Optimising Nutrition and Hydration in Care Homes-Getting It Right in Person Rather than in Policy.

The scoping review by Bunn et al. identifies an important, but often invisible, challenge of malnutrition and specifically sub-optimal hydration and nutrition in the care home environment. Those requiring residential care are generally the frailest members of society, and likely to be affected by the anorexia of ageing: a multifactorial process whereby older people fail to adequately regulate food and nutrient intake resulting in unintentional weight loss. Adequate training of all healthcare professionals to recognise the risk of malnutrition at an early stage is fundamentally important, and the window of opportunity for intervention may be at a much earlier stage than admission to the care home. The specific needs of older adults must be considered in planning interventions with regard to the effects of ageing on physiology, digestion, and absorption of nutrients. Most importantly, we must offer person-centred care which offers residents an element of personal choice in whether or not they wish nutritional intervention, and any intervention offered must have the effect of improving quality of life rather than numbers on a scale.