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

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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@...

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).

--

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