A chance to blog

In an ideal world...... all our underweight patients would be eating all their meals, drinking at least 2000 mls a day and have put on weight by the end of their hospital stay!  In some cases, that happens and it's great but unfortunately in many incidents, that is not even close to the result. What can we do when despite all our efforts, our patients don't want hardly anything? We watch them losing weight despite all our pleading, begging and the doctors asking us to "encourage oral intake".  Firstly, we can talk to them and find out what is stopping them.  Occasionally we discover medical reasons behind it such as "I get horrible heartburn when I eat", "I feel like I have a lump in my chest and food won't go down", "I feel too full", "I can't chew, it hurts".  Here we have possible examples of acid reflux, oesophageal problems, constipation or mouth ulcers. These can often be resolved with medical interventio...

Dignity and meals: To continue with the subject of Nutrition and Elderly Care in hospital, one important fact is sometimes ignored - the dignity of the patient. I mentioned in Part 1 that some patients decline to drink enough as they "will want to go to the toilet". If a patient has urgency or continence issues, this is of great concern to them for obvious reasons. Low staffing levels, distance from toilet, mobility problems all contribute to the facts that patients do not want to find themselves in an embarrassing predicament. And there are other issues.... The term "feeding" is one I dislike intensely and really try not to use. "Assistance" is the correct term I believe unless someone can give me a better one. Many patients come to hospital following a fall unable to use an arm due to injury, or, may be so weak that lifting their arms requires too much effort although in the time prior to coming to hospital, they were perfectly independent a...

                                                                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 un...