So what do we do about malnutrition? – a learning visit

Malnutrition (or undernutrition as it is more correctly called) affects far more people than most of us realise. If you are under-nourished you are more likely to have a fall, and you are more likely to get ill. If you do get ill you are more likely to go to hospital, and your hospital stay will probably be longer. You will probably die younger. And since a hospital bed costs £400 a day you will cost the taxpayer more. How much better would it be to prevent undernutrition in the first place and not only save money, but improve quality of life.

As many of you know, Brighton and Hove is bidding to become the first Gold Sustainable Food City in the UK.  So we were delighted when the city’s Health and Wellbeing Board, who make key decisions on our health and social care services, agreed last year to play their part by taking a focussed look at malnutrition in older people.

As part of this work, we were lucky to secure funding via national programme Food Power to visit the ‘Wessex Academic Health Science Network’ to find out about their inspiring work and preview their ‘nutrition wheel’ – a new tool they have developed to help a much broader range of people to understand and spot malnutrition, and to know what to do when they come across people who are at risk.

We know that 93% of the 1.3 million older people with undernutrition aren’t in institutions like care homes or hospitals, but in our community [Ref 1], living in their own houses and flats. It is these people that we want, as a city, to become better at finding and then signposting to some of the amazing support available in the city – whether to key organisations like Age UK or one of the city’s amazing and vibrant shared meals or lunch clubs, or Casserole Club which connects neighbours together over sharing food.

For this project we are thinking about prevention and about causes. Some people have undernutrition for medical reasons due to illness, but this project is focussing on those without a medical cause – who often aren’t reached because the causes and solutions can be so complicated. As we age, not only do the needs of our bodies change but we may become less mobile or less able to cook, or lose interest in food, perhaps through loneliness or bereavement. Our city has a high proportion of older people who live alone, which for some can make cooking and eating less of a pleasure and more of a chore.

We need to open up conversations in our city. Sometimes it’s not even about offering ‘support’ or  ‘signposting’ but just about raising awareness. Lots of us don’t realise that we may need to eat differently as we get older and we may see losing weight as just a natural part of the ageing process. But it isn’t and everyone needs to know that.

If you want to know more about ageing healthily and what you eat, see our downloadable Eating Well As You Age leaflet. If you work or volunteer with older people, look out later in the year for the next steps in this project– maybe soon we will have our own city-wide tool to help us be more confident in starting conversations around this topic.

We would like to thank Food Power for funding our visit and Wessex ASHN for their time, expertise and for their willingness to share their knowledge so openly so that others can learn. The visit was incredibly helpful, involving staff from public health, adult social care and the CCG (health services). It wasn’t only what we learnt, but the fact that colleagues from different areas got to think through the issues and learn about them together. Two colleagues hadn’t met before despite their roles linking and have agreed to meet up since. It was literally a journey, with the opportunity to think through on the train home how we could make something similar work in our own city. We are all busy people and it’s hard to take a whole day out but in fact it felt a time-efficient way to be jointly inspired and develop a joint approach – and felt all the more do-able for having taken place somewhere where they have already made this approach work.

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