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Fuel for Life: A Literature Review of Nutrition Education and Assessment Among Older Adults Living at Home

Nutrition is often considered the foundation of health and an important indicator of well-being. Older adults living in the community are particularly at high risk of poor nutrition due to social isolation, frailty, cognitive impairment, polypharmacy, reduced functional status, and financial instability. Older adults receiving skilled home health may also be at risk for poor nutrition as the Outcomes Assessment Information Set (OASIS), the Centers for Medicare and Medicaid Services–mandated home health assessment, does not contain items specifically related to nutrition assessment, leaving this important aspect of health potentially neglected. In the popular and empirical literature, there is a plethora of knowledge on what older adults should be eating. However, it is unclear how nutritional recommendations are provided to home health recipients and whether nutritional status is routinely included in the home health comprehensive assessment. To address this gap, we conducted a review of the literature related to nutritional education and assessment for older adults living at home. Databases MEDLINE, CINAHL, and PubMed were searched using the search terms nutrition, education, assessment, and older adults with eight studies eligible for inclusion. Results indicate several strategies to assess and improve nutritional status among older adults living in the community such as individualized nutrition counseling and the identification of malnutrition indicators. Furthermore, barriers to adequate nutrition education and assessment exist including home health care personnel, particularly nurses and home health aides, who feel ill-prepared to meet the educational needs identified. Additional research and wide dissemination of results are needed to assure the nutritional needs of older adults living in the community are met.