A nutritional assessment of homebound elderly in a physician-monitored population

Nutritional information and support for the elderly are available from many sources. Yet many older adults still remain at risk for malnutrition. This study examined the nutritional status of homebound elderly in a physician-monitored population, with access to health and social services. Older adult patients from the Home Visit Program of the Department of Family Medicine were visited, and an assessment was administered. All patients had primary care physicians who visited patients in their homes, on average, every 3 months. For this survey, the Nutritional Risk Index, the Nutritional Screening Initiative Checklist, an ADL (Activities of Daily Living) assessment, and general history questions were asked. In order to evaluate content of diet, food frequency and a 24-hour diet history were used. Questions on basic nutritional knowledge were asked, and a kitchen survey was used to examine purchasing behavior. Most patients were found to be at high nutritional risk with an average Nutritional Screening Initiative Risk score of 7, but for reasons that varied among patients. Most patients claimed to have a good appetite and enough money for food. The 24-hour diet analysis showed that many individuals did not meet 70% of RDA for major energy sources and fiber. Patient knowledge of the four basic food groups was poor. Since none of the patients shopped for themselves and many did not cook, the nutritional knowledge and food preparation behaviors of caregivers may be important for the nutritional well-being of the patient. An educational program for this population should include the caregiver as well as the patient.