Malnutrition assessment checklist

Suggested actions/interventions

Available resources detailed in text or over the page

• Discuss with GP - rule out undiagnosed conditions such as infection, anaemia, poor diabetes control, or other underlying disease
• Ensure appropriate treatment and management of underlying condition
• Review current medications and potential side effects
• Implement the 1, 2, 3 everyday Food First approach:

• • 1 pint of fortified milk
  • 2 nourishing snacks or drinks
  • 3 fortified meals per day

• Assess oral hygiene / mouth ulcers/ oral thrush, treat as appropriate
• Check teeth and dentures - refer to Dentist if appropriate
• Provide verbal prompts to chew and swallow during meals
• Modify food consistency as required:

• • Cut food into small pieces, add sauces (e.g. gravy, custard)
  • Offer softer foods; avoid dry or chewy textures
  • Mash or puree foods if necessary.

• Implement 1, 2, 3 everyday Food First approach, if unintentional weight loss is evident
• If symptoms persist, refer to Speech & Language Therapist

• Assess comfort and readiness at mealtimes (toileting, seating position, oral health, sensory aids e.g. hearing aids, glasses) 
• Consider the environment and minimise distractions
• Assess level of support required for eating and drinking

• • Consider adaptive equipment or aids
  • Offer finger foods where appropriate

• Encourage eating and drinking by using verbal and visual cues
• Promote social dining opportunities - Eating with your resident or being in a dining area may help them to mirror eating behaviour
• Identify and provide preferred foods (nutritional balance not essential)
• Assess for underlying causes (pain, depression, communication difficulties)
• Encourage 1, 2, 3 everyday Food First approach
• Refer to Dignity & Mealtime Experience guidance.

• Implement actions as above
• Assess for constipation and pain
• In residents with dementia, consider use of their life story and recreating an environment that the resident feels safe and secure this may promote eating and drinking
• If at risk of dehydration, seek medical advice
• Encourage the 1,2, 3, everyday Food First approach

• Assess underlying causes of agitation
• Optimise mealtime environment and reduce distractions
  • Offer regular finger foods throughout the day
  • Encourage Food First approach

• Screen for depression - seek medical advice if indicated
• Consider end-of-life care needs - offer comfort foods and fluids, little and often.
• Minimise distractions at mealtimes, consider preferred environment
• Provide encouragement and support with preferred meals/snacks/drinks - these do not have to be nutritionally balanced

• If all interventions have been implemented for 4 weeks and weight continues to decline:
• • Refer to Dietitian
  • Discuss further investigation with GP