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Care home residents with COVID-19 may need extra support with nutrition and hydration. This may be both during and after illness.
COVID-19 can cause mild or severe symptoms. This can affect what residents eat and drink. Some common issues that can reduce intake are:
- reduced or total loss of smell or taste
- metallic or salty taste in mouth
- shortness of breath
- extreme tiredness and muscle weakness
- loss of appetite and feeling full more quickly
Our eating well and building yourself up after COVID-19 leaflet (PDF, 644 KB) provides lots of useful information and top tips to help you support residents with COVID-19.
Malnutrition screening
The elderly and malnourished have worse outcomes and higher risk of death from COVID-19. A third of care home residents are at risk of malnutrition. Residents should be screened monthly for malnutrition risk using the malnutrition universal screening tool, also known as MUST. This will enable residents at risk of malnutrition to be identified and then treated.
Training
We have produced a free resource pack and training on identifying and treating malnutrition in care homes. If you would like to access this training email our care home medicines team.
COVID-19 nutritional care for care homes video
This video provides nutritional information on managing residents who have, or are recovering from, COVID-19.
The leaflets below provide more information on the 1,2,3 approach referred to in the video:
- fortified drinks (PDF, 223 KB)
- fortified meals (PDF, 92 KB)
- fortified milk (PDF, 71 KB)
- managing malnutrition in care homes first line advice (PDF, 115 KB)
- nourishing snacks (PDF, 122 KB)
The links referred to in the video are available below:
- malnutrition pathway protein ideas (PDF, 126 KB)
- MUST tool
Manage malnutrition
To manage malnutrition start with 1 pint of fortified milk, 2 nourishing snacks and 3 fortified 2-course meals.
For care home residents at risk of malnutrition (MUST score of 1 or more), offering the below daily can help in reducing malnutrition risk.
1 pint of fortified milk
Use fortified milk in place of normal milk throughout the day as a simple way of boosting nutritional intake without increasing volume. It can be used in hot and cold drinks, cereals, egg dishes, baking, sauces, soups and milk puddings.
Ingredients
- 1 pint whole milk (blue top)
- 50-60g/4 heaped tablespoons dried skimmed milk powder
Method
- Add skimmed milk powder to jug.
- Add a small amount of whole milk and mix to form a smooth paste.
- Gradually add remaining milk and stir/whisk well.
Calories: 540 kcal
Protein: 37g
2 nourishing snacks
Nourishing snacks provide vital additional nutrition to those at risk of malnutrition and should be offered 2 to 3 times a day. A variety of savoury and sweet snacks should be given, including a high calorie fortified snack. Below is our top recommended high calorie fortified snack.
Fortified thick and creamy yoghurt
- 1 heaped tablespoon (~15g) dried skimmed milk powder
- 1 tablespoon double cream
- 150g thick and creamy yoghurt
To make, mix the dried skimmed milk powder and double cream with the thick and creamy yoghurt.
Calories: 300 kcal
Protein: 20g
3 fortified 2-course meals
Large portions of food can be overwhelming for those with a small appetite; small regular meals with added fortification are often better received. How to fortify some common foods:
| If you have | Fortify by adding |
|---|---|
| Cereal or porridge | Fortified milk*, cream, full-fat or Greek yoghurt*, honey, syrup, jam, sugar, dried fruit, ground nuts* |
| Scrambled eggs | Butter, fortified milk*, grated cheese* |
| Soups and stews | Grated cheese*, cream, dumplings or croutons |
| Mashed potato | Butter, olive oil, fortified milk*, grated cheese*, skimmed milk powder* or double cream |
| Cooked vegetables | Grated cheese* or creamy sauces, olive oil, butter, mayonnaise or salad cream |
| Salads | Grated cheese*, olive oil or salad dressing, mayonnaise or salad cream |
| Custard and milky puddings | Skimmed milk powder*, double cream, condensed milk*, honey, syrup, sugar, jam or dried fruit |
- high protein option
Manage malnutrition with homemade fortified drinks
Alongside using the 1 2 3 approach, consider offering 1 to 2 homemade fortified drinks a day. These can help in providing extra energy, protein and other nutrients. The following recipes provide similar calories and protein to many oral nutritional supplements. Try giving them between meals and consider giving in smaller ‘shots’ over the day if preferred.
Fortified milkshake
Mix 2 heaped tablespoons of skimmed milk powder with 4 teaspoons of milkshake powder with added vitamins and minerals (Nesquik or Asda, Lidl and Morrisons alternative). Add 200mls of full-fat milk and 15mls double cream and stir well/blend.
Fortified hot chocolate
Mix 2 heaped tablespoons of skimmed milk powder with 200mls full fat milk and heat until warm. Add 4 teaspoons of hot chocolate powder with added vitamins and minerals (for example Nesquik hot chocolate powder) and stir well. Add 15ml double cream and marshmallows to finish, as desired.
Fortified fruit juice
Mix 40ml high juice cordial with 10g egg white powder, and then gradually add 180ml fruit juice (with added vitamins). Do not whisk.
Training for care homes
Our care home support dietitians, are providing free training and resources to support care homes across Cornwall and the Isles of Scilly in identifying and treating malnutrition risk. For more information, email our care home medicines team.
Page last reviewed: 7 November 2023