Recently the focus in the news regarding older people and health has been on the scandal of poor care both in hospitals (for example the issues highlighted in the Francis Report) and in the community, and the significant damage that our lack of focus on basic care has created. One story where an older lady in Banstead, Surrey was left alone with no home care for nine days as her care agency had been shut down for employing illegal immigrants was particularly sickening. She was found severely dehydrated, malnourished and barely alive having been entirely reliant on carers for all her basic needs. She later died in hospital. How is that caring?
As expected, the blame culture which thrives in our modern health and social care system has kicked in and quite rightly someone should be held accountable. But unless we all take responsibility and begin to treat people as people and take into account all their health and care requirements, rather than looking at each part of a person’s experience to be examined and treated separately, not much will change.
However, there is hope. There are many of us working today who care deeply about improving the situation for older people, listening to what they need to make their lives better and treating them as people. A big part of this is working to improve awareness and understanding of the vital role of basic care: access to food, drink, someone to talk to and support for daily living where it is needed. In many parts of the UK the system works successfully, with Local Authority, PCTs, voluntary sector and others working closely together. It is hoped that the development of Health and Wellbeing Boards that will bring together these key stakeholders, will improve things further, but much depends on those involved being committed to change.
In the meantime work to raise awareness of nutrition and hydration issues continues apace. The 20th March is Nutrition Day 2013. Run by the National Association for Care Catering (1) in partnership with the Hospital Caterers Association, the Day aims to raise awareness of the importance of good nutritional care, which includes hydration, in all social and healthcare settings throughout the UK. The Day will focus on providing vital advice and guidance to health and social professionals on the action that can be taken to help prevent undernutrition and dehydration.
Also starting on the 18th March, Patient Safety First are making a week of it with events including a web kitchen, webinars and information and advice. (2)
Meanwhile, behind the scenes the Malnutrition Task Force continues to make progress in its aim to mobilise action across all sectors by creating the right levers for change within the system as well as raising the profile of malnutrition with the public, Government and the NHS Commissioning Board.
We are an independent group of experts across Health, Social Care, Local government and the voluntary sector united to address the problem of avoidable and preventable malnutrition in older people.(3) Prevention and treatment of malnutrition must be at the heart of everything we do to ensure older people can live more independent, fulfilling lives.
On a European level the European Commission has recognised undernutrition as a key issue in tackling frailty in older people and through its European Innovation Partnership on Active and Healthy Ageing (of which the European Nutrition for Health Alliance(4) is a partner) is working to tackle the causes of undernutrition, ensuring prevention becomes a priority.
As we know, the system is slow to change, but there is more awareness of nutrition and hydration than ever before and a greater understanding of what needs to be done from policy change to personal care. It’s all about showing older people that we care.
Dr Lisa Wilson
(4) ILC-UK is a member of the European Nutrition for Health Alliance. www.european-nutrition.org