Changing the food environment: the effect of trained volunteers on mealtime care for older people in hospital.
Helen Clare RobertsPublished in: The Proceedings of the Nutrition Society (2017)
This review will describe the evidence for changing the hospital environment to improve nutrition of older people, with particular emphasis on the role of additional mealtime assistance. Poor nutrition among older people in hospital is well recognised in many countries and is associated with poor outcomes of hospital care including increased mortality and longer lengths of stay. Factors recognised to contribute to poor dietary intake include acute illness, co-morbidities, cognitive impairment, low mood and medication. The hospital environment has also been scrutinised with reports from many countries of food being placed out of reach or going cold because time-pressured ward and catering staff often struggle to help an increasingly dependent group of patients at mealtimes. Routine screening in hospital for people at risk of under nutrition is recommended. Coloured trays and protected mealtimes are widespread although there is relatively little evidence for their impact on dietary intake. Volunteers can be trained to sfely give additional mealtime assistance including feeding to older patients on acute medical wards. They can improve the quality of mealtime care for patients and nursing staff although the evidence for improved dietary intake is mixed. In conclusion, improving the nutrition of older patients in hospital is challenging. Initiatives such as routine screening, the use of coloured trays, protected mealtimes and additional mealtime assistance can work together synergistically. Volunteers are likely to be increasingly important in an era when healthcare systems are generally limited in both financial resources and the ability to recruit sufficient nursing staff.
Keyphrases
- healthcare
- adverse drug
- quality improvement
- physical activity
- acute care
- palliative care
- cognitive impairment
- end stage renal disease
- liver failure
- mental health
- chronic kidney disease
- emergency department
- cardiovascular disease
- adipose tissue
- type diabetes
- depressive symptoms
- ejection fraction
- young adults
- intensive care unit
- newly diagnosed
- prognostic factors
- climate change
- drug induced
- hepatitis b virus
- acute respiratory distress syndrome
- glycemic control
- health information
- mechanical ventilation
- high intensity