It makes perfect sense to me that social isolation and undernutrition are both a cause and consequence of each other. Most of us have probably experienced a time when we have lived on our own and needed to cook for just ourselves. Making a meal for one person can be a chore; often we choose something which is quick and far less nutritious than it could be. Thankfully for a lot of us this doesn’t happen that often. Unfortunately, there are people for whom this is an everyday occurrence. Social isolation and undernutrition are major problems in the UK, both affecting 10% of people over the age of 65. It can become a viscous circle where you lose the motivation to cook a nutritional meal for yourself; thereafter weight loss can quickly become a big issue as a result of not eating properly. As you lose weight you lose muscle power and gradually over time become weaker and less able, being motivated becomes even harder and so the cycle continues.
Up to now there have been various programmes to tackle social isolation or undernutrition but these have been done in isolation. County Durham and Darlington NHS Foundation Trust (CDDFT) and Age UK Darlington have taken a new approach by teaming up to tackle both. We were successful in being awarded Health Foundation funding to establish lunch clubs. People who have been identified as being at risk of undernutrition are invited to attend a lunch club as part of their treatment. They will receive a hot nutritious meal, which is provided by the CDDFT catering department. Whilst they are at the lunch club they will be weighed and asked questions regarding their appetite and how they are getting on with their dietary treatment. This important information is entered by a volunteer on to the Health Call Undernutrition app. The health care professional will be alerted about anyone if there are any concerns, for instance if they are losing weight or not taking their nutritional supplements. This information can be fed directly to the patient’s electronic records.
This is truly unique, not only have we brought together the health and social side of undernutrition and social isolation but digitalising the lunch club using the Health Call Undernutrition app means that information is available to health care professionals.
It is early days with the lunch clubs, but so far they have been well received by everyone who has been and we are encouraged that they keep coming back. Personally it has been lovely to see the people attending meeting up with old friends who they’ve not seen in years. In addition to the really friendly atmosphere the lunch clubs are providing, patients are saying they like the fact that their weight is being monitored while they are there and appreciate the dietary advice that is available to them when needed. There have been other positive and important outcomes such as partners being able to have some much welcomed respite from the caring role they unconditionally provide. For a few hours they can be confident that their loved one is in safe hands.
Patients are able to attend the lunch clubs for free for 12 weeks, as well as having lunch and being weight monitored there will be a program of other activities that will aim to sustain the longer term impact of reducing social isolation. This includes linking in with Barclays Bank and their Digital Eagles – who help in teaching people to better use smart devises for things such as texting, using Skype or Facetime, thus enabling them to keep in contact with family and friends, as well as raising awareness of other activities and services that can be accessed.
This is one small step in trying to tackle two problems that can have such an impact on some of our most vulnerable patients. But the question remains as to why there is such a poor awareness of the risks of undernutrition amongst the public and also the health and social care professionals. When you talk to people about undernutrition the penny does drop but there is still a lot of work to be done to get the message across that you don’t lose weight as you get older. The message regarding the risk of obesity to health is loud and clear but what role can social media play in trying to have the same importance placed on the other end of the scale?