The figures for deaths through malnutrition in our hospitals stand at 284 in 2008, that’s up from 175 deaths recorded back in 1997. The squeeze on NHS food budgets and a lack of money made available for extra help feeding frail and elderly patients could be to blame. However, some of the problem may, according to anecdotal evidence, be due to an increasing reluctance by some nurses to attend to basic needs such as feeding and hydration of patients. Often this work is left to unqualified healthcare assistants.
These figures are for deaths attributable to malnutrition and dehydration. The true figures may never be known but we do know that a large number of elderly patients have their health impacted by poor nutrition. If these official statistics are true, then the NHS is owning up to more than 1000 people dying every year in our hospitals through lack of food or fluids. That’s one third of the number of people killed in road accidents each year. Unfortunately, unlike road deaths, where enormous sums of money are spent on speed cameras and other traffic calming measures, little appears to be done to address these entirely avoidable deaths.
There’s no other way of saying this… deaths caused in our hospitals through neglect in feeding and hydration need to be made a serious offence. It’s nothing short of state sponsored murder when patients die of thirst or hunger. Until someone takes responsibility and is jailed for this, patients will continue to die needlessly.
AFternoon ETM and - oh - no other bloggers around!
ReplyDeleteYes - this is a huge problem - I have mentioned before when my mother was in the dreaded JR/Oxford where she passed away. She had asked for some tea in a small cup rather than a mug as she could not hold the mug with her weakened hands - the assistant was incredibly rude - fortunately she had not seen me as I was behind a curtain arranging Mum's cards or whatever. This "people person" accused Mum of being la-di-da; she did receive a tongue lashing from me.
However the problem persists - on a huge scale and is totally unacceptable - however there is also the other problem of the hospital super bugs - not sure of figures but roughly equivalent to road accidents annually.
Happy Days, best wishes from Cats' Mother
Hi Sarah
ReplyDeleteLike you, I'm so angry about this. I keep hearing excuses about how busy nurses are etc. But good nurses (and there are lots of them) know that feeding a patient and keeping them hydrated is as important as administering drugs. There's no excuse for patients starving or dying of thirst... none at all!
As far as bugs go, the statistics show that 3,627 patients died with C. difficile in 2009, up from just 457 in 1999; and 671 died having contracted its fellow superbug MRSA.
Tragic. But I know (from dealing with an 86-year-old mother and a 93-year-old aunt) that a lot of older people simply don't drink enough anyway because they have slight continence problems, so I think they are often a bit debydrated to start with. Not that that's any excuse. And the "carers" are so rude and rough!
ReplyDeleteMy dad is dreadful for not drinking. However, in hospital there is always the option of a drip. Mind you, I've heard stories of some elderly patients being over-hydrated. One poor lady died a very painful death with water coming out of her nose because she wad given excess fluids even though she had renal problems. Her food records were falsified by the 'carer' on the ward.
ReplyDeleteThis is a disgrace. I would be happier if this information was being spread wider than this blog (i.e. published in the press) and also "pushed in the face" of those managers and administrators responsible.
ReplyDeleteDo we as relatives have free access to their charts. It would be a worthwile excercise to have them checked by a third party. The very fact you are inspecting them ought to make the staff more watchfull. It is a disgusting state of affairs that we should even be considering this as being necessary.
ReplyDeleteI don't undewrstand the profile thing so I have posted as anonymous but I am Andy Jackson and proud of it!!
You can get access to the notes and charts but in the case I investigated, the food and drink consumed had been falsified in the patient's records. You can see what happened in the film I made. It is on Channel 4 on 21 Feb... I am waiting for confirmation of that date. I'm also starting a campaign for better hospital nutrition and feeding.
ReplyDeleteHi TM.
ReplyDeleteI hope your recovery is continuing to go well.
