One in three adults admitted into hospital are malnourished

3 million people in the UK are affected by malnutrition

Did you know that in many institutions, prisons for instance, there is a legislation that requires them to meet mandatory quality, nutritional and environmental standards on all food served*?  Makes sense doesn’t it?  That we ensure people who have no real say over the food they are served know that it is nutritionally balanced and is of good quality.

There is no such legislation governing food served in hospitals.

Over the past few years my granny has been in hospital a few times and it has always baffled me how little emphasis seems to be placed on the nutrition of patients, particularly elderly patients, and also on helping them to eat the food served.

For a loved one who is ill, there is nothing more they want to do than get back to doing the things they love. Figures suggest that 3 million+ people in the UK are affected by malnutrition1 and 1 in 3 adults who are admitted into hospital are malnourished.2 Despite this, a recent survey revealed that the majority of people over the age of 65 did not receive nutritional support during or after hospitalisation, with one quarter saying they still have not recovered from their illness a year later.3

At home my granny is perfectly capable of cooking her own meals and sitting down to eat them by herself.   I admit what when we went out for lunch recently and she was confronted with a whole seabass she needed a bit of help but on the whole she is happy to get on with it herself.   Her diet is rich in fruit and veg, there is little refined sugar and on the whole it is what you would call balanced.   We have come to realise she probably doesn’t eat enough protein and carbohydrate but trying to get an 87 year old to change their diet and what they cook themselves is a battle we are not about to tackle.

 Hospital food though is very different.  Patients recovering from operations or illnesses need food to nourish their bodies and aid recovery. Certain vitamins and minerals are essential for the absorption of drugs into the body too, such as drinking orange juice when taking iron tablets.   Or avoiding drinking tea when taking certain tablets as it flushes the system before absorption.  In fact drinking tea after a meal means that many nutrients from food are flushed before being absorbed, yet the tea trolley comes around before pudding is even finished.

I can really relate to that statistic above about the majority of the over 65s not receiving nutritional support during a hospital stay, nor us on how we can help.

Recently my granny was in hospital for an extended period after a fall at home that had left her on the ground for a number of hours.   I am talking more that 24.  I know.  Devastating.   We were prepared for the worst because many people don’t recover from such prolonged bouts on the floor and at her age the doctors needed to make us fully aware of how dangerous this could be.   Muscle wasting had occurred and my poor granny’s kidneys were struggling to cope with the process that starts when that begins, alongside hypothermia from being immobile for so long in a draught.  All her systems were running in overdrive to try and recover and as much as the machines were doing all they could, heart monitors, oxygen, a drip for fluid the real battle needed to be fought by my granny.  Who by that point had probably gone for over 48 hours without food.

Eating food whilst sitting in bed is never going to be particularly easy, so why do hospitals insist on soup as a starter?  Soup is impossible to eat without spilling at the best of times, but holding a large spoon when you are frail and sitting in bed, well it just doesn’t work.   Which means many patients don’t eat it, missing out on the warmth and the calories it deliveries.

When you really start to address food served in hospitals it just feels to me that it is all wrong.   Most of it is not made on site, it is shipped in, on industrial scales and the budgets for food per head in this country vary from less than £4 per patient per day, to over £14.   A disparity of as much as £10 per person per day.  That is huge.   And how can we expect to give an elderly person who really needs good nutrition three meals a day for £4?

My granny was given a snack each day of cheese and biscuits.  A lovely idea but with them all shrink wrapped in plastic how can you expect somebody with arthritic hands to open the packaging?  So they are left, and presumably dumped.  What a waste.

Ditto the huge jacket potato.  Delivered on a plate with no garnish, whole, butter in the plastic wrapper on the side.  Again impossible to open and nothing to make this lump of withered carbohydrate look even remotely appetising.   The same with boiled tomatoes for breakfast.  Literally two whole plum tomatoes on a plate.    It just looks revolting.  How can we ask somebody who is unwell and desperately needs nutrition to eat this?

Is it any wonder visitors bring in bags of food for their loved ones in an effort to do their best to get family members to eat?

We saw all sorts of medical staff (amazing and incredible medical staff) but nobody came and talked to my granny about her diet.  About any small changes she could make once home to get as many nutrients as possible over the coming weeks.  Maybe some oily fish and scrambled fish for breakfast as a protein hit rather than her daily muesli.

The recovery process from this fall for my granny is going to go on for months.   Not only is her body bruised and the wound on her head still healing, the emotional scars from thinking her time was up and she might not be found in time must be profound.   To recover from such a trauma will take time and I can’t help but feel that the process might be speeded up with some good nutrition.  Hearty, warming stews and lovely creamy rice puddings.

Yet I am no dietician either, I don’t know what I can do to really help.  Well I didn’t.   Since being sponsored by Abbot’s to become an advocate for my granny’s nutritional health I have been reading resources such as Nutrition News to find out as much as I can about how to help.   How to use diet as a medicine to help the recovery process and make my granny strong enough to fight the next battle.    It’s a real shame though that access to this information is not more readily available from healthcare professionals.

[1] BAPEN, 2010: http://www.bapen.org.uk/pdfs/toolkit-for-commissioners.pdf . Accessed July 2016

[2] BAPEN, 2014: http://www.bapen.org.uk/pdfs/nsw/bapen-nsw-uk.pdf . Accessed July 2016.

[3] Online survey conducted by Abbott Laboratories Ltd. (Frailty in Older Age). 2016

*.   Hospital spending on patient meals

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  • I was “lucky”!
    Admitted at midnight my first breakfast in Hospital was good. I was surprised.
    I was more amazed when, 30 minutes later I suffered a mod. severe stroke. PURE COINCIDENCE.
    Over the next 14 weeks I ate most things put in front of me without ill effects but I was helped by daily visit with goodies like fresh fruit, salmon and cheshire cheese. I even persuaded the dietitian to arrange for me to get a daily pint of full-fat milk instead of the semi-paralysed standard issue!
    As I say I was lucky. Mummy’s granny is a bit older than I and didn’t get the dietary support and help with eating that she should have. Much depends on the General Manager of the hospital. Some do “walk the walk”, see for themselves and make changes where necessary. Many do not.
    It all depends.
    Unfortunately.

  • Such a powerful post particularly as you share a personal story. Commenting for myself and on behalf of BritMums and thanking you for taking part and raising awareness.

  • Yes it’s shocking and something we’ve seen with the three elderly relatives we care for at a distance (which makes it difficult to help with taking in food for them for instance!).

    I’ve been thinking about this and how we care for our elderly in general a lot recently. What concerns me as well is how little preventative medicine/help there is. For instance physiotherapy/exercises which would prevent falls and the resultant hospital stays in the first place. So many of our elderly are left just to sit all day, yet recent health reports in the media are all saying how unhealthy that is for everyone.

    A huge rethink is needed for how we want quality dignified care for our loved ones in future in both hospitals and also care in the community.

  • Wow – I was astounded that there is legislation to ensure that food served in prison is nutritious but not the same laws governing food served in hospitals! I wish you, your family and especially your granny all the very best in her recovery. x