Elderly too often malnourished and unnoticed in hospital

May 21 2008

New research has revealed the shocking plight of some of Australia's most vulnerable citizens.

According to researchers a study carried out at Melbourne's St Vincent’s hospital has found that one in three elderly hospital patients suffer from malnutrition, but this on the whole goes unnoticed by hospital staff.

The research by nutritionists at Deakin University and St Vincent's Centre for Allied Health Research, has found that of 100 patients, 91 were either malnourished or at risk of malnutrition and 73 of these patients had recent weight loss and loss of appetite.

Only seven had been identified and referred to a dietitian, and only three had their weight recorded in their medical chart.

The study found that while health professionals' knowledge of important medical risk factors for malnutrition was good, their knowledge of malnutrition risk factors such as recent loss of weight and loss of appetite was poor and malnourished patients were not being referred to dietitians.

Study co-author Alison Bowie an accredited dietitian, says malnourished patients are more susceptible to infections and complications.

They also tend to spend longer in hospital, and are at a greater risk of their health deteriorating and Bowie says hospitals need to get better at identifying at-risk patients early on, and referring them to a dietician for treatment.

Ms Bowie says joint programs between hospital and community health workers are needed to address malnutrition, better quality control of hospital meals, and assistance for patients needing help to eat.

Claire Hewat the Executive Director of the Dietitians Association of Australia (DAA) says malnutrition is rife in hospitals, but also affected people in the wider community, including those in nursing homes.

Ms Hewat says the obesity crisis has meant the silent epidemic of malnutrition has been largely forgotten, but the DAA has made tackling malnutrition a priority.

The DAA is currently working on guidelines to better manage the condition, and on programs to educate health professionals on screening for malnutrition and when to refer a patient to a dietician.

Ms Hewat says simple nutrition strategies, such as routine screening for malnutrition and educating health professionals on what to look for, could help improve patient health and also save health care dollars.

Also an issue is the palatability of hospital meals - the drive to provide healthy hospital food means it is often low in fat and salt, which often makes them less appetising.

The researchers say malnutrition in elderly hospitalised patients remains a significant problem with low rates of recognition and referral by medical and nursing staff.

The study is published in the June 2008 issue of Nutrition and Dietetics.