Is there adequate feeding assistance for the hospitalised elderly who are unable to feed themselves?

摘要

Objective: To observe patients at meal times in order to determine the type and amount of feeding assistance required by hospitalised elderly patients and the adequacy of assistance nursing staff provide to patients. Methods: The study was an observational study. Patients admitted to the ward were observed over a one-week period encompassing all meals (breakfast, lunch, dinner and snacks) served on a 14-day menu cycle. Subjects: A total of 46 hospitalised elderly patients with mean age 86.5 +- 4.8 years admitted to the ward. Setting: The study was undertaken in a general teaching hospital geriatric ward in Sydney. Results: A high percentage of patients required some assistance with feeding at meals (70%, n = 32). The partially dependent patients had their needs basically fulfilled by ward staff. However, of the nine totally dependent patients, three were observed lacking any assistance (33%). The amount of assistance time from nursing staff was found shorter than that from non-nursing staff, 123 and 137 minutes, respectively. Nursing assistants were the main providers of assisted eating in the ward. However, little attention and time were given to that task by registered nurses.Discussion: Provision of assisted eating by nursing staff presents many problems. More than 40% of hospital food was wasted and patients' recommended intakes for preserving health were not met. Hospital feeding policies and staff arrangements therefore need reviewing. Conclusions: Although assisting patients who are unable to feed themselves is a time-consuming process, it is a vital and necessary part of nursing care.