Hydration And Nutrition – Why It Is More Than Just A Mealtime

Gavin Henderson, Head of Hotel Services at Shaw healthcare – which operates more than 80 care facilities across the UK – discusses the importance of nutrition and hydration initiatives to keep care home residents fit and healthy.

The impact of malnutrition is estimated to cost almost £20 billion a year in England alone, and over 65’s are by far the most likely to suffer the impacts of poor nutrition. This can include a weakening of their immune system as well as a greater risk of developing urinary tract infections (UTIs), and even a heightened chance of falling over, as malnutrition – along with dehydration – can cause confusion in the elderly.

All of these issues inevitably lead to lengthy hospital visits. This is a concern at the best of times, but with COVID-19 putting the NHS under even greater pressure, it is up to those in the care sector to do what they can to keep hospital visits to a minimum.

At Shaw healthcare, we have piloted several nutrition and hydration initiatives in recent years, leading to a greater emphasis on the importance of mealtimes across all our facilities.

A collaboration with the Western Sussex Hospitals NHS Foundation Trust’s Nutrition Resources in Care Homes (NRICH) programme improved the identification of malnutrition at Elizabeth House – one of our care homes in Bognor Regis. The team of care support workers were given training on tactics to spot malnutrition, as well as the appropriate prescribing of oral nutritional supplements, while the home’s cooks were given ideas on how to increase individual residents’ calorie and protein intakes using a “food first” approach.

After the training ended, the home was given two months to implement what they had learned before a final audit. The review found that the programme had helped staff better screen for residents suffering with malnutrition and had improved the mealtime experience for those at the home.

Hydration is equally important too. Several of our care homes in West Sussex took part in a pilot study in 2016, launched and funded by the Kent-Surrey-Sussex Academic Health Science Network (KSSAHSN) with support from the local Clinical Commissioning Group. It emphasised a bespoke care plan for individual residents that linked up with their own hydration needs. This led to the creation of ‘mocktail mornings’, providing residents with nutritious drinks and also offering them the chance to take a ‘hands on’ approach when choosing what to have.

The aim of the pilot was to see a reduction in the number of UTIs, falls and fractures, as residents were better hydrated.

Ensuring residents are a healthy weight and well hydrated is always important, but clearly the pandemic has shone a light on why such schemes are needed. Since the pandemic started, we have organised themed hydration days across all of our services and, in some cases, created in-house ‘cafes’ – which were not only a great way to showcase the importance of mealtimes and hydration but also a welcome distraction during the height of lockdown, too.

This has led to several localised initiatives, such as a three-month nutrition and hydration scheme in one of our East Midlands homes, Lancum House. As a result of the scheme, we found that almost all the residents gained weight – some by nearly seven per cent – in a gradual and healthy way.

It is clearer now than ever that mealtimes play a pivotal role in keeping residents healthy, and we’ve been fortunate to have a number of local health boards, councils and other groups who have been willing to support and engage with us on these plans. The various trials over recent years have created a template – one that our facilities across the UK can use during and after the pandemic.

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