Firstly, I don't want to seem like I am sticking up for those that don't attend properly to patients as I'm not - I work on a rehab ward (not a nurse or care attendant) and see it all too often - patient's tray is removed when they haven't eaten anything. The (outsourced) catering staff member kindly asks them if they want to finish more, but the tray is taken before the patient can respond with anything intelligible (unfortunately the person has had a stroke, couldn't feed themselves hence the untouched tray, and has dysphasia so couldn't respond correctly to the catering staff member). However given the catering staff member is outsourced and not a nurse they are not allowed to know anything about the patient and are not allowed to touch or otherwise assist patients).
However, sadly some of deaths from dehydration and malnutrition will continue to happen as a "chosen" (for want of a better word) cause of death. These may not account for all such deaths but are important to consider in order to look at the numbers with more perspective. These may generally be an old person that comes into hospital already dehydrated and malnourished and are sadly beyond saving. Others are those with severe dementia that really sadly lose the ability to be able to chew and swallow simply because their brain doesn't know how to do it anymore. As you mentioned there are drips and feeding tubes but these are often pulled out by the person (due to them not knowing any better) and can be far more distressing for such patients and their family and a way of prolonging the inevitable.
Again, I just wanted to add perspective, not defence.
Usually charts are not accessible unless you make a freedom of information application as all records belong to the hospital (in Australia anyway). I'm sure there are many records falsified. I'm aware of an instance where a patient died at around 3am but this was not foreseeable via their regular observations as based on the chart records the person still had a regular heart rate, normal temperature & blood pressure until 6am (which left those attending the persons death at 3am a little baffled...).
Anyway, there is such a problem with the nursing culture. Too often is patient care dominated by lunch or tea breaks and leaving on time. Hmmm, I have taken (on average) one "break" (aside from lunch) and left on time once in the last two weeks - why? Just because it is the right thing to do to get things done and for the patients. Sure, we have times when things are a bit quieter and we can relax a little and take time out to "chat" or socialise. However this culture is not so much replicated by all those involved in patient care.
I'll shut-up now! I've added my two cents :-)
The OT from down under
Hi OT
ReplyDeleteThank you for posting such an insightful and intelligent article. I think most of us realise that excessive bureaucracy and the raw emotion of relatives can conspire to turn difficult situations into tragedies. The public need to understand the pressure that many health workers are subjected to and health workers need to put their collective foot down and stand up to management when their work is being compromised by cost cutting or poor management. Health unions are very good at getting tough with management when it comes to pay and conditions, now I would like them to do the same on behalf of patients when they think poor food or bad nursing is affecting a patient's health.
As far as patient confidentiality being used to excuse poor practice by catering staff, I would say that if health authorities in the UK are happy to sell our data to large pharmaceutical firms, often with the data hardly anonymised, then surely they can share the information with catering staff about whether a patient has suffered a stroke or needs special care when eating.
The whole debate on hospital food just seems to be a litany of excuses and obfuscation. I'm so tired of hearing hospital management and catering companies telling me why food can't be nutritious, tasty and wholesome. Restaurants manage to serve food to large numbers of people and stay in business, so why can't hospitals?
There's no logic to the objections to better hospital food, there is simply a lack of will and a lack of awareness amongst the medical professions. Even dieticians seem to fail to grasp the real impact of food on sick people. They're very good at lecturing people on cutting back on fat and salt etc, but almost incapable of suggesting tasty and nutritious foods for patients who need building up. I sometimes wonder why hospitals bother employing them.
"However, sadly some of deaths from dehydration and malnutrition will continue to happen as a "chosen" (for want of a better word) cause of death. These may not account for all such deaths but are important to consider in order to look at the numbers with more perspective. These may generally be an old person that comes into hospital already dehydrated and malnourished and are sadly beyond saving. Others are those with severe dementia that really sadly lose the ability to be able to chew and swallow simply because their brain doesn't know how to do it anymore. As you mentioned there are drips and feeding tubes but these are often pulled out by the person (due to them not knowing any better) and can be far more distressing for such patients and their family and a way of prolonging the inevitable. "
ReplyDeleteThis happens much more regularly than anyone not involved would estimate. Alternative methods of hydration and nutrition are very risky there is much more to it than 'just a drip' Its not just elderly and those with dementia there are a whole host of conditions where hydration and nutrition by alternative methods are hazardous horrendous and distressing for everyone involved. I've witnessed this time and time again. I to thank and congratulate this poster for bringing a certain balance to the debate. There is no excuse for poor hospital food or for not giving assistance where needed but statistics are just numbers and take no account of circumstances which may precede .
