Meals out of reach for many older patients: study

By Lisa Lambert

WASHINGTON (Reuters) - Many elderly hospital patients may suffer from malnutrition simply because they cannot get to their food and nurses are too busy to help them, according to a study by two Australian researchers.

Helen McCutcheon, head of the School of Nursing and Midwifery at the University of South Australia, and colleague Chenfan Xia observed mealtimes in an acute care facility and found that one fifth of the 48 patients aged 65 and older could not reach food brought to their hospital rooms.

More than half could not open food packaging and more than a third struggled with cutlery. Others complained they were not sitting up properly to eat, and many struggled to pour beverages.

Malnourishment is common among older patients, with 60 percent becoming more poorly nourished while they are hospitalized, Xia said in a statement.

"And insufficient food is regarded as a major cause of the problem," she said.

Nurses could have remedied the patients' problems but were unavailable to help, the pair wrote in their study, which will appear in the British Journal of Clinical Nursing next month.

"The time nurses spent on assisting patients to eat was limited and nurses were busy with other tasks," they wrote. "Some patients waited for a long time and no one came to help them."

Nurses spent a mean time of one minute and nine seconds with those they assisted.

NURSES KEPT WALKING

At the acute care facility in southern Australia, kitchen staff delivered meals but rarely spoke to patients and did not help them get to the trays.

"Nurses would walk past patients who clearly could not reach or open their food and they would just keep walking!" McCutcheon wrote in an e-mail.

The researchers said most patients could only finish two-thirds, or less, of their meals. Some meals were too large for their appetites, but in many cases the patients could not get food into their mouths, they said.

The problem is common elsewhere, McCutcheon said.

"What we know is that people who are undernourished do not heal from whatever their primary illness is," said Linda Bell, a clinical practice specialist for the American Association of Critical Care Nurses in California.

Bell said that during the day, nurses' priorities change depending on patients' needs and abilities.

"It may not be as simple as it seems to carve out the time to feed patients," she said.

The researchers said nurses could and should do more to help patients eat.

"It is about deciding what is important -- it doesn't take much time to assist patients but it does take some thought and planning," McCutcheon wrote.