Fuel for Life: Literature Review of Nutrition Education and Assessment Among Older Adults at Home

Saturday, 28 October 2017

Maloney Astrup
College of Nursing, Villanova University, Villanova, PA, USA

Nutrition is often considered the foundation of health and an important indicator of well-being. Older adults living at home are at particularly high risk for poor nutrition due to the incidence of multiple chronic diseases such as diabetes,arthritis, heart failure and cognitive impairment, as well as the financial instability and social isolation that often plagues this population. Older adults living at home who receive skilled home health may still be at risk for poor nutrition as the Outcomes Assessment Information Set
(OASIS), the Centers for Medicare and Medicaid mandated home health assessment, does not contain items specifically related to
nutrition assessment, leaving this important aspect of health potentially neglected. An abundance of knowledge defining adequate nutrition for older adults exists. However, it is unclear how nutritional recommendations are provided to older adults or if nutrition status is consistently assessed. To address this gap, we conducted a literature review related to nutritional assessment and education for older adults living at home.
The PubMed, CINAHL, and MedLine databases were searched for relevant English language studies published between 1998 and 2016 using the search terms "nutrition”, “older adults”, “assessment”, and “education” with the two additional terms, “community” and “home health”, generating eight studies eligible for inclusion.
Five studies identified barriers to adequate nutrition and three tested interventions. Nurses are the professionals who provide nutritional education and assessment most often in the home; however both health professionals and family caregivers report feeling underprepared to assess, educate and meet the nutritional needs of older adults. Additional barriers included time constraints, lack of interprofessional communication and collaboration, poor teaching materials and that health professionals feel family caregivers do not consider nutrition a priority. Interventions such as individualized nutritional counseling and the development and testing of malnutrition screening tools have been tested to identify and mitigate risk for poor nutrition.
There is a paucity of research in the United States regarding the nutritional education and assessment of the older adults living at home. Additional interprofessional research and health care professional education could be important to improving this population’s nutrition status.