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ten - Combating malnutrition in hospitals
- Edited by Alan Walker, The University of Sheffield
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- Book:
- The New Dynamics of Ageing Volume 2
- Published by:
- Bristol University Press
- Published online:
- 13 April 2022
- Print publication:
- 25 July 2018, pp 177-196
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- Chapter
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Summary
Introduction
According to Age UK, over 3 million people across the UK are either malnourished or at risk of malnourishment, of which over 1 million are over the age of 65 (Age UK, 2017). Over 30 per cent of adults are malnourished on admission to hospital, increasing hospital stay, risk of complications and likelihood of being discharged into care (BAPEN, 2003; Stratton et al, 2004; Age Concern, 2006; Brotherton et al, 2010; Elia, 2015). Malnutrition in people aged 65 and older costs healthcare in England almost £10 billion per year (Elia, 2015). Age UK highlighted the problem of impractical eating environments for many older patients, and made seven recommendations to tackle malnutrition in older hospital patients, which focus on assistance at mealtimes and identification of patients at nutritional risk.
The Better Hospital Food programme launched in 2001 was successful in improving the quality of hospital food, although it did not specifically address older patients’ needs, for example, reduced sensory perception, smaller appetites and in some instances, eating difficulties. Approximately 12 per cent of older hospital patients have intermittent swallowing difficulty, which is of concern as the sensorial quality of foods for such patients is poor and does little to stimulate the appetite of those at particular nutrition risk.
The Department of Health (DH) and National Health Service (NHS) devised a Joint Action Plan for improving nutritional care in hospitals with five priorities for action: raising awareness of the link between good nutrition and health; ensuring accessible guidance; encouraging nutritional screening; nutrition training; and improving standards of inspection (DH, 2007). The DH Dignity in Care campaign (DH, 2006) recognised that delivering adequate food is ‘a fundamental human right’ and stressed the need for maintaining dignity and providing older people with the assistance they require at mealtimes. The Care Quality Commission's Dignity and Nutrition Inspection Programme highlighted concerns over nutritional care, including patients not being given the help they needed to eat, meaning that they struggled to eat or were physically unable to eat meals; patients being interrupted during meals, meaning they could not finish their meal; accurate records of food and drink not being kept so progress was not monitored; and many patients were not able to clean their hands before meals.
twelve - Evaluating the visualisation of dynamic biomechanical data for healthcare and design
- Edited by Alan Walker, The University of Sheffield
-
- Book:
- The New Dynamics of Ageing
- Published by:
- Bristol University Press
- Published online:
- 09 April 2022
- Print publication:
- 28 February 2018, pp 235-256
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- Chapter
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Summary
Introduction
The ‘Envision’ research described in this chapter was conducted between late 2007 and early 2009, the first of the New Dynamics of Ageing (NDA) projects to complete. The findings from the project provided the platform for further Research Councils UK funding to continue our research in this area, and so although our account is now somewhat historical, and some of the statements arising from our findings at the time relate to either the limitations of the technologies that were available to us or practices current at that point, this chapter allows us to usefully contextualise the value of this NDA Envision work with reference to what was to follow and to refer to more recently published articles where some of the themes outlined in this chapter have been discussed in more detail.
Potential value in the use of biomechanical analysis
Over four decades of research, the field of biomechanics (the study of the mechanical laws relating to the movement or structure of living organisms) has contributed knowledge about the musculoskeletal system and the way it operates dynamically in relation to muscle force and the effects of gravity. Biomechanical analysis can be used to scientifically assess the causes of the movement problems of individuals. In the healthcare context, biomechanics can be used to assess patients and to measure, for example, their progress and outcomes following treatment. In relation to the design of, for example, the built environment, furniture and transport, biomechanical analysis can be used to help provide an evaluation of the impact of design details and features on individuals’ capabilities in performing a range of daily living activities, such as the impact of the variation in the height of seating or the inclusion of armrests in furniture, or the impact of the variation of worktop and stair heights in homes and buildings.
Barriers to widespread adoption
To date, biomechanical data measurement and analysis have only been used in a small number of clinical scenarios, largely in clinical gait analysis (the systematic study of locomotion in a clinical setting). These specialist sessions are expensive both in terms of the types of equipment used to collect motion data and the specialist staff required to collect and interpret the results.