Nutrition and hydration for older people in hospital

Interesting, I've just completed an undergraduate major project - a critical literature review looking at older people in hospital and their risk of malnutrition. Despite awareness by DoH, RCN & charities - it is essentially the attitude, knowledge & skills of staff! which, of course, brings it all back to dignity & respect.

Its good to see some pro-activity.

HI,
Have a look at the insert on Nutrition and Older People which is in the
latest RCN Journal 'Nursing Older People'
It is published by the DOH and RCN so you should all be able to get a
copy.

Regards,

Lorraine
Wales

Thanks Lorraine - by chance I received a copy of this insert via the Nursing Standard a week after I completed my major project. It was pleasing to see that all the pain staking database searches and reading masses of primary research that I had found the majority (and then some) of the references quoted in the insert.

I found this very interesting as I have been a part of a Pilot Project in our Trust as a Nutrition Assistant which began on two wards and is now being rolled out to three other Care of the Elderly wards. Our job involves monitoring patients oral intake and consulting with nurses, doctors, dieticians, speech and language therapists, physio therapists and occupational therapists. It is very encouraging to read that our role is obviously so essential after reading the article.
I have to add that it is very difficult persuading some patients to eat and drink but at least we can raise the alarm and know that they will be provided with some other form of intake if all other methods fail.

I have found that the biggest obstacle to ensuring that older people in hospital remain nourished and hydrated is the lack of time and communication that staff have around individual requirements.

I have lost count of the times over the years that I have visited residents from the home I managed to discover that food is either uneaten, unpallatable, or inappropriate on account of diet, texture or ability to chew, swallow and digest - let alone eat independently.

Staff on wards invariably do not have the time to read up and inform themselves of the individuals requirements despite the information being readily available (most homes will equip the staff with a good account of the care plan and needs) with these bits of information either being lost or discarded as a patient is shunted from one ward to another.

I am particularly disappointed and continaully dismayed with the lack of care and regard that is given to people with LD or dementia in regard to nutrition and hydration whilst in hospital, with all of the above issues being apparent topped by a lack of skills and understanding from staff in working with these conditions.

Reports, studies and articles are great - unfortunately they rarely result in noticeable changes in practice.

Our role as Nutrition Assistant in our Trust has now rolled out to a few more wards. The problem seems to be though the constant need for more HCA's on Wards as opposed to having role specific staff in charge of only food and nutrition. I believe it is very much a funding issue but this could be part addressed by better training on the subject.

I agree with every word you've written Nicola Reynolds. That's my experience exactly.

When my mum was in hospital, my husband and I were there at every mealtime to ensure she had enough to eat and drink. There were never enough nurses or HCAs on duty to help all the people that needed it.