One in 4 elderly underfed

By ANGELA GREGORY

Nearly one in four elderly patients surveyed at Middlemore Hospital were found to be malnourished, but in many cases medical staff failed to notice.

An audit of 71 elderly patients revealed that 24 per cent were malnourished, and 44 per cent were at risk of malnourishment.

Concerns that malnutrition among elderly patients could be a seriously under-recognised problem prompted the survey.

The audit of the patients, with an average age of 81, showed a large proportion of those malnourished or at risk had not been identified or referred for help.

Hospital dietitian Sandra van Lill said malnutrition in the elderly needed addressing because it added to healthcare costs.

Malnourished people were more likely to develop diseases and complications.

Sandra van Lill said a plan was being developed to improve staff awareness of malnutrition and how addressing the problem could reduce health problems.

Elderly patients might need more family support or services such as Meals on Wheels, which takes advice from dietitians.

Resthomes also needed to consult dietitians, but not all did.

The elderly presented special challenges because some could not handle high-fibre food.

Because the elderly could not eat as much, they went for small high-energy meals, often skipping fruit and vegetables.

Sandra van Lill said many elderly people also lived alone, and could be suffering from depression or bereavement, which could lessen appetite.

Physiological changes also affected taste and thirst, and diseases such as emphysema and Parkinson's increased energy needs but reduced appetite.

Sandra van Lill said the malnourished elderly often presented as weak, tired and lethargic.

Residential Care NZ president Simon O'Dowd said the association supported using dietitians to plan resthome meals.

Mr O'Dowd understood most of the 460 resthomes represented by the association, just over half those in New Zealand, used dietitians.

"But if it is shown there is a deficit, we would widely promote their use."

Retirement Villages Association executive director Edward Richards said most villages had cafeterias which offered well-balanced meals to residents.

Age Concern president Dave Henry said poor nutrition went hand in hand with general self-neglect.

nzherald.co.nz/health