clinical focus
Treat food like medicine
A new study highlights the barriers to adequate food intake in older hospital patients .
Ekta Agarwal interviewed by Dallas Bastian
“ I don ’ t eat when I ’ m sick .” “ The smell of food makes me feel nauseous .” “ I ’ m quite depressed at the moment . When you get like that you don ’ t feel like eating much .”
These were some of the sentiments shared by participants of a study into older people ’ s mealtime experiences in hospital .
The QUT , Dietitian Connection and Bond University research team interviewed 25 hospital patients aged 65 – 98 years and found that inadequate dietary intake is complex and influenced by a range of barriers .
Some of them included the view that poor appetite was an expected outcome of being sick and in hospital , and feeling rushed by food service staff who needed to clear meal trays .
Patients also purposely ate less food because they were anxious about being unable to access the toilet in time , as four patients were sharing the one facility .
Co-author Dr Ekta Agarwal from Bond University said : “ Previous work that I have published demonstrates that when patients eat poorly in hospital , their risk of death increases by 2 – 3 times . Therefore , poor intake is not something that should be taken lightly in the hospital setting . There is a need to improve food awareness among staff members , patients and their families , so that food can also be treated as medicine .”
Aged Care Insight sits down with Agarwal to unpack the different ways patients rationalised their poor food intake and the hospital systems that affect their mealtime experiences .
ACI : Your previous research showed that hospital patients are more likely to die within 30 days of admission if they eat less than a quarter of the food they ’ re offered or are already malnourished , and now you ’ ve sought out older patients ’ perspectives on food intake in hospital . What insights were you hoping to gather ? EA : We know through research that as many as half of the older patients in hospitals can be malnourished and that inadequate food intake during hospitalisation is frequently reported in this population .
Previously , objective measures such as patient questionnaires or review of patient charts have been used in wider hospital patient [ populations ] to determine what the barriers are to food intake . There have been a couple of studies that have also explored the views of healthcare staff on the reasons for poor food intake in older hospital patients . These studies have been fantastic , because they ’ ve provided some useful insights into the reasons for poor food intake in older hospital patients or wider hospital patient populations .
Through a qualitative interview , which is a detailed interview , we wanted to gain a more in-depth insight into why the older patients particularly don ’ t eat adequately in hospital . Through those interviews , we also wanted to gauge their food and mealtime experiences and food-related perceptions of older hospital patients .
We knew that these perspectives from older adults would be a new addition to the literature because it had not been reported thus far , to the best of our knowledge .
One of the main themes that emerged from the interviews was ‘ validating circumstances ’ or the ways participants rationalised their poor food intake during their admission . What were respondents telling you about the way they make sense of their poor food intake ? A lot of respondents believed that poor food intake and appetite were to be expected during hospitalisation . They described that medications and the effect of the treatment that they were receiving and their own symptoms , such as nausea , vomiting , diarrhoea , stomach pain and reflux , contributed to their poor food intake .
They also believed that their appetite and food intake would return to normal when they got discharged and returned home . There were some older patients who considered medical treatment as being more important than food in making them feel better , and they also thought that food was not a priority during hospitalisation because it was all about the medical treatment .
Some respondents described feeling lonely and isolated , and missing family and friends . Some reported feeling depressed due to their medical diagnosis . Some missed their home cooking . All of these factors contributed to their low mood and affected their food intake . These were some of the reasons that patients provided themselves as to why their food intake was poor .
Another main theme related to the ways hospital systems and practices were perceived by patients as contributing to their poor food intake . What were some of the key factors at play there ? Participants felt that the hospital environment was not generally conducive to eating . For example , they felt that they were frequently interrupted by doctors and nursing staff and other allied healthcare professionals during meal times . Whilst patients acknowledged that the interruptions had an impact on their ability to eat food , they accepted such interruptions as part of a busy hospital environment and did not feel that they should challenge it .
24 agedcareinsite . com . au