Before discharging an older patient or anyone with heart failure, diabetes or kidney disease, ask: 'In the past month, have you worried that food would run out before you had money or help to get more?' A yes is a readmission risk that no drug change will fix. It also changes prescribing — a patient who skips meals is at risk of hypoglycaemia on insulin or sulfonylureas, and a low-salt diet that the family cannot afford will not happen. Write the answer in the discharge summary so the next clinician sees it.
- Ask a single food insecurity question before discharge.
- A yes should change hypoglycaemic prescribing in patients who may skip meals.
- Give dietary advice the household can actually afford and cook.
- Record the answer in the discharge summary.
Why it matters
Food access quietly drives readmissions and hypoglycaemia that are blamed on the disease.
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