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October 06 |
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Eat Well While in the Hospital
by Susan Mills-Gray, Nutrition and Health Specialist |
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It is well documented that older people who enter the hospital inadequately nourished are at greater risk for complications after surgery. Recent studies also make it clear that seniors are often at risk of becoming undernourished while in the hospital. An Arkansas study of 500 hospital patients (age 65 and over, with a hospital stay of at least four days or more) found that over 20% of these patients ate less than half the calories they needed to maintain their body weight. This is of particular concern for older people who can’t reverse a nutrition deficit as quickly as a younger person. It can also result in a downward spiral in health. When an older person stops eating, they become weaker and are at greater risk of developing complications. If malnourished before entering the hospital, the weight loss during the hospital stay becomes even more serious. The risk of dying while in the hospital is eight times higher for older adults who became malnourished. Often complex
medical problems and the need for diagnostic tests make feeding
decisions and nutrition orders difficult. No matter the reason for
nutrition decline, families and friends of hospitalized elderly patients
will want to take an active role to prevent unwanted weight loss of
their loved ones. ´ If the patient stops eating because he/she dislikes the hospital food, bring in something to tempt the appetite, as long as the doctor approves.´Does the patient seem nauseated? Check with the doctor for drugs to relieve the discomfort. There are also medications available to stimulate the appetite. Discuss potential side effects with the doctor. Some drugs used to treat nausea or stimulate appetite can cause delirium. ´Does the patient have difficulty chewing or swallowing? If so, see that the hospital provides meals of soft or pureed foods. If the person has difficulty with utensils, help with feeding, or you can request utensils with easy-to-grip handles. ´Keep the patient company while they eat, and if possible, eat with them. Old and young and alike eat better when they have company. ´Remind the person to
eat. Sometimes, encouragement is all it takes. If that doesn’t seem to
work, ´If a patient has doctor’s orders to eat "nothing by mouth," be assertive. Check on why, how long the order will be in place and if other nutrition support can be provided to ensure adequate nourishment. ´Be open to alternatives for nutrition support for patients who won’t or can’t eat, such as tube feedings. Sometimes families don’t understand tube feeding and misinterpret it as terminal care. Tube feeding is often the best way to help a patient maintain nourishment and not lose nutritional ground while recovering from surgery or illness.-- Adapted from an article in Tufts University Health & Nutrition Letter, August 1999. |
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Kris Jenkins jenkinsk@missouri.edu Regional Specialist Human Environmental Sciencs Last revised: 03/18/09 |