This project moves beyond viewing undernutrition in elderly solely as a physiological problem resulting from insufficient dietary intake and instead conceptualizes it as a social and relational challenge linked to loneliness and a lack of social belonging.
Malnutrition, loneliness, and lack of belonging are closely linked and are among the biggest drivers of functional decline and increased service needs. Inadequate food and drink intake is common among older adults living at home and can increase the risk of malnutrition, leading to reduced health, coping, and quality of life.
Municipalities are exploring new solutions for sharing tasks with community resources outside of health and care services, such as social innovation through increased collaboration with family members, volunteers, and other local resources.
In this preliminary project, we will create a systematic overview of what is being done in Norwegian municipalities and volunteer work to prevent and treat malnutrition and facilitate good meals for those living at home.
Full project title: Meals and elderly: Togetherness and timely action to prevent undernutrition, loneliness and reduce future needs for health and care services (METT).
This project is part of the strategic research area Future Health and Care Services.
Participants
More about the project
The number of elderly in Norway is expected to increase from 900,000 in 2024 to 1.5 million by 2050. These demographic changes will challenge the capacity of the health and care services, highlighting the need for effective preventive measures and new approaches to early intervention and cross-sector collaboration.
Studies find that approximately one-third of community-dwelling older adults receiving home care services are at risk of undernutrition. Inadequate food and fluid intake can lead to muscle loss, risk of falls and infections, undernutrition, hospitalization and increased need for municipal health and care services.
In 2022, the societal costs associated with undernutrition in this age group were estimated at NOK 1.2 billion.
Early identification and prevention remain challenging
Despite the serious consequences and substantial societal costs associated with undernutrition, early identification and prevention remain challenging in municipal health and care services.
Undernutrition among older adults is often a gradual and multifactorial process influenced not only by health-related factors, but also by psychological, social, and environmental conditions. Older adults may experience reduced appetite, functional limitations, loneliness, grief, or difficulties accessing and preparing meals long before nutritional problems become clinically visible.
These factors frequently fall across the boundaries of health, social, and community services, making undernutrition difficult to detect and address through traditional service structures alone. As a result, preventive efforts require a more holistic approach.
Research shows multidirectional relationships between social isolation, loneliness, depression, cognitive decline, and inadequate food and fluid intake among older adults. Meals are important social arenas, and in shared meals, food intake is often higher.
A recent Norwegian study found that one in four older adults experiences loneliness, and the risk of undernutrition is greatest among those who live alone and have limited social support networks. In a pilot project conducted in the Nordre Aker district of Oslo, 15 home care staff identified loneliness and depression as important drivers of inadequate food intake, while the social aspects of meal experiences were found to positively influence appetite.
Still, national quality indicators show that only 29 percent of older adults receiving home nursing care are assessed for risk of undernutrition. Time constraints have been identified as a major barrier preventing home care services from both identifying and treating undernutrition effectively.
Project objective
Consequently, there is a need for innovative and feasible models that enable earlier identification of risk factors and mobilize resources beyond the health sector alone.
Strengthening collaboration between health services, community organizations, volunteers, families, and older adults themselves may offer new opportunities for preventing both loneliness and undernutrition before the need for more intensive health and care services arises.
The overall objective of METT is to co-create and evaluate the feasibility of interventions targeting nutritional risk and loneliness among community-dwelling older adults.
