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Putting the focus back on mealtime

Posted Sep 25th, 2017

Putting the focus back on mealtime

It’s a shocking statistic. Nearly half of all patients admitted to Canadian hospitals are malnourished.

Niagara Health dietitians Andrea Digweed and Lina Vescio have seen firsthand the preventable health impacts malnutrition can have on patients.

“They may come to the Emergency Department for weakness, and they’re treated for that and sent home, but it’s the underlying issues related to aging that bring them back in,” said Andrea. “It’s not being able to buy groceries or prepare meals that may be contributing to the problem. The more nutritious food you eat, the better your overall health. Tea and toast isn’t going to cut it.”

Seniors can face many challenges to eating at home such as limited income to buy groceries, lack of interest in cooking or eating when living alone and age-related health changes.

According to the Nutrition Care in Canadian Hospitals study, malnutrition is a wide-spread problem that if left untreated could cause a continuous circle of issues for patients. These patients experience longer hospital stays and are at higher risk for readmission within 30 days. The majority are seniors.

As one of five Canadian hospitals to participate in more recent research conducted by the University of Waterloo, Niagara Health has been involved from the early stages in identifying solutions to address patient malnutrition.

As a result of our work with Waterloo’s More 2 Eat study, new processes were introduced at Niagara Health to assist our teams in identifying malnourished patients and supporting them with resources to improve nutrition both while in hospital and after they are discharged. Patients admitted to Niagara Falls, St. Catharines and Welland Sites are now asked two screening questions:

  1. Have you lost weight in the last six months without trying?
  2. Have you been eating less than usual for more than a week?

When a patient answers yes to both questions, it triggers a referral to a hospital dietitian who develops a personalized nutrition plan to find foods they prefer eating or offering supplements and fortified menu items, among other options.

“The Niagara Health team has been very successful in their activities, ensuring that patients with nutrition problems are identified on admission and treated in a timely manner,” said Professor Heather Keller, Schlegel Research Chair in Nutrition and Aging at the Schlegel-University of Waterloo Research Institute for Aging.

“Patients also indicated they encounter quite a number of barriers to eating even while in hospital,” added Marilee Stickles-White, Niagara Health Regional Manager, Clinical Nutrition Services.

“Some of those barriers are simple things that we take for granted like opening packages on a meal tray.”

The program also involves recruiting volunteers to provide added support and socialization to patients during mealtime.

“Mealtime is a social time,” said Marilee. “It’s nice to see a friendly face encouraging them to eat.”

Niagara Health is already seeing positive results. The average number of mealtime barriers identified by patients in hospital has been significantly reduced. The project also helps patients return home by connecting them with community supports like Meals on Wheels and grocery delivery services, for example, as well as community dietitian services.

“It’s working with our community partners to ensure these patients have the support they need when they go home so we don’t see them back for the same reasons,” Lina said.

“We’ve noticed the benefits of getting to them quicker. Getting to them quicker means we can avoid barriers, get the proper nourishment set up such as supplements or preferred foods - so when they get home we can start them on the road to healthier eating.”

Niagara Health System