[PHNUTR-L] 58 percent of older hospital patients have problems
eating, 31 percent leave most of their meal
Kathrynne Holden, MS, RD
fivestar at nutritionucanlivewith.com
Tue Sep 26 09:53:35 PDT 2006
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Public release date: 25-Sep-2006
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
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
"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
* 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
* Staff often took their meal breaks at the same time as the
patients and these should be rescheduled to enable them to provide more
* 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/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
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