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Registered Dietician Dr Mabel Blades explains why it’s so important to look out for malnutrition in older people and how to assess it

I’m Dr Mabel Blades and as a Registered Dietitian, all aspects of nutrition enthuse me and I am passionate about helping people to adapt diets. This includes helping people to learn more about food and nutrition. I have written books and training packs and delivered training on nutrition and dementia and regularly see people who have the condition.

Therefore, when there was a request to provide an input for Unforgettable I was keen to help. I am a member of the British Dietetic Association and the Older People Specialist Group. If you have any topics you want me to write about I will do my best to cover them.

One of the first things I felt was worth covering is the assessment of malnutrition – this should be carried out regularly in hospitals and care homes. If someone is malnourished they become prone to all sorts of disorders like being less able to do things, more prone to infections and having muscle weakness. Therefore it is important to do something about it at an early stage by providing additional snacks as well as fortifying foods plus giving encouragement and assistance with eating.

Local Registered Dietitians will often be able to provide information on how to provide extra calories in a simple and effective manner via initiatives such as “Food First”.

The assessment of malnutrition is usually done by the use of a tool such as the Malnutrition Universal Screening Tool (MUST) which is very simple to use and was produced by the Malnutrition Advisory Group. The assessment is usually done monthly and is based on giving a score for each of the following:-

•    The body mass index which needs a knowledge of the persons weight and height
•    The percentage unplanned weight loss that has occurred
•    Establishing any acute diseases

The scores are added together to give an overall risk of malnutrition and if malnutrition is likely to use this as part of a care plan.

So if you are supporting someone with malnutrition do ask about the types of food to encourage them to eat. Or if you are worried about someone losing weight enquire about malnutrition screening in care homes and hospitals. Also, if you are supporting someone in their own home ask health professionals about malnutrition screening.

Finally, you may find looking at the MUST tool is of interest and it will show just how easy it is to do as well as what should happen if someone is malnourished.

Dr Mabel Blades is a Registered Dietitian and Nutritionist with a PhD in diet and diabetes. She worked in the NHS for many years managing a dietetic service but now works as an independant consultant. She has written various books, does training in nutrition and food safety, acts as editor to Nutrition and Food Science journal as well as speaking at conferences and on the radio.