Elderly patients becoming malnourished in hospital

Elderly people are being left to go hungry on NHS wards, says a report published today.

Those who enter hospital malnourished can get worse during their stay or become malnourished there.

The report from the charity Age UK found almost one in three nurses believe their own relative could enter hospital with nobody noticing they were malnourished.

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The study – Still Hungry To Be Heard – builds on previous research which showed some elderly people receive no assistance with meals despite struggling to eat.

Those who have difficulty swallowing are sometimes put at risk of choking by not being given pureed food, while others have their food trays placed out of reach at the end of beds or on tray tables that are too high.

The charity has also heard of elderly people receiving no help with cutting food into smaller pieces or opening lids on containers.

Food trays are also sometimes taken away untouched without any questions, according to the charity.

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The study found fewer than half of hospitals screen older patients for malnutrition on admission to hospital and only a third screen patients during their stay.

Only five per cent screen on discharge, despite evidence showing good nutrition both in and out of hospital helps people get better.

The report found many hospitals were largely ignoring guidelines which say people should be screened.

The accompanying survey of 1,000 nurses found fewer than half thought their workplace screened older patients often enough. According to 71 per cent of nurses this was due to a lack of time, other priorities and training.

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Figures for 2008/09 showed almost 180,000 patients left hospital malnourished, a number that has been rising, and 239 died of malnutrition during their stay in 2007.

Malnutrition is thought to cost the NHS 7.3bn per year, affecting 23 per cent of people under 65, increasing to 32 per cent among the over-65s.

Age UK's Hungry To Be Heard campaign was launched in 2006 and the charity said it had seen improvements since then but charity director Michelle Mitchell said there was still more to do.

"It's extremely worrying that nurses still don't feel confident that a fundamental problem such as malnourishment will be picked up when an older person enters hospital," she said.

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"While recognition of the issue is high, not enough is being done to ensure that words are transferring into action on the wards.

"It is vital that the Government, Care Quality Commission (CQC) and NHS trusts fulfil their role in tackling this serious issue.

"The Government must introduce compulsory monitoring so that this issue can be effectively tackled.

Dr Peter Carter, general secretary of the Royal College of Nursing, said compulsory screening for malnutrition would tackle the inconsistency between hospitals.

"In order to achieve this, it is crucial that all the appropriate screening equipment and training is provided for health and social care workers to make nutrition a priority in their workplace."

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