Due to frailty and health problems, older adults regularly move between home and different health care settings. In this situation, the optimal transfer of nutritional care is important, especially since about 10% of community-dwelling older adults is malnourished. There is room for improvement in transmural nutritional care in the Netherlands.
Therefore, the Dutch Ministry of Health asked the Dutch Malnutrition Steering Group (DMSG) to start the Nutrition Passport project. Within this project, the DMSG worked together with patients, and professionals in health and social work in three different regions in the Netherlands. Each region evaluated current situations and developed goals for their region that would contribute to better nutritional care for older adults when they move between home and health care settings.
As a result of the project, the DMSG developed a guide to improve transmural nutritional care, which is available on the DMSG website (in Dutch). Key factors for success to improve nutritional care were, among others, to start a regional team of a broad network of professionals involved. This network includes professionals in health care and social work, as well as local policy officers. The guide explains how to start this network and describes conditions for success.
The guide also contains a Nutrition Passport. This passport belongs to the older adult and can be used to coordinate appointments with professionals. It also contains relevant information for professionals and for the older adult (e.g. contact details of meal delivery organisations).
In addition, this guide includes documents that were developed in the different regions (e.g. information for older adults, documents for nutritional transfer between health care settings), depending on the needs and wishes of each region. All these documents are free to use and can be adapted to local situations.
We encourage dietitians to use information and experiences from this project in their local situations to improve transmural nutritional care, together with professionals in health and social work and local governments.