Hidden phenomenon costing our hospitals over €1.4bn per year
Laura Bardon – Guest blog
Although malnutrition may be something you associate with the children from the LiveAid video, it is in fact quite a common issue in Ireland. ‘But I don’t see starved looking people roaming the streets of Dublin’ I hear you exclaim. Well, the term malnutrition incorporates both undernutrition (a lack of one or more nutrient) and overnutrition (too much of one or more nutrient… most commonly seen as obesity). The aspect I am predominantly referring to is undernutrition or specifically protein energy undernutrition. This occurs when an individual (young or old) isn’t consuming adequate amounts of protein (most commonly in meat, fish and dairy products) or energy (calories… all foods contain calories but carbohydrate-based foods such as breads, pastas, potatoes and cereals are our body’s first port of call for energy) which results in weight loss. Often, malnutrition can arise as an individual is unwell and requires more calories and protein than normal for healing and to fight disease/infection.
Over time, malnutrition can cause a decline in functionality, cognition and overall health status, leaving older people more vulnerable to falls, disease, a loss of independence and ability to self-care. If this reduction in quality of life isn’t enough to make us want to tackle this problem, malnutrition also results in massive economic burden as malnourished patients are more likely to be admitted to hospital, have longer hospital stays and have poorer wound healing compared to their adequately nourished counterparts. In fact, malnutrition within hospitals is estimated to cost the state a whopping €1.42 billion. However, there are ways in which we can start to combat this issue. Within hospitals, patients are screened for malnutrition and referred to a dietitian to provide nutrition support if a patient is at risk or already malnourished. Protected mealtimes are also in place in many hospitals whereby doctors/nurses/physios/other healthcare professionals cannot complete scans/assessments on patients while a meal is in progress. This encourages patients to eat while the food is hot and also prevents them from being distracted by other activities going on in the ward.
Most older people reside in the community and approximately 5-10% of these are malnourished. New research within UCD aims to tackle malnutrition in the community either before malnutrition develops or in the early stages of the condition so that it can be prevented/treated in a timely fashion. Older people who are divorced/separated/never married, have been hospitalised in the past year or who have mobility difficulties (difficulty climbing stairs or walking for 100m) are more likely to develop malnutrition in the future. These factors should be used as little red flags for people to monitor themselves or be monitored- eating 3 meals a day and 2 snacks is important to prevent weight loss. Keeping active is also important to maintain muscle mass and prevent wasting. Older people are recommended to complete 150 minutes of moderate-intensity exercise per week. This can be broken down into shorter 10-minute chunks and spread out at different times throughout the day. If you are concerned that you or a loved one may be malnourished, consult your local GP or public health nurse.