Loneliness and Malnutrition
The latest figures from NHS England show that three million, or one in 20 adults, are affected by malnutrition at a cost of ￡20 billion a year. With social isolation, there is a risk of it growing further. Social workers can provide caregivers with the support they need to reduce this, linking them to services to prevent and treat malnutrition.
Crucially, it’s important to know the signs, which include:
- Tiredness and low energy
- Loss of appetite
- Unintentional weight loss
- Clothes, jewellery or dentures becoming loose
Malnutrition affects every system in the body and results in increased vulnerability to illness and complications, which can lead to prolonged hospital stays, more visits to the doctor and in some cases, death.
The main bodily systems malnutrition affects and its consequences are:
- Difficulty coughing which increases the risk of chest infection
- Heart failure
- Anxiety and depression
- Reduced ability to fight infection
Malnutrition is also associated with psychological issues. Mental health problems such as depression and anxiety or a change in mental state due to bereavement can affect a person’s appetite and interest in eating. Loneliness and social isolation have been linked to increased risk too.
So once you’ve identified the signs, what are effective dietary solutions for malnutrition? If someone suddenly loses their appetite, becomes thinner, or steadily loses weight unintentionally, it is important to speak to a GP or a registered dietitian.
For some time now, the treatment for malnutrition has often included the prescription of oral nutrition supplements. However, for dietitians, the preferred first step is to encourage a ‘food first approach’. This is likely to focus on encouraging people to eat higher calorie and protein foods more often.
Taking a ‘food first’ approach can be seen as a straightforward solution, however increasing food intake for people with a smaller appetite, which is likely to be the case if they have been undernourished, can be challenging. Adding things like a slice of cake, cheese and full fat milk to one’s diet can all be beneficial, as these are energy dense foods. Loss of appetite can be especially common amongst older adults, so smaller and energy dense meals are crucial.
Malnutrition remains one of the most common nutritional challenges among older adults in the UK. Social workers along with professionals within health and care have a key role to play in the recognition and prevention of this challenging disease, as they often have close and regular contact with older adults in the community. Weight loss is not an inevitable part of ageing and it is always worth asking an older adult some gentle questions about their dietary intake and any recent, unintentional weight loss if you are concerned.
Screening tools for malnutrition are available. The most commonly used is the Malnutrition Universal Screening Tool (MUST). The MUST is simple to complete and useful for identifying if someone is malnourished.
When it comes to preventing and treating malnutrition, social interventions are as important as clinical interventions. Encouraging people to eat with friends and family and visits from volunteers such as Age UK’s befriending services apply in normal times. Under social isolation this becomes more challenging. Phone calls and enabling clients to engage with online communication platforms to access support networks are solutions that should be explored.
Emily Stuart is a dietitian for apetito and Wiltshire Farm Foods