Jan 02, 2018

Studies show elderly patients require more nutrition during respite care

Elderly patients in respite need more protein to help them recover after hospital.

Recent studies find that elderly patients, particularly those recovering after hospitalisation in respite care (or convalescent care), need more protein in their diets. Their bodies need extra protein to recover from sickness, surgery, or injury — and they may already be malnourished or undernourished when they enter the hospital.

Common foods served to convalescing elderly

Annette Tan’s December 2017 news article, “Elderly patients in respite need more protein to help them recover,” lists several popular foods that are served to elderly patients in Singapore and Asia. Although these common foods are easier to consume, Tan questions whether they are sufficient during convalescence. In fact, when the body suffers from chronic illness or malnutrition, it starts breaking down muscle to find the nutrients it needs. As a result, an already malnourished body may heal more slowly.

  • In Singapore, convalescent homes frequently serve rice porridge made from water or broth to elderly patients. In Australia, aged care facilities often serve oat porridge too and unfortunately, porridge contains very little protein.
  • Chicken essence, fish cartilage broth, rice water, and soups are also typical foods for elderly patients in this Singapore where the study was undertaken. However, these foods may lack sufficient nutrients for elderly patients recuperating after hospitalisation as well.

Recent studies indicate that elderly patients require more nutrition

In addition, Tan’s article cites significant studies which show that elderly patients are not getting enough nutrition:

  • The findings of Tan Tock Seng Hospital’s study on patients in a Singapore nursing home were published in the Journal of Nutrition Health and Aging in Jan 2010. The study found that as many as 52 percent of subjects participating in the study were undernourished or malnourished.
  • Professor Nicolaas Deutz of Texas A&M University conducted a US study on 652 hospitalised patients that were 65 years of age and over, and the findings were published in the Clinical Nutrition Journal in 2016. The study included an observation of the patients’ nutritional health after they were released from hospital.It found the following:

1) There was a 50% reduction in the mortality rate among the patients who received a high-protein oral nutritional supplement; and

2) The patients’ weight, Vitamin D levels, and nutritional status also improved during the study’s 90-day, post-discharge observation period.

Ways to improve nutrition in meals for the elderly

These above-mentioned studies show that there is a need to improve the nutrition of elderly patients while they are recuperating.

Here are some of the recommendations from Annette Tan’s December 2017 news article:

  • The studies lead author Professor Deutz recommends protein intakes of 1.2 to 1.5 grams of protein for each kilogram that an individual weighs.
  • Doctors agree that when possible, it’s best to meet nutritional requirements through food rather than supplements.
  • Patients’ meals can be fortified through adding extra protein from milk, nuts, and nut butters. You can also make porridge more nutritious by adding sesame oil, eggs, or minced meat.
  • Many elderly patients don’t have the appetite or the ability to swallow when they are hospitalised, so they are in danger of becoming (more) malnourished. In these cases, Dr. Tan recommends frequent snacks with protein throughout the day.
  • Dr. Tan also recommends a “texture modified diet” for those patients with difficulty swallowing.
  • A popular food used to increase a patient’s nutritional intake is the smoothie, made by blending fruit and vegetables with milk or yoghurt. However, Dr. Tan warns, blended foods frequently need to be watered-down, as a result losing some of their nutritional value. That’s when nutritional supplements may be necessary.

Symptoms of malnutrition

Here are list of common signs that indicate malnutrition:

  • Hair becomes dry and sparse, and easily falls out.
  • The patient complains of always feeling cold.
  • The individual is irritable or tired.
  • Wounds take longer to heal.
  • Cheeks and eyes become sunken, a result of fat disappearing from the face.
  • The individual demonstrates a chronic inability to concentrate.

Families, caregivers, hospitals, and convalescent aged care facilities (respite care) need to be aware that elderly patients run a high risk of suffering from under-nutrition and malnutrition during convalescence.

And in many cases, elderly patients are already suffering from malnutrition before they are hospitalised. Furthermore, it’s important to keep in mind that aged individuals in recuperation may require additional high-protein foods, texture-modified foods, and/or vitamin supplements as their bodies heal from wounds or chronic illness.

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