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Nutritional advice in common clinical situations (revised August 2009)
- Author:
- BRITISH GERIATRICS SOCIETY
- Publisher:
- British Geriatrics Society
- Publication year:
- 2009
- Place of publication:
- London
Under-nutrition in older people admitted to hospital is common, and the risk of being malnourished increases during hospitalisation. It is also poorly detected by nursing and medical staff. This good practice guide paper covers nutrition screening, the importance of creating the right environment to support eating and drinking, management of under-nutrition in hospital, ethical and legal considerations, nutrition and stroke, nutrition and dementia, and nutrition in the community and care homes. It includes reference to key resources and guidance about nutritional care in hospital, and makes recommendations covering the advice of dieticians and speech and language therapists, training to enable health professionals to assess and meet nutritional demands, management of dysphagia, policies for review of patients, and development of policies to support nutrition which include auditable standards.
Eat, drink and be healthy: malnutrition on the wards
- Author:
- TAYLOR Jennifer
- Journal article citation:
- Health Service Journal, 4.6.09, 2009, pp.22-23.
- Publisher:
- Emap Healthcare
The health of many older patients in hospital is being jeopardised through lack of attention at meal times. This article provides some tips on how to ensure older patients eat properly. These include a short case study which outlines a volunteering programme at Darlington Memorial Hospital.
Hungry to be heard: the scandal of malnourished older people in hospital
- Author:
- AGE CONCERN ENGLAND
- Publisher:
- Age Concern England
- Publication year:
- 2006
- Pagination:
- 26p.
- Place of publication:
- London
Six out of 10 older people are at risk of becoming malnourished, or their situation getting worse, in hospital. Up to 14% of older people aged over 65 years in the UK are malnourished. Four out of 10 older people admitted to hospital are malnourished on arrival.Patients over the age of 80 admitted to hospital have a five times higher prevalence of malnutrition than those under the age of 50. Up to 50% of older people in general hospitals have mental health needs. Patients who are malnourished stay in hospital for a longer time, require more medications, and are more likely to suffer from infections. The toll of malnutrition on health and health care costs is estimated to exceed £7.3 billion per year (much more than obesity). Over half of this cost is expended on people aged 65 years and above.
Time to listen in NHS hospitals: dignity and nutrition inspection programme 2012
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2013
- Pagination:
- 37
- Place of publication:
- Newcastle upon Tyne
Comparing the results of the 2011 dignity and nutrition review with these latest findings, the inspectors found that more hospitals were meeting people’s nutritional needs. However, fewer hospitals were treating patients with dignity and respect. 50 hospitals were inspected against five standards: respecting and involving people; meeting their nutritional needs; safeguarding them from abuse; staffing; and records. 33 hospitals were meeting all five standards. At the other end of the scale, three hospitals were meeting just two of the five standards, one hospital was meeting only one and one was not meeting any. (Original abstract)
Time to listen in NHS hospitals: dignity and nutrition inspection programme 2012: summary
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2013
- Pagination:
- 5
- Place of publication:
- Newcastle upon Tyne
This inspection report compares the results of the 2011 dignity and nutrition review with the 2012 findings. The main findings are that more hospitals are meeting people’s nutritional needs but there are fewer hospitals where patients are always treated with dignity and their privacy and independence respected. (Original abstract)
More than just not being alone: the number, nature, and complementarity of meal-time social interactions influence food intake in hospitalized elderly patients
- Authors:
- PAQUET Catherine, et al
- Journal article citation:
- Gerontologist, 48(5), October 2008, pp.603-611.
