RCN National rally in London in May against all cuts in the NHS budget
RCN National rally in London in May against all cuts in the NHS budget

Four out of ten older people admitted to hospital have malnutrition on arrival, says a new report by Age Concern.

The Royal College of Nursing backed the report, saying it was not nurses’ fault, but that cuts and staff shortages meant for many nurses, time had become a luxury.

Pauline Ford, RCN advisor for older people, said: ‘It is unacceptable if patients are not getting the help they need.

‘Nurses desperately want to be able to give the standards of care they were trained to give, but need the support and resources to do so.

‘Most importantly they need to be given the time to care.’

Hungry to be Heard – The scandal of malnourished older people in hospital says patients over the age of 80 admitted to hospital have a five times higher prevalence of malnutrition than those under the age of 50.2.

‘Whether their condition goes unnoticed, or untreated, and worsens during their hospital stay is a lottery.

‘Older people and their relatives are left worried and not knowing whether they will be given appropriate food or help with eating it.

‘The result is that six out of ten older people are at risk of becoming malnourished, or their situation getting worse, in hospital.

‘Malnourished patients stay in hospital for longer, are three times as likely to develop complications during surgery, and have a higher mortality rate than well-fed patients.

‘Ending the scandal of malnourished older people in hospitals will save lives.

‘Despite everyone recognising that there is a problem, it persists.’

The report adds: ‘As a result, one of the most frequent issues raised with Age Concern by the relatives of older people who have been in hospital is the lack of appropriate food and the absence of help with eating and drinking for people who are unable to manage this for themselves.

‘Until malnutrition in hospitals is ended, the lack of respect for the dignity of older people will continue to be a national scandal.’

Age Concern insists: ‘The Department of Health must treat food, and help with eating it, as a key issue in the NHS delivery of essential standards of care.’

The Age Concern report continues: ‘Older people’s health and dignity are undermined in hospitals across the country because policy is not being put into practice.

‘Age Concern believes that the malnutrition of older people has no place in a modern society.’

The report adds: ‘The government has stated that there should be a shift to patient-led care in the NHS.

‘Age Concern believes that food and help with eating it should be a central focus of patient-led care.’

Age Concern stresses that ‘having systems in place to tackle malnutrition is not enough in itself – steps must be taken to ensure that those systems are working effectively.’

The report cites the Patient and Public Involvement Forum’s view: ‘The Forum receives anecdotal comments indicating patient and carer concerns over the quality of food and the perceived lack of help with feeding.

‘We are aware that many patients from the minority communities are having food brought in by relatives and carers.’

The voices of older people and their families

Age Concern has received many complaints from older people and their relatives about their food in hospital and the help, or lack of it, that they were given to eat it.

Some of those contacting Age Concern have asked to remain anonymous and it has, therefore, hidden their identities.

Age Concern has also not identified the hospitals involved.

However, in each case, the hospital has self-assessed that they are compliant with Core Standards 15a and 15b.

Meals arrive with the cover on, taken away again with the cover still on

A. was admitted to hospital before Christmas 2005 and had surgery, but he didn’t pick up afterwards.

His meals were being delivered to his bed with a cover on, and then taken away again with the cover on. No-one was checking that he was eating.

He was depressed about his illness and so had stopped eating.

When A.’s daughter raised this with the hospital they offered to put her father on a course of antidepressants.

She refused and insisted that they give him confidence training and ensured that he was eating his food. He then improved dramatically.

No help with eating despite suffering from Parkinson’s disease

79 year-old R. was admitted to hospital in October 2005 following a fall.

He suffered a loss of appetite partly due to being away from home but also because he found the meals unappealing.

He received no encouragement nor help to eat from staff, despite suffering from Parkinson’s disease.

Eventually meals were puréed which appeared to R.’s family to be for the convenience of the staff as there was nothing wrong with R.’s ability to chew.

Fortified drinks were always left out of his reach and he became dehydrated.

By the time he left hospital in December, he had lost a considerable amount of weight.

Despite labels attached to each menu, given inappropriate food P. was admitted to hospital in December 2005 for an urgent heart operation.

He suffered from Coeliac Disease and was unable to digest gluten.

The hospital menus provided meals for various special diets but not for Coeliac Disease. He was also allergic to eggs and onions which would cause him intense pain if ingested.

Despite his wife attaching labels to each menu describing what he couldn’t eat, he was often given inappropriate food, such as minced beef and onions, by the catering staff.

In the final few months of his life, he was readmitted and diagnosed with ischaemic bowel disease, which meant that nothing was to go into his bowel, and he was put on a drip.

However, menus continued to be placed on his tray.

In desperation, his wife placed a sign above his bed stating that they would blame the staff personally if they gave him food. Only then did the staff take notice.

G. was in hospital during November and December 2004. He needed help to eat his meals but the tray would be left on the bedside table.

The meals would often go cold, sometimes having been left for 40-50 minutes.

G. would then be expected to eat the food or, if he wouldn’t, would be told off and the meal thrown away.

G.’s family made sure that they were always there at mealtimes to help their father and other patients.

Although G. was unable to chew, he could manage some soft foods and eat puréed meals.

However, during the 16 days he was in hospital, he was given the same meal of puréed mince on 12 occasions.

Only when G.’s family were able to time their visits as the daily meal tickets were being completed did he receive something different – and even then it was not always what they had asked for.

78 year-old S. was in hospital for six weeks from April 2006 and found the food ‘dreadful’.

The food was brought in from a distance and re-heated in a microwave, and S. found it to be ‘completely denatured and tasteless’.

During her stay in hospital, she lost about 20lbs and dropped two dress sizes. She believes that some of the weakness she continued to experience at home was due to not eating properly in hospital.’