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How to care for someone with malnutrition

What is malnutrition?
Malnutrition is described as having insufficient food or other substances for good health and condition. As we get older, our eating habits can change – putting us at more risk of becoming malnourished. It is estimated 1.3 million people over 65 suffer from malnutrition, with the vast majority (93%) live in their own homes.
If a loved one has noticed a change in sense of taste or smell, alteration in food preferences or simply have a reduced appetite, it is vital to ensure that their dietary requirements are still being met. In this article, we’re going to look at how to spot signs of malnutrition early and give you advice on how you can help care for someone who is at risk or living with malnutrition.

What causes malnutrition?
Understanding what could be causing your loved one to not be receiving the nutrients they need is the next step to caring for them. There are several causes of malnutrition ranging from health conditions, to physical and social factors and side effects of medicines – each of which can lead to a poor diet, reduced appetite or issues with the body absorbing nutrients from food.
Common health causes include:

  • Conditions which cause long term loss of appetite such as sickness bugs, cancer or liver disease
  • Dementia is a condition that can cause the person to forget to eat
  • Mental health conditions such as depression and schizophrenia
  • Some medicines can also cause unwanted side effects such as nausea and loss of appetite
 Physical and social factors can include:
  • Poor fitting dentures or painful teeth
  • Low income
  • Reduced mobility which makes it more difficult to cook and get to the shops
  • Limited knowledge of nutrition and cooking
 Spotting the signs of malnutrition
The first way to care for someone with malnutrition is being able to recognise the signs. The main symptom of malnutrition is unintended weight loss, although this is not always obvious. Some other signs to look out for include:
  • Unintentionally losing 5-10% of their body weight within three to six months
  • Their body mass index (BMI) falling under 18.5
  • Clothes, belts and jewellery becoming looser over time
Other symptoms may include:
  • reduced appetite or a lack of interest in food and drinks
  • chronic fatigue 
  • feeling weaker
  • poor concentration
  • often feeling cold
  • poor mood or depression
If you notice these symptoms in a loved one, encourage them to seek medical advice.

Malnutrition treatment
If a loved one is diagnosed with malnutrition or undernourishment, you may be given advice to follow at home or they may be referred to a dietitian for further support. Depending on the severity of the malnourishment, the following options may be advised as forms of treatment:
  • Changes to diet or adding of supplements to the diet
  • Home care for those with mobility issues to help prepare meals
  • Using a home meals delivery service, such as the service from Wiltshire Farm Foods. This offering ensures your loved one has delicious meals in their freezer whenever they’re needed
You can find more information and support on the NHS website.

How to prevent malnutrition
If you believe your loved one is at risk of becoming malnourished, taking these social and psychological factors into account may reduce this risk:
  • Encourage social dining – whether this be through family meals or encouraging your loved one to attend lunch clubs organised in your local community
  • Serve them their favourite foods to try and encourage eating
  • Choose foods that remind loved ones of a happy time e.g. childhood or holidays
There are also medical or physical factors you should be aware of to increase their intake of nutrients:
  • Check whether a reduced appetite isn’t a side effect of any medication they are taking
  • Encourage them to be involved in the cooking process; seeing and smelling the food may stimulate appetite
  • Make sure they are comfortable in the dining area. Are they sat up properly? Do they have their glasses on?

Managing malnutrition at home
A change in diet is the best way to manage malnutrition at home. The British Dietetics Association (BDA) recommends encouraging snacking between meals, particularly on high protein, high energy snacks, to increase nutritional intake. The BDA guidelines suggest 3 meals and 3 snacks a day.
Introducing drinks such as milkshakes and adding whole milk to tea and coffee is an easy way of increasing calorie intake. As is, fortifying existing foods by adding butter, cream, cheese or whole milk to mashed potato or sauces, adding cream to porridge, having puddings with creamy yoghurt and adding cream to soups if cooking at home.
Mini Meals Extra from apetito are also a good way of maintaining the required calorie and nutrient intake, but in a smaller manageable portion. This great range of small delicious meals that serves up that satisfying main meal feeling and containing 501-514 calories and 20-27g of protein and make a great solution for lunch or dinner. Combined with high calorie snacks and breakfasts they can form part of a convenient solution to help manage malnutrition for those with small appetites.