Undernutrition remains a considerable problem in health-care settings and policies throughout Europe. In 2002, the Council of Europe published a report on food and nutritional care in hospitals, which contained over 100 recommendations for improvement. The current report explores the prevalence, causes and specific consequences of undernutrition in care homes and home care. It builds upon the work of the Belgian National Food and Health Plan and the international workshop on undernutrition in care homes and home care, which was organised in Brussels on 22 and 23 November 2007 by the Belgian Federal Public Service of Health, Food Chain Safety and Environment.The report examines the major barriers to proper nutritional care in these health-care settings and explores the roles and responsibilities of all actors involved. Detailed recommendations for action on different levels have been elaborated by experts from several Council of Europe member states to improve awareness, screening and management of undernutrition.
Table of figures
Preface
Acknowledgements
Glossary
Abbreviations
Executive summary
1. Introduction
2. Prevalence and causes of undernutrition in care homes and home care
Undernutrition
Prevalence
Causes
3. Consequences of undernutrition for older people
Morbidity- Mortality
Quality of life
4. Impact of undernutrition on health care costs
Optimal nutrition and dietary goals in older people
Cost-effectiveness and cost-benefit assessment
Influence of the health cost finance structure
Quality of life of the caregiver
5. Assessing and treating undernutrition in care homes and home care
Nutritional risk screening and nutritional assessment
Nutritional support, treatment, monitoring and follow-up
Nutritional support in dementia and the final stages of life
The hospital-care home-home care continuum
6. Strategies to tackle undernutrition in hospitals
7. Strategies to tackle undernutrition in care homes and home care
Raising awareness
The roles and responsibilities of health care workers
The general practitioner- Family doctor
Care home and home care nursing staff
The dietician
The roles and responsibilities of health care facilities
Care homes
Food provision
Home care
The role and responsibilities of society
The person at risk
Food services
Society stakeholders
The roles and responsibilities of policy makers
Conclusions
Appendix A: Recommendations of the scientific group of undernutrition experts advising on the Belgian National Food and Health Plan: undernutrition screening and nutritional assessment
Appendix B: Practical measures set out in the "nutrition quality charter" for care homes (CHs) and care and nursing homes (CNHs)
Bibliography
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