Nutrition and Hydration Week 2014 Part 1
In this month leading up to Nutrition and Hydration Week 2014, I am going to focus on the issues surrounding keeping our elderly nourished and hydrated. This is not as easy as it sounds when many are suffering the effects of Alzheimer's, Dementia, Parkinson's Disease and other health related issues that frequently, exhibit their symptoms as people get older. Patients that arrive in our hospitals are often already malnourished and dehydrated and our job is to try and help them improve their condition prior to them returning to where they live.
Assessment is the first part of the process. All patients are weighed upon admission and their MUST score checked using the Malnutrition Universal Screening Tool. Patient's who are found to be underweight are then referred to the Dietician who carries out a nutritional assessment and suggests extra snacks and supplement shakes in between meals, or, prescribes higher calorie supplements to be given.
Sometimes patients are not eating because they have swallowing difficulties, often associated with Dementia or Stroke and may need a modified, easier to eat, diet. If such problems are suspected, a referral is made to the Speech and Language Therapy team who will then assess the patient and recommend a softer or pureed diet and thickened fluids if necessary. Such modified diets can prevent aspiration and the onset of pneumonia so assessment is very important.
Other issues that can prevent a patient from eating or drinking are: lack of desire to eat or no trigger feeling of hunger and thirst, ill-fitting dentures, few teeth, mouth infections, a fear of needing to go to the toilet too often (a common cause of dehydration), depression, control factors and even suspicions of food being poisoned!
In a hospital setting, some do not like to eat alone, others do not like to eat when others are watching, some do not like certain meals and others will not drink plain water but are afraid to ask for something different. Many find the meals too big and would rather not start eating than cause waste. (They think that someone else will have it if they don't touch it.)
In the further blogs I will be discussing ways to work around some of these problems and find ways to encourage a better dietary intake.