I've been listening to patients' complaints and there is a lot of bad practice. I think some of the problem is lack of communication and a brusque manner of some medical staff. Of course there are many cases where dehydration can't be avoided but there are many others which really cannot be excused.
ReplyDeletei worked in a hospital kitchen i never worked in a dirtier place the size of this kitchen could have been able to make thousands of GOOD meals a day but everything was powdered, frozen or in tins. the food that went to the canteen was great but the food that went to the wards was so awful that when i had my child at this hospital i refused to eat anything or even drink the water everything was brought in from outside, and every girl on the ward had carryout food every night, you couldnt even eat the cereal , i knew to save costs they had stopped using a very good brand name, and they replaced it with what i can only call sawdust. i could go on and on the stories would make your hair curl. bevan must be turning in his grave
ReplyDeleteWell done Traction Man - keep up this good work.
ReplyDeleteMy elderly mother was admitted to hospital for a couple of days of routine physiotherapy. Due to lack of care she ended up staying there for 3 months and eventually died there as a result of malnutrition and dehydration. I wish you well with your campaign and hope it achieves some real improvements.
I'm upset to see how people are so willing to attack nursing staff at a drop of a hat.
ReplyDeleteAs a nurse myself, I know that there is a poor practice from individuals due to whatever means, but as I work in intensive care, which is a 1 nurse 1 patient speciality, I expect from myself and from others a high quality of care.
But, I relocated for a job after qualifying as my trust (and the whole of Greater Glasgow in Scotland, in fact!) is wanting to have a nurse overseeing the work of 5 HCAs, rather than being a nurse led ward, with maybe 2 HCAs assisting.
The Royal College of Nursing has documented the correlation between low qualified nursing staff numbers and poor nursing care.
Yet, nursing vacancies go unadvertised, staff leave and posts are not refilled, HCAs are give a couple of extra study days in cannulation and ECG placement and they are deemed fit to replace a degree qualified nurse.
Its not that nursing staff are "too posh to wash", its simply that the demands are SO great of the few nursing staff left on the wards that patient care slips.
And I feel sick to my stomach to see it happening.
And allthis happens as hospital managers award themselves massive pay rises. The chief exec of Heart of England NHS Trust is paid £240,000!
ReplyDeleteI just watched your dispatches programme and quite frankly I wouldn't serve some of that food to my dog.
ReplyDeleteI currently work in a private nursing home and must admit the food quality is excellent. All cooked on site and freshly prepared daily. Having previously worked in a number of health trust run homes it is a lovely change from processed meals and grey sausages.
Not that I wish to defend current methods of food preparation but I must point out the difficulties faced. Firstly there is the hugh cost involved of feeding so many people. Government legislation now demands a certain number of choices at each meal but there is still always someone who doesn't like whats on offer. Also there is a large number of dietary requirements to be catered for: allergies (to all kinds of things not just the traditonal nuts etc.) coeliac sufferers, CF patients, those on soft or minced diets, diabetics and those on thickened fluids to name but a few.
Those who have mention using drips to hydrate patients - yes this seems like a quick and easy solution but i assure you it is far from that. There are all sorts of complications. It is worth pointing out also that many patients or families especially elderly refuse drips.
To those who have mentioned superbugs I strongly urge you not to believe everything you hear in the media. Many Healthy individuals carry MRSA for years and never show any symptoms. It may only show itself when they are admitted to hospital for some other reason. Increased numbers are due inpart in increased testing for MRSA. It is highly prevelent anywhere large numbers of people are living in close proximately including prisions and university dorms.
I hope that you continue your good work and that all health care facilities have healthy fresh food cooked onsite soon