222843 Intervention effect of nutritional supplements for the poor, at-risk of frailty, elderly in Korea

Sunday, November 7, 2010

Insook Lee, PhD , Community Health Nursing Department, College of Nursing, Seoul National University, Seoul, South Korea
Kwang Ok Lee, PhD, Corresponding author , Community Health Nursing , College of Nursing, Seoul National University, Seoul, South Korea
EunOk Choi, PhD, RN, CDE , Department of Nursing, Inje University, College of Medicine, Busan, South Korea
Young Ko , Communiy Health Nursing Department, College of Nursing, Seoul National University, Seoul, South Korea
Hyo Shin Kim , Community Health Nursing Department, College of Nursing, Seoul Natinal University, Seoul, South Korea
Background & Issues: Preventive home health visitation for the elderly is an important part of community health care, focusing on assessment, care plan development, monitoring and follow-up. In this study, public health nurses screened the functioning ability of elderly community members and classified them into 3 groups; healthy, at-risk of frailty and frail. Among those in the groups of at–risk of frailty & frail, nurse monitoring or disease management guides were not sufficient to increase their functioning ability. An additional intervention was to adjust the nutritional content of the diet of the elderly participants. The objective of this study is to test the effect of nutrition supplementary pills or nutrient-rich food, in addition to the nursing guides for disease management, in improving the frailty score and bone density of the elderly.

Description: Frailty was measured with a 31 item assessment tool, developed and tested for validity. The study target group were elderly at-risk of frailty community members in Korea, with scores of 9.5 or above. The first group was provided preventive home visitation, which included assessment, and a nursing guide for nutrition and exercise (N=69). The second group was provided vitamin D and Calcium supplements, along with home visits (N=66). The third group received calcium-reinforced milk (in place of the vitamin D and Calcium supplements), in addition to the routine home visiting services (N=63). After 6 months intervention, the frailty score and bone density was tested.

Lessons Learned: The greatest change of frailty scores was within the milk supplement group. Looking at the the difference in scores for the pre-post test, using the home visitation group as a base, the calcium pill group scored 1.42, with the milk group scoring 2.58. In bone density, the difference was 13.8 and 17.8, respectively.

Recommendations: In nursing intervention for the elderly, it is more efficient to support nursing guides with material assistance, due to elderly community members lacking resource accessibility. It is especially important to supply nutrionally-enhanced food, rather than pills, as it is more efficient in increasing motivation to eat, and encouraging self-management by the at-risk of frailty elderly.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Program planning
Public health or related nursing
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1) Define the effect of the preventive home health visitation and nutritional supplements for at-risk of frailty elderly 2) Describe characteristics of frailty within the elderly community

Keywords: Elderly, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: the funding source is a local government in Seoul.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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