9.4.2-Step 2-Underlying causes of malnutrition

Step 2-Assess for and address underlying causes of malnutrition

Consider availability of adequate diet and identify any difficulties with reduced or altered food intake relating to:

  • Ability to swallow or chew, ability to shop/cook, assistance required with feeding, dentition etc.
  • Impact of medication on appetite or nutritional intake
  • Physical symptoms (e.g. reduced mobility or balance, pain, GI symptoms, vomiting)
  • Medical diagnosis (including cancer, mental health issues, e.g. depression, COPD), side effects of treatment and prognosis
  • Environmental and social care issues including finance, substance abuse, inadequate support at home etc.

Consider solutions to these issues, e.g. onward referral to appropriate services or assessments.

People with eating, drinking and swallowing (dysphagia) difficulties should be assessed by speech and language therapists. Thickeners/thickened ONS are outside the remit of this guidance.