Skip to main content
SpringerLink
Log in

A multifaceted intervention model can give a lasting improvement of older peoples’ nutritional status

  • A Multifaceted Intervention Model
  • Published:
The journal of nutrition, health & aging

Abstract

Objective

The purpose of this study was with a multifaceted intervention model improve the nutritional status of elderly people living in residential homes to increase their energy intake and to maintain improvements over time.

Setting

Three different municipal residential homes in the south-east of Sweden.

Participants

The study population consisted of 67 elderly people. A within-subjects design was used which means that the participants were their own controls.

Intervention

A multifaceted intervention model was chosen, which included education on both theoretical and practical issues, training and support for staff, and individualized snacks to the residents.

Measurements

Nutritional status was measured by Mini Nutritional Assessment (MNA), the consumption of food was recorded by the staff using a food record method for 3 consecutive days. The length of night-time fasting has been calculated from the food records.

Results

Nutritional status improved after 3 months of intervention and was maintained after 9 months. Weight increased during the whole study period. Night-time fasting decreased but not to the recommended level.

Conclusion

This study shows that it is possible by a multifaceted intervention model to increase energy intake including expanding snacks and thereby improve and maintain nutritional status over a longer period in the elderly living in residential homes. This result was possible to achieve because staff received education and training in nutritional issues and by provision of support during a period when new routines were introduced.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ödlund Olin A, Koochek A, Ljungqvist O, Cederholm T. Nutritional status, well.being and functional ability in frail elderly service flat residents. Eur J Clin Nutr. 2005; 59, 263–270

    Article  PubMed  Google Scholar 

  2. Lorefält B, Ganowiak W, Pålhagen S, Unosson M, Toss G, Granérus A-K. Factors of importance for weight loss in elderly patients with Parkinson’s disease. Acta Neurol Scand. 2004; 110:180–187

    Article  PubMed  Google Scholar 

  3. Saletti A, Yifter-Lindgren E, Johansson L, Cederholm T. Nutritional status according to Mini Nutritional Assessment in an institutionalized elderly population in Sweden. Gerontology. 2000; 46:139–145

    Article  PubMed  CAS  Google Scholar 

  4. Keller HH, Østbye T. Do nutrition indicators predict death in elderly Canadians with cognitive impairment? Can J Public Health. 2000; May–Jun:91(3):220–244

    PubMed  CAS  Google Scholar 

  5. Akner G, Cederholm T. Treatment of protein-energy malnutrition in chronic nonmalignant disorders. Am J Clin Nutr. 2001; 74: 6–24

    PubMed  CAS  Google Scholar 

  6. Mowé M, Bøhmer T. Reduced appetite. A predictor for undernutrition in aged people. J Nutr Health Aging. 2002; 6:81–83

    PubMed  Google Scholar 

  7. Wetergren A, Ohlsson O, Hallberg IR. Eating difficulties in relation to gender, lenght of stay, discharge to institutional care, among patients in stroke rehabilitation. Disabil Rehabil. 2002; 24(10): 523–533

    Article  Google Scholar 

  8. Banks M, Bauer J, Graves N, Ash S. Nutrition. 2010; 26: 896–901

    Article  PubMed  Google Scholar 

  9. Scrimshaw NS, SanGiovanni JP. Synergism of nutrition, infection, and immunity: an overview. Am J Clin Nutr. 1997; 66: 464S–477S

    PubMed  CAS  Google Scholar 

  10. Vanderwee K, Clays E, Bocquaert I, Gobert M, Folens B, Defloor T. Malnutrition and associated factors in elderly hospital patients: A Belgian cross-sectional, multicentre study. Clin Nutr. 2010; 29: 469–476

    Article  PubMed  Google Scholar 

  11. Topinková E. Againg, Disability and frailty. Ann Nutr Metab. 2008; 52 (suppl 1): 6–11

    PubMed  Google Scholar 

  12. Barton AD, Beigg CL, MacDonald IA, Allison SP. A recipe for improving food intakes in elderly hospitalized patients. Clin Nutr. 2000; 19(6): 451–454

    Article  PubMed  CAS  Google Scholar 

  13. National Food Administration. Förslag om råd om bra mat i äldresomsorgen. Remissversion 2010-10-06. (In Swedish)

  14. The National Board of Health and Welfare. Näringsproblem i vård och omsorg. Prevention och behandling inom äldreomsorgen. SoS rapport 2000:11. (In Swedish).

