone Road Health Centre, and at Clayponds Rehabilitation Hospital.
The stands were well received by patients and staff, who engaged on the topic.
Vicky Nikodimova, Nutrition Support Dietitian says:
“Most nursing homes now have electronic records which should trigger malnutrition risk automatically. But as per CQC standards, care providers need to be supported in meeting nutritional and hydration needs of their clients and educating care staff can achieve it. Care homes have been receiving MUST and Food first training from our service in person over many years now, so should have some level of awareness by now. However, due to high turnover of their staff it has not always been possible to reach everybody who is involved in the residents’ care.”
The team delivers face to face training on the Malnutrition Screening Tool (MUST) screening and Food First approach at care homes within their area, but realised they needed to do more. So they produced a 20-minute video to offer the training on demand for care home staff.
“We wanted to expand our reach, particular for night staff who might miss out on our day training sessions. So we developed a training video that we will be using in addition to our face to face sessions. We’re sure it will help teams to manage and treat malnutrition once it’s identified, thereby improving care for patients” said Bal Sembi, Nutrition Support Clinical Lead and Manager.
This video training will be shared with 27 care homes across Ealing which receive nutrition support service.
The Dietetic team will continue providing face to face sessions when required and hope that their efforts will help to increase awareness amongst more healthcare staff, reduce waiting lists, and costs, as fewer patients will need oral nutritional supplements when malnutrition is caught early.
What next?
Looking to the future, the team is keen to innovate and bring important training and messages about nutrition using more digital platforms.
“We will continue exploring possibilities to produce more videos to reach a wider audience such as specific patients groups to provide support for the challenges they are facing with their diet because of their conditions, whether it is dementia, or Parkinson’s disease,” says Vicky.
