Malnutrition is a serious condition that can affect a surprisingly diverse group of people. It can happen for various different reasons and have serious, long-term effects on both physical and mental health and wellbeing. Weight loss concerns become more prevalent among older people and those with more complex needs. Ensuring that person-led care is in place in residential care settings can go a long way towards protecting people’s nutritional condition and monitoring their calorie intake to keep them healthier and properly fed.
When a person’s diet does not contain enough nutrients, this can also lead to weight loss over the longer term. Being underweight can have a serious effect on a person’s ability to fight off infections, keep mobile, recover from illnesses, injuries and operations and enjoy strong and stable mental health. Sometimes, a person’s physical condition makes it harder for them to retain enough weight, for example if they are tube fed, have severe allergies or have difficulties swallowing. In these cases, weight needs to be monitored even more closely to ensure that it does not dip dangerously low.
What is the MUST score?
A helpful tool for care workers seeking to monitor the weight of those in their care is the MUST score. MUST stands for ‘Malnutrition Universal Screening Tool’ and is an integral part of the Care Vision care management software. Used in numerous care homes, clinics, hospitals etc., it helps to assess a person’s risk of becoming malnourished and provides essential information and guidelines to draw up a weight management plan that is tailored to the individual under analysis. The MUST score is calculated via a five-stage process:
- Measure height and weight to work out the person’s BMI score
- Note the percentage of unplanned weight loss that has occurred and give this a score
- Note effects that any acute conditions and diseases have on weight loss and score
- Add these figures together to identify overall MUST score
- Use results to create an individualised weight management plan
MUST scores range from 0 for low risk, through to 1 for mild concerns and routine weight monitoring and 2 for those considered to be at a high risk of malnutrition and unwanted weight loss. In the latter case, the person is referred to a nutritional expert and a plan put in place with stated goals and regular review points.
How to ensure good nutrition this winter?
As 2022 draws to a close, the winter weather brings challenges around keeping older and vulnerable people healthy and well nourished. Some tips for helping them to eat well and keep their MUST score under control include the following:
- Lunch is a very important meal. Many people think of breakfast as the most important meal of the day, but for older people and those in residential care, lunch has a wide range of benefits too. For instance, the body tends to metabolise healthy fats, vitamins and nutrients better during the day, rather than at night when people are asleep.
- Serve plenty of green, leafy vegetables. These have lots of anti-oxidants in them to ward off colds and offer a delicious, easy-to-eat way to take in some of the required ‘five-a-day’ fruit and veg servings.
- Bulk out meals with wholegrains, such as brown rice and quinoa. These are packed with essential nutrients and help keep people feeling full for longer. They are also easier to swallow than other food items like pasta or boiled potatoes.
- Add plenty of vitamin D. Again, this helps strengthen the immune system and keeps people healthier for longer. Grains, eggs, fish and dairy are all good options, especially if you use vitamin D enriched versions. Adding vitamin D to meals wherever possible is also important when the winter comes around, as there is less exposure to sunlight and other natural sources.
- Omega-3 fatty acids can help with people’s nutritional needs too. They lower the risk of developing or exacerbating problems with joints, such as arthritis, as well as helping to protect the body against heart disease. Good sources of omega-3 fatty oils include nuts and avocados.
Finally try to tempt reluctant eaters with food and meals that are visually pleasing as well as delicious to eat. We often tend to enjoy food with all of our senses, so it’s worth taking that extra effort to produce something that looks, smells and tastes amazing. This helps make mealtimes more enjoyable.