Wednesday 29 May 2013

Britain is no country for hundreds of thousands of old men in need of nourishment in their own homes

The word 'malnutrition' inevitably conjures up mental images of starving children in Africa, but it is also an issue much closer to home here in Britain, with an estimated 3 million people either, suffering from it, or at risk of becoming underfed. The resulting problems are believed to cost the public sector several billion pounds from, for example, avoidable hospital admissions and extra visits to the doctors for treatments for the range of illnesses malnutrition can cause.

Recent media coverage of malnutrition in Britain has focused on hospital staff not ensuring patients eat and drink properly but research by 'BAPEN', a charity that raises awareness of the problem, shows that 93% of the 1 million old men and women affected by malnutrition are in the community and just 5% in care homes and 2% in hospitals.

Finding ways to improve this situation formed the basis of a round table discussion recently held by the 'Guardian' newspaper in association with the medical nutrition company, 'Nutricia'. The debate was conducted under the 'Chatham House Rule', which allows comments to be reported without attribution to encourage a frank exchange of views and on that basis the following points were made by experts, that :

* "A lot of this is in people's homes and is thus hidden. We have to make it an issue that people talk about so that people know that other people struggle with it and make malnutrition something that people can talk about and not feel there's a stigma about it."

* "Older people's cupboards can contain only cat food, not food for the person who lives there. This is a massive issue now." 

* "We need to bust a myth: that it's normal to lose weight as you age." 

* "Older people losing weight are often assumed to be normal, so people don't look for the medical, social, environmental or psychological causes of that", which can include poverty, disability, loneliness and self-esteem issues.

So why are one million old men and women in Britain not eating properly ?
Well, medically, malnutrition can be either a cause or an effect of illness and those suffering from :

* cancer and taking certain cancer medications may lose their appetite.
* dementia may lose interest in food.
* not eating properly can become exhausted or even confused which raises their risk of having a fall or getting an infection and needing antibiotics.
* depression, perhaps exacerbated by social isolation with their family all living many miles away, may also be  under-eating.

Question : Who isn't willing to help with this problem ? 
*144 of the 152 local authorities in England which have not identified a 'strategic needs assessment' identifying lack of nutrition as a problem with one round table participant saying :
"That's staggering. Think of all the unhappiness and ill-health they could prevent, and all the money they could save, if they picked up malnutrition as an issue."
* politicians, both local and national, who have been frustratingly slow to take it seriously.

Question : Who is willing to help ?
Answer :
* The 'Malnutrition Task Force', set up in 2012, an independent group of experts from the fields of health, social care and dietary advice, aiming to  to prevent and address malnutrition among old men and women.

* 'Carers UK'  which published a report in 2012, entitled 'Malnutrition and Caring: The hidden cost for families' and highlighting how families caring for ill or disabled relatives are struggling to cope with the consequences of malnutrition, such as further deterioration of health.

* A joint initiative between 'Age UK', the 'Local Government Association' and 'National Health Service' working to improve older people's care in all settings.

* The round table discussion by the 'Guardian' and 'Nutricia' which suggested :
-  an advertising campaign to banish the myth of inevitable weight loss as people age and to ask "do you know what your loved one – or neighbour – is eating?".
- neighbours taking it in turn to cook for each other.
- greater use of voluntary organisations to visit isolated older people, check on their welfare and cook for them.
- hiring more specialist nutrition nurses and shifting resources from hospitals into community-based care.
- doctors conducingt annual assessments of the weight and body mass index of all over-65s, to identify malnourishment as early as possible.

So what are one million old men and women not getting ?  
England's 'Public Health Director of Health and Wellbeing', Professor Kevin Fenton, who has admitted that : "Malnutrition is a complex issue with a range of contributing factors" has the answer : "For a healthy diet people should eat plenty of starchy foods, fruit and vegetables, some milk, dairy, meat, fish and other non-dairy sources of protein and only small amounts of food high in fat and/or sugar."

My earlier posts about lonely old men in Britain :

Britain is no country for more and more lonely old men ;

Britain is a country in an epidemic of lonely old men :

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