Spokane
County
Assessing the Nutritional Health of Seniors
Assessment Tool
Nutrition Screening Questions from the Determine Your Nutritional Health
Checklist
I have an illness or condition that made me change the kind and/or amount
of food I eat.
I eat fewer than 2 meals per day.
I eat few fruits or vegetables.
I eat or drink few milk products.
I have 3 or more drinks of beer, liquor or wine almost every day.
I have tooth or mouth problems that make it hard for me to eat.
I don't always have enough money to buy the food I need.
I eat alone most of the time.
I take 3 or more different prescribed or over-the-counter drugs a day.
Without wanting to, I have lost or gained 10 pounds in the last 6 months.
I am not always physically able to shop, cook, and/or feed myself.
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