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Malnutrition can derive from causes that are independent of the patient's desire to feed themselves or which manifest themselves with the refusal of the meal; while for the former the strategies for solving and compensating the problem are more predictable, for the latter it is not always easy to have effective and prompt intervention procedures available. The importance of a method that investigates the causes of food refusal and provides rehabilitative pathways to accepting the meal, designed to intervene on fasting in a structured way, lies in the timeliness and clarity of the roles. I.R.M.I.E. (Investigation of the Rejection of Meal in the Institutional Elderly) analyzes the refusal of the meal and the consequent malnutrition linked to it, in the elderly subject institutionalized and not. It is thought of as a trace to identify the causes that lead the fasting patient to a condition of vital risk and to propose strategies of compensation and resolution to the problem. It is the premise of an individualized plan. It should be discussed as a team in the case and also given to the family member by the same or alternatively by a professional elected to the role, with a subsequent comparison. The planning of an intervention plan will follow, according to the procedures proposed in the manual that includes it, related to the identified causes, and of the resources exploitable in the service.

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The refusal of food in the elderly patient: identification of the causes of rejection of the meal in senior age and hypotheses of intervention to prevent, treat and rehabilitate malnutrition