Up to 81 per cent of elderly patients are at risk for inadequate nutrition, a report in RNJournal.com states. Nutritional assessment is key to early detection, aggressive intervention and favourable outcomes. Objective tests involving clinical, biochemical and anthropometric testing are more complicated and, often, less accurate for aged clients. Among the many assessment tools, five have been shown to easily and reliably measure and predict nutritional problems in the elderly.
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Mini Nutritional Assessment
The Mini Nutritional Assessment tool (MNA) incorporates physical examination, anthropometric measures and questions to determine a person's risk for nutritional problems. Physical signs of malnutrition such as thinning hair, easy bruising and skin manifestations are combined with the other findings to identify inadequacies in an elderly person's nutritional status. Scores obtained differentiate between those at risk and those at high risk for malnutrition.
Mini Nutrition Assessment --- Short Form
The Mini Nutritional Assessment --- Short Form (MNA-SF) is a reliable and efficient tool. A shorter version of the Mini Nutritional Assessment, it takes a four minutes to complete the six questions comprising it. In the MNA-SF, calf circumference rather than BMI (body mass index) measurement can be used. The questions ask about intake, mode of feeding, prescription medications, mobility and concurrent diseases.
Nutritional Form for the Elderly
The NUFFE, or Nutritional Form for the Elderly, has 15 items. Among those are history, diet and a general assessment that considers the person's ability to self-feed, among other considerations. In a study cited in RNJournal.com that used and created this tool for elderly in-patients, increased detection of nutrition problems resulted. This, in turn, increased patient referrals and overall satisfaction while it decreased numbers of infections and lengths of stay.
Resident Assessment Instrument
Many nursing homes use the Resident Assessment Instrument (RAI) to help determine nutritional problems in their residents. This method uses current weight and height, any history of weight loss and the quality and quantity of intake observed when determining the resident's potential for malnutrition. The RAI is initiated when the resident is first admitted, and those deemed at risk are referred at once for appropriate physician, nursing and dietary interventions.
Nutritional Health Screen
The Nutritional Health Screen tool is used by family members and health professionals to detect alterations in nutrition. Questions are answered yes or no, and responses are totalled to reveal an overall score. With 10 questions, it takes only a few minutes to get results. Totals of 6 or above indicate a high risk for malnutrition. Families using this tool, which has conversation-provoking questions, can learn a lot.
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- IMAJ: Assessment Tools for Nutritional Status in the Elderly; Yitshal N. Berner, MD, MPH; 2003
- RN Journal of Nursing: Malnutrition in the Elderly : An Unrecognized Health Issue Parts 1 and 2 : Sept. 2010 : Carol Eliadi, EdD, JD, APRN et al.
- American Academy of Family Physicians: The Geriatric Patient --- A Systematic Approach to Maintaining Health; 2000