Current practices of dietitians in the assessment and management of malnutrition in elderly patients

Aim This study aimed to determine the strategies used by dietitians to assess, treat and monitor elderly patients diagnosed with, or at increased risk of, malnutrition and to compare these with evidence-based guidelines and the current literature. Methods An online survey was distributed to members of the Dietitians Association of Australia (DAA) working in an inpatient/outpatient facility or private practice/consultancy. Dietitians working with elderly people (≥65 years old) were invited to participate. The survey was informed by DAA's evidence-based guidelines and was pre-tested. Responses of dietitians were analysed by years of experience, service setting and approaches taken to assess and manage malnutrition. Results One hundred sixty surveys were returned. Fourteen per cent of respondents worked in services that had no malnutrition policies. A Subjective Global Assessment tool was used by 59% of respondents and 95% recommended oral nutrition supplements when malnutrition or risk of malnutrition was diagnosed. Eighty-three per cent focused on increasing both energy and protein intake; however, 64% of respondents did not consider the nature of the protein source and only 62% discussed sarcopenia. Patients at risk of malnutrition were monitored slightly less frequently than those with diagnosed malnutrition. Conclusions Respondents generally use practices that align with current assessment and treatment practice guidelines and use validated assessment tools; however, at sites where no policies exist, protocols are needed. Treatment protocols exist in less than 50% of workplaces, suggesting that specific malnutrition treatment guidelines for the elderly may be needed.