An at-risk concept used in homes for the elderly in the United Kingdom

In Great Britain, the matrons, often without training in catering or nutrition, are usually confronted with the responsibility of planning menus in homes for the elderly. They face the problems of budgeting restrictions, increases in food prices, staff shortages, and low wages for staff. Previous nutrition surveys of the elderly have isolated special concerns with intakes of ascorbic acid, potassium, energy, protein, vitamin D, and iron. This pilot study explores the next step: The practical applications of these findings to residential homes. Questionnaires were devised to obtain information from the matron, cooks, and residents and from the investigators' general observations. Specific at-risk factors were isolated, taking into account administrative, psychologic, and social conditions, as well as food. By a system of grading (with comments) into low, moderate, or high nutritional risk to residents, the strengths of each home could be used as positive examples to improve other homes; appropriate advice could then be given to each home.