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Starved in the Midst of Plenty
Nursing home " src="http://www.ukqcs.co.uk/wp-content/uploads/2014/01/Starved-in-the-midst-300x199.jpg" width="300" height="199" />In 1859 Florence Nightingale suggested that thousands of patients were 'annually starved in the midst of plenty, from want of attention.’ Sadly, 150 years later, it is still being suggested that nutrition remains a neglected area of care. It is estimated that a million of over 65s in the community, and 37% of older people who have recently moved into care homes are at risk from malnutrition.
Malnutrition Prevention Project
The final recommendations in the Francis Report on the Mid Staffordshire NHS Foundation Trust Public Inquiry, the Care Quality Commission Dignity and Nutrition inspections and Adult Social Care Survey, demonstrate that some organisations are still failing to provide older people with adequate food, drink and support when they need it. Yet people that are malnourished experience increased ill health, hospital admissions, GP visits and risk of infection.
In response, a government funded pilot project has started this month in Lambeth and Southwark and Salford. The Malnutrition Task Force’s Malnutrition Prevention Project will seek to raise awareness in care homes, GP surgeries, and with volunteers. The aim is to increase diagnosis and treatment of malnutrition, and to improve support and care for this vulnerable group.
Whilst these projects are underway, what can professionals do to ensure they are providing good nutritional care?
5 Key Principles
Addressing malnutrition revolves around 5 key principles:
- Raising awareness amongst residents, relatives and staff to support prevention and early treatment of malnutrition.
- Working together within a care home but also with GPs, other health professionals, catering staff and relatives.
- Identifying malnutrition early through screening and regular assessment.
- Delivering personalised care, support and treatment.
- Monitoring and evaluating resident weight, improvements and outcome.
Some of the measures that may be helpful to consider include:
- Raising awareness among staff and visitors by displaying visual information about the importance of nutrition and hydration.
- Providing and recording training for staff, including how to assist someone with eating and drinking particularly in dementia sufferers.
- Implementing and recording nutrition screening, regular monitoring of residents’ weight and investigating any unintentional weight loss.
- Protecting meal times, making them the highlight of the day for residents and encourage trips to the dining room.
- Creating a food profile for each resident.
- Keeping the resident at the heart of meal decisions. This may include using photographic menus, flexible meal times for those with dementia, the option of smaller meals or a snacking diet and gathering feedback from residents and relatives on a regular basis.
Unfortunately, malnutrition is often everybody’s concern yet nobody’s responsibility. We should all ensure we do what we can.
Ayela Spiro, British Nutrition Foundation – QCS Expert Nutrition Contributor