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Nutrition Risk in Home-Bound Older Adults: Using Dietician-Trained and Supervised Nutrition Volunteers for Screening and Intervention*

Published online by Cambridge University Press:  31 March 2010

Sophie Laforest*
Affiliation:
Department of Kinesiology, Université de Montréal Groupe de recherche interdisciplinaire en santé (GRIS), Université de Montréal CSSS Cavendish, Centre de recherche et d'expertise en gérontologie sociale (CREGES)-CAU
Benita Goldin
Affiliation:
Cummings Jewish Centre for Seniors
Kareen Nour
Affiliation:
Groupe de recherche interdisciplinaire en santé (GRIS), Université de Montréal CSSS Cavendish, Centre de recherche et d'expertise en gérontologie sociale (CREGES)-CAU
Marie-Andrée Roy
Affiliation:
Research Centre on Aging, Health and Social Services Centre–University Institute of Geriatrics of Sherbrooke
Hélène Payette
Affiliation:
Research Centre on Aging, Health and Social Services Centre–University Institute of Geriatrics of Sherbrooke Université de Sherbrooke
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Sophie Laforest, Ph.D., Université de Montréal, Department of Kinesiology, C.P. 6128, succ. Centre-Ville, Montreal, QC H3C 3J7. (sophie.laforest@umontreal.ca)

Abstract

Nutrition screening and early intervention in home-bound older adults are key to preventing unfavourable health outcomes and functional decline. This pilot study's objectives were (a) to test the reliability of the Elderly Nutrition Screening Tool (ENS©) when administered by dietician-trained and supervised nutrition volunteers, and (b) to explore the feasibility of volunteers' doing nutrition screening and intervention for home-bound older adults receiving home care services. Both participating clients (n = 29) and volunteers (n = 15) were community-dwelling older adults. Volunteers met with participating clients, assessed nutritional risk with the ENS©, provided nutritional education, and developed and helped implement intervention plans. To assess ENS© inter-rater reliability, we compared results obtained by nutrition volunteers and a dietician. Agreement was high (≥80%) for most items but was higher among volunteers than between volunteers and the dietician. We conclude that nutrition volunteers can assist in screening and educating older adults regarding nutritional risks, but intervention is best left to professionals.

Résumé

Le dépistage du risque nutritionnel et l'intervention hâtive en nutrition auprès de la population âgée confinée à domicile sont des déterminants clés de la prévention de divers problèmes de santé et d'incapacités physiques chez cette population. Cette étude pilote avait pour objectifs: (a) de mesurer la fidélité de l'instrument de mesure « Questionnaire de dépistage nutritionnel des aînés » (ENS©) lorsqu'administré par une nutritionniste et par un bénévole formé; et (b) d'explorer la faisabilité pour un bénévole de faire du dépistage et de l'intervention en nutrition auprès d'une population âgée confinée recevant des services de soutien à domicile. Les participants (n = 29) et les bénévoles (n = 15) étaient des personnes âgées vivant dans la communauté. Les bénévoles ont rencontré les participants, ont évalué leur risque nutritionnel à partir de l'échelle de dépistage ENS©, ont offert de l'éducation nutritionnelle, et ont développé et aidé à l'implantation des plans d'intervention nutritionnelle. Afin de calculer la fidélité inter juges du ENS©, les résultats obtenus à partir de cet instrument par les bénévoles et par la nutritionniste ont été comparés. Le pourcentage de concordance était élevé (≥80 %) pour la plupart des items, mais plus élevé parmi les bénévoles qu'entre les bénévoles et la nutritionniste. Nous croyons que des bénévoles formés au sujet de la nutrition peuvent épauler les nutritionnistes pour le dépistage et l'éducation des risques nutritionnels, mais que l'intervention nutritionnelle devrait être réservée aux professionnels.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2007

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Footnotes

*

This project was made possible by a financial contribution from Health Canada and Canadian Heritage. We also wish to thank the CSSS Cavendish, Centre de recherche et d'expertise en gerontologie sociale (CREGES)-CAU for its support of this project. Appreciation is also extended to Richard Goudreault of the Montreal Public Health Department for his technical assistance with the data and to Silvia Straka for her general comments and recommendations in the writing of the paper. All the older adult nutrition volunteers who donated their time and expertise are also to be commended for their immeasurable contribution to the intervention's success. We further thank the members of the Advisory Committee for their invaluable input and direction regarding the intervention development and evaluation: Colleen Reavell, Miriam Hopmeyer, Debbie Ungar, Rona Maisel (CJCS); Cathy Rigas (CLSC René-Cassin); Katherine Gray-Donald (McGill University); and Phyllis Leebosh (CJCS seniors' volunteers).

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