[PHNUTR-L] 58 percent of older hospital patients have problems eating, 31 percent leave most of their meal

[Kathrynne Holden, MS, RD]

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Public release date: 25-Sep-2006
http://www.eurekalert.org/pub_releases/2006-09/bpl-5oo092506.php

Contact: Annette Whibley
wizard.media at virgin.net
Blackwell Publishing Ltd.

58 percent of older hospital patients have problems eating, 31 percent 
leave most of their meal

Malnutriton a major issue among patients over 65


Older patients need greater support, fewer interruptions and more 
sensitive care at mealtimes, according to research published in the 
October issue of the UK-based Journal of Clinical Nursing.

Researchers from the University of Adelaide, Australia, spent two weeks 
studying 48 hospital patients and 50 nurses during mealtimes on two 
medical wards.

They discovered that 58 percent of the patients, who were aged 65 or 
over, had problems eating. Just under a third (31 percent) left more 
than two-thirds of their meal and only 15 percent had eaten it all.

More than half of the patients they studied (55 percent) had problems 
opening food and about a third found it difficult to use cutlery (36 
percent) and add seasoning (32 percent).

More than a fifth (23 percent) were too far away from their food and 18 
percent said their eating position was uncomfortable or they had 
problems pouring drinks.

Although nurses were good at describing the food and encouraging 
patients to eat it, practical support was only given to a small 
percentage of patients. For example only six percent were made more 
comfortable or helped with cutlery.

Interruptions were also frequent. One in five patients (19 percent) had 
a doctor's visit during mealtimes and more than half (51 percent) had 
mealtimes interrupted by other staff, mostly nurses (92 percent).

Three patients were asked about their bowels while they were eating and 
four male patients had urine bottles place on the table beside meals.

"Recent research suggests that 40 percent of older people are 
malnourished when they are admitted to hospital" says lead researcher 
Chenfan Xia, who was based at the University at the time of the study - 
with co-author Professor Helen McCutcheon - and now works in an aged 
care facility.

"The nutritional status of 60 percent of all older patients will 
deteriorate further while they are in hospital, with those who were 
malnourished in the first place suffering worst. And insufficient food 
is regarded as a major cause of the problem.

"This is an important issue, especially with a growing elderly 
population, because poor nutrition and malnourishment is linked to poor 
health, slow recovery and longer hospital stays.

"However most of the research to date has been carried out in care 
homes, so little is known about the situation on hospital wards."

The researchers make a number or recommendations:

     * Nutrition should be given a higher priority in ward routines and 
staff training.

     * Food intake needs to be monitored in the same way as urine output 
and drugs. The study found that monitoring was very patchy and often 
only covered fluid intake.

     * Many patients were put off by large portion sizes and the 
researchers suggest that serving smaller portions at more regular 
intervals or providing nutritious drinks between meals are two possible 
solutions.

     * Staff often took their meal breaks at the same time as the 
patients and these should be rescheduled to enable them to provide more 
help.

     * Interruptions such as doctors' visits should be discouraged 
during mealtimes and staff should be more sensitive about discussing or 
highlighting issues such as toileting during meal times.

Lack of support for older patients during mealtimes was also highlighted 
by a recent Age Concern survey carried out in the UK. The charity found 
that nine out of ten nurses don't always have time to help patients who 
need help with eating and has launched a campaign – Hungry to be Heard – 
to tackle the issue in UK hospitals.
###
     * Mealtimes in hospital – who does what? Xia and McCutcheon. 
Journal of Clinical Nursing. Volume 15, pages 1221-1227 (October 2006).
-- 
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
"Ask the Parkinson Dietitian"  http://www.parkinson.org/
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