Targeted nutritional intervention as a tool to support self-sufficiency in a geriatric patient

Czech version

Authors: Mikulecká Věra
Authors‘ workplace: Oddělení následné péče, Krajská nemocnice Liberec, a. s.
Published in: Geriatrie a Gerontologie 2024, 13, č. 1: 27-31
Category:

Overview

An 86-year-old polymorbid woman was hospitalized in the trauma ward for a femoral neck fracture, osteosynthesis performed. The patient was then transferred to the aftercare department for further treatment and rehabilitation. Here she was diagnosed with dementia and malnutrition syndrome. Despite the set nutritional support, the patient‘s body weight decreased significantly during the hospitalization. At discharge, regular visits to the geriatric outpatient clinic were scheduled with the patient‘s family for easier management of dementia treatment and nutritional support. As part of a comprehensive geriatric assessment, a targeted nutritional support plan adapted to the patient‘s carefully organized home care system was developed in cooperation with a nutritional therapist. In cooperation with the nutrition clinic, the nutritional support plan was slightly optimized according to the patient‘s dietary preferences. During the next control examination in the geriatric outpatient clinic, a positive effect of the therapy in increasing body weight, improvement of frailty syndrome, nutritional status and sarcopenia was noted as early as three months after discharge from hospital. The described case shows the practical benefit of regular nutritional screening of seniors and case management by a geriatrician with a nutritional therapist, nutritionist, patient‘s family and home care workers.

Keywords:

geriatric patient, malnutrition, nutritional support, home care, self-sufficiency

Sources

1. Guigoz YS, Lauque BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002; 18: 737–757.

2. Klbíková T, Topinková E. Posouzení výživového stavu v komplexní diagnostice a managementu geriatrické křehkosti. Geriatrie a Gerontologie 2018; 7(1): 33–39.

3. Grofová Z. Výživa ve stáří. Medicína pro praxi 2009; 6(1): 42–43.

4. Topinková E. Využití standardizovaných škál pro hodnocení stavu výživy u starších nemocných. Česká geriatrická revue 2003; 1(1): 6–11.

5. Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature – What does it tell us? J Nutr Health Aging 2006; 10(6): 466–485.

6. Lim S, Ong K, Chan Y, et al. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr 2012; 31(3): 345–
350.

7. Jurašková B, Hrnčiariková D, Holmerová I, et al. Poruchy výživy ve stáří. Medicína pro praxi 2007; 4(11): 443–446.

8. Šíma P. Nutriční imunologie. Interní medicína pro praxi 2011; 13(6): 255–258.

9. Zadák Z. Výživa v intenzivní péči. Praha: Grada Publishing 2002.

10. Hrnčiariková D, Vaňková H, Bielaková K, et al. Vyhodnocení nutričního stavu a sarkopenie geriatrického pacienta. Klinický doporučený postup výboru České gerontologické a geriatrické společnosti ČLS JEP. Geri a Gero 2024; 13(1): ?

11. Vágnerová T. Nová kritéria pro diagnostiku malnutrice – co nám říkají? Geri a Gero 2019; 8(1): 20–26.

12. Cederholm T, Jensen GL, Correia MITD, et al. GLIM Core Leadership Committee; GLIM Working Group. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr 2019; 38(1): 1–9.