Nurses 'too busy to feed elderly patients due to cutbacks'

13 April 2012

Older hospital patients are having their lives put at risk because nurses are too busy to help them with eating, warns a leading charity.

Vulnerable patients - some of whom are already malnourished - are getting worse because of underfeeding in hospitals, says Age Concern.

It is launching a campaign today to end the scandal of thousands of older patients being left to starve because nine out of 10 nurses do not have time to feed them.

The initiative Hungry to be Heard comes after a series of reports highlighting widespread problems of malnutrition in hospitals and care homes.

The cost to the Health Service is estimated to exceed £7.3 billion a year because poorly fed patients stay in hospital longer, have a higher mortality rate and are three times more likely to develop complications during surgery than well-nourished patients.

Gordon Lishman, director-general of Age Concern, said 'Hospitals are in danger of becoming bad for the health of older people.

'The majority of older patients are being denied some of the basic care they need, leaving hundreds of thousands of older patients malnourished.

'It is shocking the dignity of patients is being overlooked. From ward to board, everone needs to address this problem.'

Nine out of ten nurses do not always have time to help patients who need assistance with eating, according to a survey of 500 nurses carried out by the charity.

It says six out of 10 older patients are recognised as at risk from becoming malnourished or even more underfed while in hospital, yet very little is being done about it.

In particular, patients over 80 admitted to hospital are five times more likely to be malnourished than those under the age of 50.

In many cases, nurses and care staff fail to help patients eat meals, which are too often unappealing.

Families also complain about food being placed out of reach of incapacitated patients, while others see meals whipped away before patients have had time to finish eating.

Older patients occupy two thirds of general hospital beds but simple safeguards are not being implemented.

These include a 'red tray' system alerting nurses to patients who need most help - because of age, physical or mental infirmity - by making sure their food arrives on a red coloured tray.

The warning follows the Daily Mail's long-running Dignity for the Elderly campaign highlighting abuses caused by underfeeding and poor nursing practice in hospitals and care homes.

Playwright Alan Bennett last year voiced his concern about care homes, saying people can 'quite respectably starve to death'.

The Royal College of Nursing (RCN) said lack of staffing meant nurses found it difficult to assist patients at mealtimes. Around 20,000 NHS staff, including nurses, are thought to have lost their jobs this year as a result of cash-strapped trusts making economies.

Pauline Ford, RCN advisor for older people, said 'This survey by Age Concern highlights just how serious the problem of understaffing on many hospital wards has become and how for so many nurses time has become a luxury.

'It is unacceptable if patients are not getting the help they need to eat or drink.

'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.'

Protected mealtimes

She knew of 'fantastic examples' of older patients being properly looked after, but nurses who were worried should be asking for protected mealtimes - when attention is entirely focused on helping patients eat - and specialist equipment to help patients feed themselves independently.

Research by the British Association for Parenteral and Enteral Nutrition (BAPEN) last year triggered concern about malnutrition in nursing and long-term care homes, where 30 per cent of residents were 'clinically malnourished'.

It wants all hospitals to check the nutritional status of older people when they go into hospital.

Professor Marinos Elia, chairman of BAPEN, said 'Up to 40 per cent of all patients on admission to hospital are malnourished.

'However, malnutrition remains a low priority for most healthcare workers - and thus often remains unrecognised and untreated.

'This is in spite of clear clinical evidence that those at risk of malnutrition stay in hospital longer, succumb to more infections and other complications and need greater access to medical care.'

Guidance has been issued by the National Institute for Health and Clinical Excellence (NICE) recommending screening on admission to both hospital and care homes in England and Wales.

Prof Elia said 'If implemented, more patients will be identified as being at risk of malnutrition and appropriate care and treatment will be provided.

'BAPEN calls upon England to follow Scotlands example and ensure screening for malnutrition becomes compulsory on admission to hospital.'

Andrew Castle, GMTV presenter, said I am backing the Age Concern campaign because recently my own mum was in hospital, and we started to take in meals for her as we were concerned she wasn't getting the food she needed.

'I didnt realise that this was an experience shared by many other people.

'All NHS Trusts need to promise to spring into action to ensure that unnecessary malnutrition is eradicated from their wards.'

ITV presenter Jeremy Kyle, said he was shocked by the need for the campaign.

He said 'When someone close to you is in hospital it is an anxious time already, without having to be concerned that basic care such as help with food is being over looked.

'I had no idea that so many older people in hospitals were malnourished and to think that this is being over looked is just mind-boggling.'

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