Question

Discuss the purpose of a screening tool like the DETERMINE checklist. What does this acronym stand for and where would this tool be most appropriately used? How is risk measured with this checklist? Once risk is identified, what is the next logical step?

Answer 1

The Older American Act Nutrition program uses the DETERMINE checklist to find elder people at high risk of low nutritional intake. It is targeted towards those elder who are not institutionalized

The acronym stands for

D - Disease - Does the patient suffer for any disease that make him/her alter their diet (score-2)

E- eating poorly- do they eat less than 2 means a day (score 3) or do they eat less vegetables (score-2) or do they drink beer, wine everyday (score- 2)

T - tooth loss or mouth pain - does the patient have any such oral condition that restricts it for eating properly (score-2)

E - economic hardship - does the patient have some economical problems. Is food affordability the problem (score-4)

R - reduced social contact - do they eat alone all the time (score-1)

M - multi medication - does the patient take more that 3 prescribed or over the counter medications (score-1)

I - involuntarily weight gain or weight loss - has the patient gained or lost 10 pounds over 6 month without trying too gain or lose. (Score-2)

N - Need physical assistance - is the patient physically not able to shop, cook and feet him/herself (score-1)

E - elder more than 80 yrs (score-1)

This tool can be used by all non institutionalized elder people. Based on the yes responses to the question above a total score is calculated.

Based on score the nutritional risk is calculated.

The measures to be taken will be based on the total score calculated. The corrective measures are as follows

0- 2 = good - no risk - to be assessed after 6 months

3 - 5 moderate nutritional risk - to patient needs to assess his nutritional status and can seek guidance from the health department, senior nutrition program. Reassess after 3 months

6 and above - high nutritional risk - the nutritional problems needs to address by a professional. The patient should bring this checklist next time he/she visits a doctor or meet a dietitian, qualified health professional.