Time for change to tackle malnutrition among older people in Scotland

Published: 5 October 2020

Food Train and University of Glasgow study recommends mandatory community screening by health and social care agencies to identify older age adults in danger of malnourishment and food insecurity.

A significant step-change is needed in health and social care to intervene earlier to prevent malnutrition among older people in Scotland, a new study has found.

Research by the University of Glasgow’s Dr Kate Reid and Professor Catherine Lido, in partnership with the charity Food Train, has led to a series of calls to action to improve the experience of living into older age in the area of food security, health and nutrition.

These include recommending a requirement for all agencies working with older people to carry out community screening for early signs of malnutrition and to recognise that poor mental health also places the older adult at risk of malnutrition and food insecurity.

Greater screening, the organisations say, will not only save lives but also rising NHS costs linked to the falls and fragility associated with the one in 10 older age adults in the UK reportedly exhibiting signs of malnutrition.

Details of the findings - gathered during a year-long study in which 169 older adults were surveyed - have been released in the lead up to UK Malnutrition Awareness Week (October 5-12) during which Food Train will highlight the need for political and policy intervention to drive through the changes.

Food Train, which is in its 25th year, provides practical, social and emotional support to help older people eat well, age well and live well at home. It commissioned the university study through its Eat Well Age Well project, established to tackle malnutrition among older people across Scotland.

Access to food, lack of local shops, services and opportunities for social eating are some of the factors fuelling the problems which older people face when accessing and enjoying food - all issues exacerbated by the Covid-19 pandemic and associated shielding and social distancing measures.The Food Train organisation has responded to unprecedented demand for its home shopping where customer numbers have risen by 70% to 3,300 at their peak this spring.

Laura Cairns, Food Train’s Eat Well Age Well Project Manager, said: “The problem of malnutrition among older people does not have the recognition it desperately needs. It is too often overlooked in comparison to more dominant public health messages surrounding diet and obesity. Yet this is a serious problem, faced by unacceptable numbers of people in modern Scotland. Tackling this requires a significant step-change.

“The issues malnutrition causes are considerable, not least affecting physical and mental health. By better identifying those at risk, at an early stage, we can improve the lives of older people and reduce the financial pressures on health and social care services.

“The findings of this report highlight the need for action that we see in Scotland’s communities. It’s time for change and we are looking forward to making that case to MSPs as we try to get these recommendations enshrined in policy, particularly the right to food, supported by stronger funding models which protect social care and the wider third sector.”

The report - The Role of Food Security and Malnutrition Risk with Psycosocial Indicators of Healthy Ageing in Place - recommends four key actions:

  • Community Screening for early signs of malnutrition should be mandatory for all statutory agencies with a role in supporting older people.
  • Training on malnutrition and unintentional weight loss should be embedded into basic training for all health and social care professionals.
  • More secure investment should be made in community initiatives that address social isolation by providing befriending and opportunities for older people to eat, shop or cook with others.
  • Policy, practice and research needs to take account of the fact that food poverty and food insecurity are not the same for vulnerable older people.

Report authors Dr Kate Reid and Professor Catherine Lido, Psychologists and Lecturers at the University of Glasgow, state: “During Covid-19 we have witnessed how quickly food systems and access to food can be disrupted, placing previously food secure adults at increased risk of malnutrition.

“The social care sector is facing unprecedented pressure in terms of its sustainability to respond to an ageing population coupled with the magnitude of the impact of Covid-19 on recipients of services, their carers and volunteers.

“Beyond the Covid-19 pandemic, ensuring smooth access to food systems within connected communities cannot be fully released when the model for social care funding is based on short-life funding streams and precarious job security for paid staff .

“In order to create an age friendly society and to promote dignified human welfare, we need to maximise the health of all citizens in the area of food security, nutritional health and wellbeing, particularly the most vulnerable, socially isolated older adults in society.”

The university academics believe a broader understanding of food insecurity is needed, with access to food not simply down to financial means. Cooking at home was found to be a particular issue with many older adults reporting that they are more likely to opt for ready meals, snacks or cold convenience food such as sandwiches. Loneliness, families living further apart and neighbours not knowing each other as well as they used to are also factors.


Food Train

Food Train is an award-winning charity and social enterprise. Since 1995 it has been making life easier for older people, providing vital services to those no longer able to manage independently, through age, ill health, frailty or disability.

Across all of its service areas, Food Train aims to continue expanding services and support for older people to enable them to eat well, live well and age well at home. It currently has regional branches operating shopping services in Dumfries and Galloway, Dundee, Glasgow, Renfrewshire and East Renfrewshire, Scottish Borders, Stirling and Clackmannanshire and West Lothian. See more at www.thefoodtrain.co.uk.

Its Eat Well Age Well project is funded by the National Lottery Community Fund. For more details on its work, go to www.eatwellagewell.org.uk.

UK Malnutrition Awareness Week

UK Malnutrition Awareness Week is organised by BAPEN, a Charitable Association that raises awareness of malnutrition and works to advance the nutritional care of patients and those at risk from malnutrition in the wider community, and the Malnutrition Task Force. For more details, click here.


First published: 5 October 2020

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