Some facts, actions, words or health situations should alert the healthcare providers and families to the possible existence of risk. Particular vigilance is required in the following situations:

patient complaints :

aching legs, lack of interest, loneliness, fatigue, refusal to go out, GI problems (diarrhoea/constipation), loss of appetite, rapid feeling of fullness, forgetfulness.

patient lifestyle :

any event leading to major changes (loss of a loved one, disease, loss of independence), poor diet (less than 3 meals a day), mobility problems, low income, absence of family or neighbours (especially important for the elderly), confusion.

clinical signs :

loss of 5 to 10% of the patient’s normal weight over the previous 6 to 12 months, asthenia, dehydration, amyotrophy, dental/buccal problems, dermatological problems (atrophy, difficult or slow healing, brittle nails, bed-sores), difficulty with swallowing or chewing, falls, fractures, etc.

risk situations :

depression, dementia, taking more than 5 medications a day, bed-sores, burns, any illness/disease (more particularly cancer, cystic fibrosis, HIV +, kidney failure, respiratory failure, Alzheimer’s), neuro-degenerative problems, memory loss