  15. Brown LE, Copeman J. Nutritional care in care homes: experiences and attitudes of care home staff. J Hum Nutr Diet. 2008; 21: 383

    Article  Google Scholar 

  16. Bachrach-Lindstrom M, Jensen S, Lundin R, Christensson L. Attitudes of nursing staff working with older people towards nutritional nursing care. Jour Clinl Nurs. 2007; 16(11): 2007–2014

    Article  Google Scholar 

  17. Polit DE, Beck CT. Nursing Research. Generating and assessing evidence for nursing practice 8ed. Lippincott Williams & Wilkings. 2008

  18. Bassey EJ. Demi-span as a measure of skeletal size. Ann Hum Biol. 1986; 13: 499–502

    Article  PubMed  CAS  Google Scholar 

  19. Guigoz Y, Vellas B, Garry PJ. Mini nutritional assessment. A practical assessment tool for grading the nutritional state of elderly patients: In: Facts, Research and Intervention in Geriatrics supplement. 1997; 2: 15–60

    Google Scholar 

  20. Vellas B, Guigoz Y, Garry J, Nourhashemi F, Bennahum D, Lauque S, Albarede JL. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999; 15:116–122

    Article  PubMed  CAS  Google Scholar 

  21. Guigioz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The mini nutritional assessment as part of the geriatric evaluation. Nutr Rev. 1996; 54: 59–65

    Article  Google Scholar 

  22. World Health Organization. Energy and protein requirements. Report of a Joint FAO/WHO/UNU Expert Consultation. World Health Organization Technical Report Series 724 Geneva. 1985

  23. Nordic Nutrition Recommendations NNR 2004 — integrating nutrition and physical activity. Nordic Council of Ministers 2005-01-01

  24. Hågelin L, Hagman U, Nilsson M. Evaluation of the meal model “Matmallen” — A means of estimating consumed amounts of food. Scand J Nutr 1995; 39: 79–83

    Google Scholar 

  25. Kost och näringsdata (Food and nutrition data). Dietist XP version 3.0. 2007

  26. The Swedish National Food Administration. Vikttabeller för livsmedel och maträtter (Weight tables for food and dishes). Uppsala. 1992

  27. Oxman AD, Thomson MA, Davis DA, Haynes B. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. Can Med Assoc J. 1995; 15: 1423–1431

    Google Scholar 

  28. Beck AM, Damkjær K, Sørbye LW. Physical and social functional abilities seem to be maintained by a multifaceted randomized controlled nutritional intervention among old (>65 years) Danish nursing home residents. Archives of Gerontology and Geriatrics. 2010; 50: 351–355

    Article  PubMed  Google Scholar 

  29. Wikby K, Ek A-C, Christensson L. Implementation of a nutritional programme in elderly people admitted to resident homes. Scan J Caring Sci 2009 23: 421–430

    Article  Google Scholar 

  30. Westergren A, Hedin G. Do study circles and a nutritional care policy improve nutritional care in a short — an long-term perspective in special accommodations? Food & Nutrition research. 2010; 54:DOI:10.3402/fnr.v54i05.5402

  31. Endevelt R, Werner P, Goldman D, Karpati T. Nurses’ knowledge and attitudes regarding nutrition in the elderly. J Nutrition Health Aging. 2009; 13(6): 485–489

    Article  CAS  Google Scholar 

  32. Ödlund Olin A, Armyr I, Soop M, Jerström S, Classon I, Cederholm T, Ljunggren G, Ljungqvist O. Energy-dense meals improve energy intake in elderly residents in a nursing home. Clin Nutr. 2003; 22(2): 125–131

    Article  PubMed  Google Scholar 

  33. Ödlund Olin A, Koochek A, Cederholm T, Ljungqvist O. Minimal effect on energy intake by additional evening meal for frail elderly service flat residents—a pilot study. J Nutr Health Aging. 2008; 12(5): 295–301

    Article  PubMed  Google Scholar 

  34. Milne AC, Potter J, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. 2009; 15;(2): CD003288

    Google Scholar 

  35. Gibson R. Principals’of Nutritional Assessment. 1990 Oxford University Press New York

    Google Scholar 

  36. Brink P, Wood M. Advanced design in nursing research. 2nd ed. London: SAGE Publications 1998

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nursing Science, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden

    B. Lorefält

  2. Faculty of Health Sciences, Linköping University, The Research and Development (R&D) Unit in Local Health Care, County of Östergötland Sweden, Linköping, Sweden

    Susan Wilhelmsson

  3. R&D Unit in Local Health Care, County Council of Östergötland, S:t Larsgatan 9D, SE-581 85, Linköping, Sweden

    Susan Wilhelmsson

Authors
  1. B. Lorefält
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan Wilhelmsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susan Wilhelmsson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lorefält, B., Wilhelmsson, S. A multifaceted intervention model can give a lasting improvement of older peoples’ nutritional status. J Nutr Health Aging 16, 378–382 (2012). https://doi.org/10.1007/s12603-011-0362-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-011-0362-4

Key words

Search

Navigation