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Sammanfattning

Adequate nutrition is crucial for frail and ill elderly. In Sweden, poor nutritional status among elderly in hospitals and in community care has been reported in mass media and study reports. A retrospective study of hospital records and community acts is here presented. Notes on nutrition of 94 patients (80 years>) during their last stay in acute somatic medical care were analysed. Also, community acts for those who had received home-care after discharge. Prospectively in addition, focusing the need for nutrition, one elderly person was observed and interviewed after discharge from hospital to community care in own home as a case study. Three questions were asked: 1) What was documented on nutritional needs during the acute medical care episode? 2) In case of home-care after discharge, what was documented on nutritional needs in community acts? 3) What actions for meeting demands for adequate nutrition is planned by community home-care services for an elderly client discharged from hospital to own home? In this sample notes on nutrition were made in 87 percent of the acute medical care patient records. In the community services acts, notes on nutrition were rare. In the case study, needs of high-energy food intake and psychological support during meals were not adequately planned for and met in home care. The conclusion is, that in order to undertake caring responsibilities for elderly, knowledge of nutritional needs, psychological and social support as well as documentation skills is necessary within all levels of care and important indicators of quality of care. At the community level, in plans for home care and in individual care of elderly clients, explicit and planned assessment must be made for nutritional needs and meal situation. Also, for the continuity of care between hospital and community care and evaluation.

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