A Dietician’s Bedside Supervision in a Geriatric Ward Is Effective

Introduction: Health professionals have greater focus on nutrition issues when having access to a dietician. The aim of this study was to examine the effect of having bed-side access to a clinical dietician in a geriatric ward. Methods: A follow-up study included consecutively all patients admitted in two geriatric wards during three time periods of 2½months each. The intervention was health professionals’ bed-side access to a clinical dietician. Patients hospitalized during the intervention period were compared to patients hospitalized before and after. Patients hospitalized ≤2 days and not screened were excluded. Data on nutritional screening, patients’ daily energy and protein intake, change in body weight from admission to discharge, and a nutrition plan and prescribed oral nutritional supplement at discharge were analysed using ANOVA analysis of variance and Chi-squared test. Results: A total of 554 patients (81%) were at nutritional risk. During the intervention period the compliance of diet registration was better. The patients’ protein and energy intake was higher during the intervention compared with that before and after the intervention (p = 0.04/p = 0.005). Fewer patients lost weight during and after the intervention. Length of hospital stay (LOS) was 1 median day longer in the period before the intervention compared with that during and after the intervention (7 days). LOS was associated with weight change. Conclusions: Health professionals’ access to a bedside dietician in a geriatric ward seems to improve protein and energy intake and thereby the older patients’ body weight, but not sufficiently. The dietician also enhances the staffs’ awareness of nutrition improvements after discharge.

Patient-Reported Fatigue Is Associated with Poor Energy Intake and Readmission to Hospital

Objective: To investigate patient-reported factors those promote or inhibit food intake in older people after discharge from hospital. Background: Disease-related malnutrition leads to poor appetite, decreased food intake and affects convalescence negatively. Design: Secondary analysis of two intervention groups from an RCT. Methods: 111 older adults received nutritional follow-up one, two and four weeks after discharge. Self-reported food intake was classified as adequate (AQ) or inadequate (IAQ) energy intake two weeks after discharge. Data on inhibitory and promoting factors, body weight, ADL-function, readmission and mortality were analysed and comparison made between AQ and IAQ groups. Results: More IAQ participants reported fatigue and eating all meals alone. All participants lost body weight, but more IAQ participants lost body weight. More IAQ participants were readmitted to hospital 30 days after discharge. Conclusion: “Fatigue” and “eating all meals alone” affect food intake negatively, leading to loss of body weight and readmission to hospital.