Abstract
The aims of the study were to describe the characteristics of meals-on-wheels (MOW) recipients, including prevalence of malnutrition amongst those who have received input from the Nutrition and Wellbeing Service (NWS) and to explore whether the NWS had an impact on the nutritional status (malnutrition risk) of recipients over time. Support services, for example, MOW, play an important role in the prevention and treatment of malnutrition in the community. In the UK, MOW services are under threat. However, little is known about how they support the health and well-being of older people. This study reports on the characteristics of MOW recipients and investigates change in nutritional status over time. A retrospective study of MOW recipients of nutritional concern who were offered a check through the NWS was conducted. Demographic, social and health information were gathered at the initial visit. Nutritional status (risk of malnutrition) was obtained using the validated Malnutrition Universal Screening Tool (MUST), at the initial and subsequent visits. Changes over time were investigated for recipients receiving at least two follow-up visits. An initial visit was made to 399 MOW recipients, and 148 recipients had two or more follow-up visits. At initial screening, 177 (44%) of recipients were at medium or high risk of malnutrition. Frailty was significantly related to malnutrition risk (P = 0.049). At follow-up, there was a reduction in malnutrition risk. The MOW service was associated with a reduction in malnutrition risk. By offering well-being visits within a MOW service, malnutrition can be identified early. Future studies into how MOW services might delay or prevent the need for support from acute health services and social care are warranted.
Highlights
Malnutrition is a serious condition, characterised by multifactorial causality (Volkert, 2013), thought to affect 1.3 million older adults in the UK (Malnutrition Task Force, 2013; Malnutrition Task Force, 2019) with 93% of malnutrition occurring in community settings (Elia and Russell, 2009)
The aims of the study were to describe the characteristics of MOW recipients, including prevalence of malnutrition amongst those who have received input from the Nutrition and Wellbeing Service (NWS) service and explore whether the NWS had an impact on the nutritional status of recipients
56% of recipients were at low risk of malnutrition and 44% at medium or high risk at the initial visit
Summary
Malnutrition is a serious condition, characterised by multifactorial causality (Volkert, 2013), thought to affect 1.3 million (or 1 in 10) older adults in the UK (Malnutrition Task Force, 2013; Malnutrition Task Force, 2019) with 93% of malnutrition occurring in community settings (Elia and Russell, 2009). With a predicted increase in life expectancy within the UK and worldwide (Office for National Statistics, 2017), this global phenomenon of population ageing will result in an increase in the numbers of older people at risk of malnutrition. The costs associated with malnutrition within England are substantial, estimated at £19.6 billion per year (£23.5 billion in the UK), equivalent to around 15% of total health and social care (Elia, 2015). Despite these statistics, there is little academic work exploring interventions to either prevent or address malnutrition in older people
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