Preventing malnutrition in older people through holistic nutritional assessment

There are increasing numbers of older people in the UK, a significant proportion of whom are at risk of malnutrition. Malnutrition is not an inevitable consequence of ageing, but can occur due to an interplay of physical, social, psychological, financial and environmental factors. It is essential that nurses undertake a holistic nutritional assessment, including malnutrition screening where appropriate, to identify an older person's nutritional status and risk of malnutrition. This assessment should be followed up by interventions tailored to the individual's needs and circumstances to support their nutritional needs. This article discusses malnutrition in older people and considers the distinction between chronological age and ageing in the context of frailty, a key factor in malnutrition risk. The article also considers factors that influence malnutrition in older people, explores aspects of a holistic nutritional assessment, discusses malnutrition screening and describes a 'food first' approach to enhancing nutritional intake. The authors use a fictional case example to illustrate the issues discussed and suggest ways in which nurses can reflect on their practice in this area of their work.