Development and evaluation of preventive nutrition and mobility concepts for elderly people in (partially) inpatient care facilities
Scientific direction: Prof. Dr. Reinhold Wolke
Duration: 01.01.2019 until 31.12.2021
Promotion: IKK classic
In Germany, around 783,400 people are cared for on an inpatient basis and around 74,000 on a semi-inpatient basis in 13,600 care facilities by 730,000 employees. 94 percent of the nursing homes mainly care for elderly or very old people; 70 percent of the residents are 80 years and older (Destatis 2017, GKV Spitzenverband 2018). Residents of inpatient long-term care facilities are significantly more frequently affected by a "pathological" aging process. Compared to people of the same age who still manage self-caring independently or with help at home, they are particularly characterized by their above-average need for help and care. (Bartholomeyczik et al. 2010, p. 869; Schreier 2011, p. 15)
The aim of preventive or health-promoting services in inpatient nursing facilities is to improve the health situation and resources of those in need of care with their participation. In addition to the general strengthening of the health-promoting potential of care facilities, the following fields of action are named in the guideline on prevention: Nutrition, physical activity, cognitive resources, psychosocial health and prevention of violence (GKV-Spitzenverband 2018).
Profound knowledge is available for the field of action "nutrition" selected for this project. There is already an S3 guideline on "Clinical Nutrition in Geriatrics" for nutritional care in geriatric institutions (Volkert et al. 2013, p. e1).
Especially for dementia patients, the "ESPEN guidelines on nutrition in dementia" (Volkert et al. 2015, p. 1) as well as the national expert standard "Ernährungsmanagement zur Sicherung und Förderung der oralen Ernährung in der Pflege" (DNQP 2017) (Nutrition management to ensure and promote oral nutrition in care) are available. Despite further numerous national and international guidelines on the prevention and treatment of malnutrition, it has not been possible to reduce the prevalence of malnutrition in the past (see Löser 2011; Norman et al. 2008). The same applies to the field of action "mobility", where a national expert standard is also available.
At EU policy level, it is argued that this state of affairs is unacceptable and that research or studies should be promoted to investigate the effects of nutritional therapies on nutritional status. In addition, explicitly interdisciplinary research projects are required (Council of Europe Committee of Ministers 2003). The central problem here is the lack of knowledge transfer, the translation of existing evidence-based findings into practice, and the implementation of these findings in the daily care routine (Edwards, Mills 2013, p. 447; Behrens 2010, p. 25; Grol, Grimshaw 2003, p. 1225).
The present project takes up exactly these demands: Interdisciplinary nutrition and mobility concepts are to be developed and implemented in a sustainable way with the local actors involved, because only close cooperation and networking of all professional groups involved, using all available resources and competencies, will enable the best possible care and support of patients (Riedel, Lehmeyer, Elsbernd 2013). These practice concepts will be planned and developed specifically for the setting on the basis of existing medical guidelines, expert standards of care and other evidence-based literature and will be applied with scientific support (Wolke et al. 2015).