Impact of social isolation on the fragility and quality of life of elderly

Abstract

Methods: Twelve healthcare professional (HCP) focus groups with 75 participants were conducted: community dietitians (n¼17), registered dietitians working in industry (n¼5), community and residential care nurses (n¼22), physiotherapists (n¼12), pharmacists (n¼9), occupational therapists (n¼6) and speech and language therapists (n¼4). Focus group discussions were audio-recorded and transcribed verbatim. The data were coded and analysed using thematic analysis to develop key themes, and illustrative quotes were extracted. Results: Similar views on malnutrition management existed across professions. 'Gaps in Primary Care Management' was the first key theme wherein HCPs identified resource and communication limitations. Barriers included limited or no dietetic services, limited home care services, and poor communication between general practitioners and wider primary care team members which resulted in inappropriate or delayed treatment. The second key theme, 'Challenges with ONS use in the Community', encapsulated several issues HCPs experienced with ONS usage including inappropriate prescribing and lack of monitoring of treatment goals. Conflicts of interest regarding industry dietitians assessing and treating older adults in residential care settings was highlighted by participants who worked within the health service. Conclusion: This study highlights that more emphasis is needed to identify patients when they are at risk of malnutrition to avoid severe malnutrition presentations currently seen. Community dietitians for older people are required to address many of the issues raised including the need for awareness, education and training, resources, and malnutrition care pathway structures.