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.
Age 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 Green Wing 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?
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