There’s a new virus spreading around geriatric wards of the UK’s National
Health Service and it’s got hospital managers quaking in their pinstriped suits.
Even more worrying than MRSA, this infectious little viral is set to infect the
elderly, making them – and their carers – proactive.
Concern – the charity that represents the interests of older people- is
using viral marketing via YouTube to highlight the problems of malnutrition in
elderly patients as part of its campaign Hungry
to be Heard. In true bioterrorist style, Age Concern have inoculated the
internet – that well-known hangout of the old and infirm (well we’ve got nothing
better to do during these long cold nights in our furry mono-slippers now that
we can’t afford the warm glow of a single-bar fire, have we?). The clips take a
lighthearted look at the problems of mealtimes for elderly hospital patients,
basing the on the Channel 4 Sitcom, The
and demonstrate some simple ways in which the problem might be ameliorated, like
protected mealtimes, more appropriate food and mealtime volunteers.
While I’m all in favour of this approach to raising awareness and, in the
office earlier, it also gave myself and colleagues another opportunity to
reminisce about TV shows gone-by, there is – as usual – a more serious issue
behind the message than even Age Concern may be aware.
One of the many stories I didn’t get chance to post from the Nutrition
Society Summer Meeting over the summer was one on a truly excellent
scientific presentation given by Professor Gary Frost. Along with his colleagues
at Imperial College London, Frost has been looking at the issue of malnutrition
in elderly patients at his own local hospital, the Hammersmith. Malnutrition is
a serious issue in hospitals, not least because patients are already sick when
they arrive – not a good start when you’re trying to treat them. Malnourished
patients are difficult to treat, but, as frost pointed out, once they get into
hospital, the situation generally gets worse, not better. Acute care due to
malnutrition in hospital costs the NHS around £7 billion a year, he said, so
hospital managers looking to save costs should be clambering over themselves by
now trying to feed their patients better.
Taken from a scientific perspective, malnutrition on the ward is a complex
problem, but studying it is no easier. ‘The problem is that the evidence base is
not very strong just yet,’ said Frost and, worse still, ‘the design of studies
is seriously flawed.’
Many older patients already have a decline in their nutritional state of
admission to hospital, but ‘the longer they stay, the worse it gets.’ To
exacerbate the problem, said Frost, the human body in this situation is probably
its own worse enemy. The combination of illness or trauma and malnutrition just
makes the situation worse still. At this stage it seems, patients could be
headed on a downward spiral. ‘malnutrition is still not recognised as a medical
problem,’ he explained and even though we are starting to discover the
physiological effects of illness and malnutrition, we don’t have sufficient,
reliable data to make informed decisions about what to do best. Worse still, he
said, despite the best efforts of doctors, nurses and nutritionists, patients
are seen by a number of different people in a complex, unfamiliar setting.
While there is certainly no harm in lobbying for improving the food and
eating environments of these vulnerable patients, scientifically, the metabolic
response remains a mystery.
To find more about the problems facing the nutrition in clinical settings,
why not visit CABI’s specialist internet resource, NutritionandFoodSciences?