Institutional feeding of the elderly.

Not only is there a high prevalence of malnutrition among the elderly admitted to hospital and other institutions, but nutritional status seems to decline during admission, not only as a result of disease but also problems with catering and feeding policies, which are not well-geared to the needs of the sick. This results in high food wastage rates and inadequate macro- and micronutrient intakes to meet requirements. In the elderly, decreased portion size and increased energy, protein and micronutrient density have been shown to be effective in decreasing wastage and improving intake. Other strategies for improving intake are reviewed, including a better environment, a reduction in drugs causing anorexia, help with eating, and less interruption of meals by procedures and ward rounds. Targets for nutritional intake and aims of feeding are reviewed.