Malnutrition: "unsustainable condition"

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Malnutrition in those in need of care could be prevented by diet therapy. According to the Federal Social Court, it is classified as a remedy, but is not paid for by the health insurance companies.

In mid-February, the Rheinische Post made a well-founded article referring to a current study by the federal government and denouncing malnutrition among patients in Germany. In this study (ErnSiPP study), which was prepared and recently published in connection with the 12th nutrition report of the Federal Government, the situation of elderly people in need of care in private households was examined more closely for the first time. Terrifying result: Two out of three people in need of care at home are apparently malnourished. At 13 percent, their share is twice as high as in the rest of the population. In addition, a further 57 percent are at high risk of malnutrition.

Many of these people in need of care, among other illnesses, suffer from loss of appetite, reduced feeling of hunger and thirst, as well as chewing and swallowing difficulties. They avoid certain foods and then eat more and more one-sidedly until they finally suffer from significant malnutrition. Those cared for at home, in particular, have problematic eating habits.
The Association of Dieticians - Deutscher Bundesverband e. V. (VDD) criticizes the numbers as scandalous and rates the situation as dramatic. This is also recognized by the political side, said VDD President Doris Steinkamp in a statement. However, there is still no real will to change the situation. So far, only the symptoms have been fiddled with, instead of tackling the problem fundamentally.

There were possibilities, because already in 2000 the Federal Social Court found that diet therapy should be classified as a remedy. This should actually result in malnourished patients being entitled to professional advice and support, which would also have to be financed by the health insurance companies. Unfortunately, diet therapy is still withheld from patients and is not prescribed as a benefit.

Another example: If swallowing hurts constantly, speech therapists can work with patients. However, a dietician cannot be included as a nutrition specialist because diet therapy cannot be prescribed. The VDD demands that patients must be able to eat independently for as long as possible and to be provided with sufficient and balanced care.

“The expertise is there, dieticians are specially trained for this and are available as experts. Nevertheless, these unsustainable conditions of malnutrition occur in our country because funding alone is not secured, ”criticizes Doris Steinkamp. Nursing services and speech therapists would like to include dieticians in the treatment of the often older and multimorbid patients, but also failed because of the financing. The VDD President finally calls on those responsible to make changes. (pm)

Image: Gerd Altmann,

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