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Nutrition Care Plan Medium risk of malnutrtion (MUST score 1) Patient’s name: NHS no: Height (m): Weight when care plan initiated (kg): BMI when care plan initiated (kg/m2): Date Record Weight (kg) Record MUST score Goals: Prevent further weight loss/ promote weight gain. Improve nutritional status and /or promote wound healing Check for underlying causes such as pain/nausea, constipation/diarrhoea, medications that could affect appetite. Actions: Individual to record all food eaten for 3 days as a baseline and to monitor improvements or deterioration, and to complete food and fluid checklist form. MUST monthly or sooner if clinical concerns. Encourage small frequent meals and snacks, with high energy and protein foods and fluids. Review progress against goals. If improving continue on this plan until MUST=0, ‘Low risk’. If deteriorating consider treating as ‘High risk’. Supply ‘Food First’ leaflet and discuss fortifying meals. On-going management and review: Weigh and rescreen Food First Advice This leaflet is designed to help people with a small appetite or those losing weight, to improve their dietary intake. Fortify Your Meals Nourishing Snacks and Drinks Aim to have 3 fortified meals a day Aim to have 2-3 a day Snacks and drinks between meals will help to boost your nutritional intake To fortify your meals: • Add cheese to soups, mashed potatoes, vegetables and pasta dishes • Use butter or margarine in sandwiches, on potatoes and with crackers or vegetables • Add cream or evaporated milk to puddings • Add jam, honey or milk powder to puddings, porridge and breakfast cereals • Use cooking methods that involve the use of oils or butter e.g. frying and roasting • Choose full fat / full cream foods with sugar instead of low fat/ sugar varieties Snack ideas: • Sandwiches filled with cold meats, cheese, tinned fish, egg • Toast with baked beans, cheese, butter and jam or honey • Crumpets, scones or teacakes with honey, jam, treacle, cheese or butter • Thick and creamy yoghurt with honey/syrup • Malt loaf or fruit cake with butter and jam • Nuts/dried fruit/chocolate/crisps/biscuits • Soup made with fortified milk, double cream and grated cheese Nourishing drink ideas: • Hot chocolate/milky coffee/malted drinks • Milkshakes or smoothies (made using fortified milk or full cream milk) Fortified Milk Helpful Tips Aim to have 1 pint of Fortified Milk a day Fortified milk recipe: • Add 4 tablespoons of dried milk powder to 1 pint full cream milk • Mix well • Eat little and often (every 2-3 hours) • Choose the food you fancy and try to eat in company • Ready meals or a meal delivery service are a good choice if you struggle to prepare meals • Gentle exercise or getting some fresh air can help increase your appetite • Ask for support from friends and family to help with shopping and cooking meals Use fortified milk in place of your usual milk through-out the day e.g. in drinks, on cereals, in sauces and milk puddings If you have not been referred to the Dietitian and need more specific dietary advice for a particular medical condition (e.g. Diabetes mellitus) or on-going weight loss, please ask your GP to refer you to your local Dietetics department.