- Publisher:
- Oxford University Press
This study evaluated the social facilitation of elderly patients' food intake beyond the presence of mealtime companions by assessing various relationships. The study examined the relationships between patients' intake and (a) the number of interpersonal exchanges with mealtime fellows, (b) the nature of behaviours expressed by the patients themselves and their fellows, and (c) the degree of complementarity between these. Interpersonal exchanges and intake were observed on repeated mealtime occasions (n = 1,477) nested within 32 geriatric patients (21 women, 11 men; age, M = 78.8 years) in a rehabilitation unit located in Canada. Participants' intake was estimated from plate leftovers. Interpersonal behaviours were examined for both participants and patients with whom they interacted in terms of agency and communion dimensions, following the interpersonal circumplex model of human interaction. With the use of multilevel regression analyses, the number, nature, and complementarity of behaviours that participants engaged in and were exposed to on a given meal were computed to test their impact on intake. The total amount of interaction between patients was positively related to intake. The effect was significant for both participants' own behaviours and those to which they were exposed, and it varied with the nature of the interaction; effects were significant in terms of frequency and complementarity for communal behaviours, and complementarity only for agentic behaviours. Effects could only partly be explained by meal duration effects. The results provide support for the effect of the number, nature, and complementarity of mealtime interpersonal behaviours on the food intake of elderly patients, and they may inspire new approaches to ensure adequate intake in this malnutrition-prone population.
Patient and family views of nutritional status
- Authors:
- GORDON Harriet, BEST Carolyn, SUMMERS Jill
- Journal article citation:
- Nursing Times, 110(17), 2014, pp.13-14.
- Publisher:
- Nursing Times
A small scale survey was conducted to explore relatives and patients' views of their nutritional status on arrival in hospital and how this might change during their stay. In total, 57 patients aged over 65 and 48 relatives/carers participated in the survey. The survey found that patients were more likely to state they were in a poor nutritional state than relatives. However, relatives were more inclined to expect patients' nutritional state to improve whilst in hospital.There was no evidence to suggests that family members who lived further away were more or less likely to report concerns about the nutritional state of their relative. It is suggested that better communication is needed to ensure there is a better understanding of patients' capabilities to eat independently in hospital. (Original abstract)
Food and drink - the basic requirements of life
- Authors:
- DENNIS Monica, ALLEN Judith
- Journal article citation:
- Journal of Adult Protection, 13(3), 2011, pp.167-173.
- Publisher:
- Emerald
In December 2008, the Daily Mail published an article written by a founder member of the organisation ‘A Dignified Revolution’ (ADR) detailing negligent, unprofessional and uncaring practice in an elderly relative's hospital care. In response to this, 94 people from around the UK wrote to ADR providing their own examples of either being a patient in hospital or witnessing their loved one’s distress. This paper analyses this correspondence, particularly addressing one of the most common areas of concern; the management of hydration and nutrition. The vast majority of the criticisms were directed towards severe deficits in nursing practice. The experiences that were shared demonstrated not only a contravention of the nurse's code of practice, but also an abuse of older people's fundamental right to eat and drink. The findings also demonstrate the severe harm that can be caused to vulnerable older people and the trauma caused to relatives and carers. Many respondents were dismayed at the complete lack of nursing assessments and the inconsistencies in the documentation about their relatives' care, including food and fluid charts, which was so fundamental to their care needs.
How we treat the sick: neglect and abuse in our health services
- Author:
- MANDELSTAM Michael
- Publisher:
- Jessica Kingsley
- Publication year:
- 2011
- Pagination:
- 384p.
- Place of publication:
- London
The author brings together a range of evidence to highlight the decline of care in our health services. The book looks at the causes of poor care and the lack of accountability for those responsible. The political, moral, professional and legal implications of a failure to care are highlighted and suggestions for making changes are made. A wide range of issues are covered including: dignity; management of continence; nutrition and hydration; staffing levels and attitudes; manslaughter; misinformation and spin; human rights; and the legal implications of neglect and abuse.
Seen but not heard: elderly women's experiences in hospital
- Authors:
- FREEMAN Amy, O'CONNOR Deborah
- Journal article citation:
- Canadian Social Work Review, 19(1), 2002, pp.65-84.
- Publisher:
- Canadian Association for Social Work Education
This article identified critical gaps in five areas: bathing, mobility, nutrition, communication and care of dentures. Additionally patients lost their sense of personal identity whilst in hospital. To cope with such gap in care, patients looked to alternative sources of support including informal care from family members.