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Age Concern is tackling the widespread problem of malnutrition in hospitals by joining forces with Dr Jackie Morris, Chair of the BGS Policy Committee, in producing advice and information for those affected.

“If you eat well in hospital you are more likely to recover from illness quickly and get home sooner. Unfortunately, a staggering six out of ten older patients are put at unnecessary risk of malnutrition during their stay,” says Dr Morris.

Age Concern knows the extent of the problem only too well having been inundated with calls since the official launch of its “Hungry to be Heard” campaign. There are heart-breaking stories of frail and vulnerable older people not being given the simple assistance they need to be able to eat when they are in hospital. Age Concern says that in hospital and in the community, nearly a million people over 65 years are malnourished.[1]

Shockingly, nearly seven out of ten nurses admit they would not be confident that a family member would get the food and help they needed if they were a patient in their hospital. [2]

Dr Morris says, “The prevalence of malnourished older patients in hospitals is worrying. It is vital that all hospital staff work to address this problem, but there are things that relatives can do to help loved ones. It can be difficult to spot because symptoms can also be those associated with the signs of being unwell but if you are at all concerned it is essential that you speak to a health care professional.”

Dr Jackie Morris – advice on spotting the signs of malnutrition

Things to look out for:

• A poor appetite is not normal at any age and at any stage of ill health. A recent change in food intake accompanied by signs such as leaving food or drinks untouched are important indicators to spotting malnutrition.
• Look out for unintentional weight loss, particularly clothes looking baggy or wedding rings becoming loose. However, remember malnutrition can affect everyone - no matter what their size. It can even affect people who are obese.
• Symptoms include recurring infections, difficulty in recovering from illnesses or difficulty keeping warm.
• Pressure sores can be more prevalent in people with malnutrition.
• Dizziness can become more common and therefore falls might be more likely in someone who isn’t getting the nutrients they need.
• Problems with teeth, the mouth and gums can be a key indicator. Gums can become swollen or bleed.
• Tooth decay can increase or alternatively dentures can become loose.
• Difficulty swallowing will make eating difficult so it is important that this is identified as soon as possible, as this can lead to problems.
• Not always the easiest subjects to discuss, but bowel movements are important. Constipation or diarrhoea can be associated with malnutrition.

What can you do:

• Malnutrition can be treated, especially if the signs are picked up early. If you are ever worried, it is important to raise your anxieties with a health professional.
• Concerned relatives can help by encouraging loved ones to eat. Visit them at home around mealtimes – eating is usually more enjoyable with company. Also, by visiting at meal times you can assess what food they are eating and see if they have any difficulties. If your loved one is in hospital and needs help eating, you could arrange to visit at meals times to help them with their meals.
• People often tell Age Concern that they are concerned about making a fuss when they are in hospital as they are worried about this affecting their treatment, but it is important to know your rights. The Department of Health requires all parts of the NHS to ensure that patients have a choice of nutritious food and drink and receive help from staff with feeding when required. So you are not asking for anything to which you are not fully entitled.
• While in hospital talk to nurses about nutritional assessments being incorporated as a regular part of care. This may include being weighed on admission and then at regular intervals, and have a record kept of meal intake and nutritional supplements being given where needed.

Age Concern has produced two leaflets with Dr Jackie Morris. Both are available free to the public.

1. Is an older person you care for malnourished?

2. Don’t go hungry in Hospital.

References:
1) Age Concern estimate from Malnutrition among Older People in the Community, European Nutrition for Health Alliance, 2006

2) From ICM Polling of 500 nurses conducted for Age Concern in August 2006

Case studies are availabe from Age Concern. Contact: Mel Beardon on
020 8765 7511

For more information on the campaign itself, contact Age Concern on telephone 0208 679 1609.