Counseling Older Adults on Nutrition (Cont'd)

Brief Counseling Strategies for Healthcare Providers

Despite the passage of a federal law in 1990 requiring nutrition education in medical schools, a recent survey found that less than half of American medical schools required a nutrition course.⁴ It is no surprise, then, that many physicians and other healthcare providers lack adequate training or tools to give older adults brief, effective advice on nutrition.

The Nutrition Prescription

The American Academy of Family Physicians created a nutrition prescription form as a tool to make it easy to dispense nutrition advice.⁵ The advice can help set goals and provide support. A provider can tailor it to a specific individual’s needs and circumstances by writing in the number of daily servings of grains, vegetables, fruits, dairy and protein recommended for that older adult. Suggested dietary changes such as “eat more vegetables” can also be indicated on a checklist. A sample of the form is available at http://familydoctor.org/298.xml.

Lifestyle Prescription Model

A similar technique, developed by the Australian Department of Health and Aging, uses a lifestyle prescription model based on the five As:⁶

Ask
The practitioner identifies a poor diet as the lifestyle issue.

Assess
The practitioner discusses the issue with the older adult and talks through steps for change.

Advise
The practitioner makes recommendations for action and gives the written prescription to the older adult.

Assist
The practitioner provides the older adult with relevant information (guidelines, pamphlets, etc.).

Arrange
The practitioner may refer the older adult to another service provider (a walking group, dietitian, etc.).

Here is an example of how a practitioner can apply the five As during a check-up.

         © Commonwealth of Australia, 2005

⁴ Soliah, L. (2004) "A Survey of Nutrition in Medical School Curricula." Today's Dietitian 6(2):20.

⁵ American Academy of Family Physicians. (2005) "Nutrition Prescription." Available at American Academy of Family Physicians on the World Wide Web: http://familydoctor.org/298.xml?printxml.

⁶ Australian Government Department of Health and Aging. (2004) "Lifestyle Prescriptions." Available at Commonwealth of Australia on the World Wide Web: www.health.gov.au/internet/wcms/publishing.nsf/Content/health-pubhlth-strateg-lifescripts-index.htm/.