Most of us here have either elderly parents or relations and I came across this table called Meals On Wheels and found it a very interesting check list that we all could use.
Also the information on this link is very good.
Evaluating and Treating Unintentional Weight Loss in the Elderly - February 15, 2002 - American Family Physician
Common treatable causes of weight loss in elderly patients should be sought. The mnemonic "Meals on Wheels" is useful for remembering these etiologies (Table 2).1,20 Another approach is to distinguish among four basic causes of weight loss: anorexia, dysphagia, socioeconomic factors and weight loss despite normal intake.18 Often, these causes are interrelated. Whatever approach is used, the initial evaluation can yield a reason for weight loss in a large number of patients.17
TABLE 2
"Meals on Wheels": A Mnemonic for Common Treatable Causes of Unintentional Weight Loss in the Elderly
M Medication effects
E Emotional problems, especially depression
A Anorexia nervosa, alcoholism
L Late-life paranoia
S Swallowing disorders
O Oral factors (e.g., poorly fitting dentures, caries)
N No money
W Wandering and other dementia-related behaviors
H Hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoadrenalism
E Enteric problems
E Eating problems (e.g., inability to feed self)
L Low-salt, low-cholesterol diet
S Stones, social problems (e.g., isolation, inability to obtain preferred foods)
Adapted with permission from Morley JE, Silver AJ. Nutritional issues in nursing home care. Ann Intern Med 1995;123:850-9, with additional information from Reife CM. Involuntary weight loss. Med Clin North Am 1995;79:299-313.
HISTORY
The first step in the history is to obtain information about the weight loss itself. It should be possible to determine if the patient is predominantly not hungry or is feeling nauseated (or even vomiting) after meals, if the patient is having difficulty eating or swallowing, or if the patient is having functional or social problems that may be interfering with the ability to obtain or enjoy food. A combination of these factors may be present.
An interview with a knowledgeable caregiver is essential because the elderly patient may deny or be unaware of the weight loss or the aforementioned difficulties. If the patient's measured weights over time are not available, the caregiver may be able to estimate the amount of weight that the patient has lost through changes in the patient's clothing size.
A nutritional assessment should be performed. The dietary history includes the availability of food, the patient's use of nutritional (and herbal) supplements, the adequacy of the patient's diet (amount of food consumed, balance of nutrients, etc.) and the patient's daily caloric intake. The Mini Nutritional Assessment, a tool that has been validated in the elderly for measuring nutritional risk, can be used to collect some of this information (Figure 1).21 Once the shorter form of this instrument has been validated in the elderly, it may be a more practical tool for the family physician
Also the information on this link is very good.
Evaluating and Treating Unintentional Weight Loss in the Elderly - February 15, 2002 - American Family Physician
Common treatable causes of weight loss in elderly patients should be sought. The mnemonic "Meals on Wheels" is useful for remembering these etiologies (Table 2).1,20 Another approach is to distinguish among four basic causes of weight loss: anorexia, dysphagia, socioeconomic factors and weight loss despite normal intake.18 Often, these causes are interrelated. Whatever approach is used, the initial evaluation can yield a reason for weight loss in a large number of patients.17
"Meals on Wheels": A Mnemonic for Common Treatable Causes of Unintentional Weight Loss in the Elderly
M Medication effects
E Emotional problems, especially depression
A Anorexia nervosa, alcoholism
L Late-life paranoia
S Swallowing disorders
O Oral factors (e.g., poorly fitting dentures, caries)
N No money
W Wandering and other dementia-related behaviors
H Hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoadrenalism
E Enteric problems
E Eating problems (e.g., inability to feed self)
L Low-salt, low-cholesterol diet
S Stones, social problems (e.g., isolation, inability to obtain preferred foods)
Adapted with permission from Morley JE, Silver AJ. Nutritional issues in nursing home care. Ann Intern Med 1995;123:850-9, with additional information from Reife CM. Involuntary weight loss. Med Clin North Am 1995;79:299-313.
HISTORY
The first step in the history is to obtain information about the weight loss itself. It should be possible to determine if the patient is predominantly not hungry or is feeling nauseated (or even vomiting) after meals, if the patient is having difficulty eating or swallowing, or if the patient is having functional or social problems that may be interfering with the ability to obtain or enjoy food. A combination of these factors may be present.
An interview with a knowledgeable caregiver is essential because the elderly patient may deny or be unaware of the weight loss or the aforementioned difficulties. If the patient's measured weights over time are not available, the caregiver may be able to estimate the amount of weight that the patient has lost through changes in the patient's clothing size.
A nutritional assessment should be performed. The dietary history includes the availability of food, the patient's use of nutritional (and herbal) supplements, the adequacy of the patient's diet (amount of food consumed, balance of nutrients, etc.) and the patient's daily caloric intake. The Mini Nutritional Assessment, a tool that has been validated in the elderly for measuring nutritional risk, can be used to collect some of this information (Figure 1).21 Once the shorter form of this instrument has been validated in the elderly, it may be a more practical tool for the family physician
