In an earlier article in this journal, the author looked at malnutrition in the community from the patient's perspective (JCN, 28(2): 40–4). Here, she examines some practical tips on how community nurses can provide help for patients in danger of becoming malnourished. Malnutrition may have been caused by a chronic problem that has resulted in years of gradual deterioration and prompt action can prevent malnutrition escalating further and affecting the patient’s overall health. In this case, more detailed and supportive treatment from family, friends and healthcare services may be required to help implement changes in a patient's routine. By using some of the ideas highlighted in this article, and with regular monitoring and support, nurses can better help patients in the community to recover quickly from, or avoid, malnutrition.
This article examines malnutrition, a complex issue that has wideranging implications in terms of patient experience and resources - evidence suggests that malnourished people are repeat attendees at GP surgeries, incur higher prescription costs and experience twice as many hospital admissions than well-nourished people. While there have been many hospital initiatives targeted at reducing the risks of malnutrition, in the community the solution remains challenging. Recommendations include arranging services so that health and social care professionals can work together to overcome nutrition issues, making extra resources available to combat malnutrition and improving the monitoring of patients' nutritional state. As healthcare shifts to a more community-based model, there needs to be a reallocation of resources from hospitals to community to ensure that efforts to tackle malnutrition have a more realistic chance of success.
Eating well in later life is an essential part of enabling older people to live independently at home for longer. However, with increasing funding cuts to community care services in the context of an ageing society, is enough being done to encourage good nutrition in later life? This article discusses the importance of nutrition for older people and explores how community practitioners are ideally placed to spot the early warning signs of malnutrition and encourage patients to take better care of their diet.
Helen Willis, Dietitian, Wiltshire Farm Foods
This article discusses nutrition in relation to patients in the community who are living with venous leg ulcers. The author explores the complex issues surrounding the care of this patient group, which is predominantly made up of older people who often have several underlying medical conditions and may live alone in their own homes or in supported residential settings. The article covers the physiology and aetiology of venous leg ulcers and explores how nutrition plays a role in the healing process. It advocates a holistic approach, taking into account the many factors involved when considering nutritional status and suggests interventions that are available to nurses and healthcare professionals working in the community.
Jennifer Lunnon is a staff nurse in the Intensive Care Unit, Royal Devon and Exeter Hospital
Dr Finbarr Martin discusses the nutritional needs of elderly people.
Dr Finbarr Martin, MD, MSc FRCP is a Consultant Physician and Senior Lecturer, Guys & St Thomas’ Hospital Trust, London.
Article accepted for publication July 2001.
Suzanne Williams gives an overview of a proposal to pilot a standard for screening the nutritional status of the over 65s. Suzanne Williams RGN, BSc Hons, District Nursing is a Community Matron, Norwich PCT. Article accepted for publication: February 2005
Joanne Wright looks at how community nurses can help patients to maintain optimum nutrition
Joanne Wright RGN, RM is a Practice Nurse, Brighouse, West Yorkshire.
Article accepted for publication: September 2006
Margaret Barnett discusses the nutritional management of patients with respiratory disease
Margaret Barnett, RGN, MSc in Nursing Studies, COPD Dip. is a COPD Specialist Nurse, Plymouth NHS.
Article accepted for publication: May 2008
