When I was writing the first tip on how to go about Choosing a Care Home I got rather distracted by one of the reasons why there is so much pressure to get an elderly relative out of hospital as soon as you can – food, or rather the lack of anything edible to eat. There are no two ways about it, poor food in hospital helps kill older people.
There are many reasons why older people find it difficult to eat in hospital. It’s lazy to blame staff members for not having the time, the training, or the foresight to realize that someone needs help and encouragement to eat when they are feeling poorly and their appetite is probably jaded. Also, it is not that the food itself is always unappetising even though famous chefs, economists, politicians, nutritional experts have all looked at the provision of hospital food and found it wanting in many cases.
But why is allegedly “hot” food and drink often served revoltingly tepid? The sign on the food trolley where my mother unfortunately found herself to be a patient stated that this was a health and safety measure – to prevent people burning themselves. Really? Or perhaps simple expediency for transporting hot food over miles of hospital corridor and having too few staff to serve to too many patients? I don’t care about the reason. I do know that my stomach turns when faced with a plate of congealed gravy and that is when I’m feeling fit and healthy.
My mother’s own experience in two different hospitals also highlighted the problem of being offered food in manageable portions. My mother had a very small appetite, even before she became ill. When we would go out for lunch it was often hard to find a restaurant or pub which would serve a small portion. Being somewhat over the age of 12, she was ineligible for a “child’s” meal – even if chicken dippers and spaghetti hoops wouldn’t have been her menu of choice. How much more civilised in Italy where she was offered a piccolo portion of the most wonderful, crispy, lavishly topped pizza, all served with smiles and respect.
When my mother was first admitted to hospital, she was in a local general hospital with, interestingly, a very poor reputation. She was offered the option of small portions of tasty hot food and the staff cared enough and had the time to help her to eat. The second, to which she was transferred – with an international reputation for excellence – gave no such choice and presented great chunks of food, inedibly dry and barely warm, which she could just not manage at all. She wasn’t fussy eater – as a Headteacher she’d survived forty years of institutional eating – but she simply couldn’t face taking even a small bite of the huge plates of stuff dumped on her hospital table. There was no support to help her to eat. It took a week for the hospital nutritionist to visit her.
We travelled to see her daily in this London hospital and, to tempt her appetite, brought in tasty morsels and flasks of tea of sufficient strength and temperature to be drinkable. This could not prevent her from becoming malnourished though and this, of course, weakened her already fragile health. She couldn’t wait to get out of there as quickly as possible so we could help her to eat properly at home.
In Italy, it is assumed that relatives will bring the food for any patient of whatever age. I don’t know what happens when relatives live miles away and there isn’t anyone to help. Whilst I can’t see that being a feasible option here, surely it can’t be beyond the wit of man or woman to come up with a solution. After all, encouraging patients to die slowly of complications exacerbated by malnutrition simply because the logistics of providing food are totally inadequate is cruel, shocking, shameful and, to say the least, uneconomic. In all the talk about improving standards of the meals themselves; tackling the problems of delivering hot meals to wards and distributing them to patients whilst they are still hot, we still need a small army of valuable, respected and surely, economically viable, “Nutrition Support Carers” in hospitals to make sure patients actually get something appetising and appropriate to eat and have someone there, at the right time, to help them to eat it.
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