Chocolate, trifle and cheese sweeten the pill for patients
Thursday November 05 2009
OUT goes the horribly thin soup, grey, anaemic sandwiches and vegetables boiled so long that they contain little if any nutritional value.
In comes tasty potatoes served with lashings of hot butter, full-fat milk, lots of cheese, desserts such as trifle and -- wait for it -- chocolate.
Welcome to the brave new world of hospital food where from now on patients are to be given a relatively high-fat, high-calorie diet to ensure they don't leave malnourished.
Responding to years of concern about food that fails to provide enough energy to help people recover or fight illnesses, the Department of Health yesterday issued food guidelines to be adopted immediately.
Three meals should be served every day -- but instead of lying in bed desperate for the next meal, patients should now have access to nourishing snacks which should be given mid-morning, mid-afternoon and late evening.
They will also be available on the wards at all times and be routinely offered to patients.
Exceptions
Crucially, it has been ordered that daily diets for most patients should contain at least 40pc fat. Exceptions to the rule include diabetics and people with high cholesterol.
A report on nutrition in hospitals, compiled with the input of hospital nutritionists, doctors and patient groups and chaired by Philomena Flood, nutritional manager at St James's Hospital, warned a general improvement in the level of nutrition education in all hospital staff is necessary.
Currently there is a lack of co-operation between medical, nursing, dietetic and food service staff.
The new guidelines are specific to the needs of hospital patients who require higher energy and fat stores to fight illness and infection.
Until now, the department said executives and staff may not have fully understood the importance of highly nutritious food for ill patients and had not had a strong enough influence on what kind of food is bought and served in hospitals.
To beef up their calorie intake, patients will now be served with more energy providing foods such as buttered potatoes and vegetables, full-fat milk, cream and two desserts a day. In addition, there will be high calorie between-meal snacks provided.
From now on, standard menus will also ensure all salads are dressed in oil, crackers will come with butter and cheddar cheese while sandwiches will now be filled with meat and mayonnaise.
The guidelines say: "The high-protein, high-calorie menu is intended as the standard or normal menu in acute hospitals. Most patients in acute hospitals have higher energy needs than normal and may have smaller appetites.
"Patients admitted to hospital generally have nutritional needs that would not be met by following [healthy eating] guidelines.
Guidelines
The guidelines state that all menus should take account of the ethnic and religious needs of patients and everyone should receive an accurate description of menus to allow them to make a choice.
Other suggestions for small, high-calorie meals include milk pudding made with whole milk with cream added, chocolate mousse, fortified soup, cheese on toast, trifle and chocolate.
In future, staff must try to prevent vitamin loss by not soaking vegetables, use bicarbonate of soda, cook in a minimal amount of water and cook in batches.
The use of "sip feeding" needs to be supervised and a nutrition-supplement monitoring charts should be designed and used.
Margot Brennan, of the Irish Nutrition and Dietetic Institute, said it was well established that people who are admitted to hospital are at increased risk of malnutrition.
"That is why it is correct to have higher fat options unless their illness has different requirements," she said.
Ms Brennan said the hospital environment can dull a person's appetite and this is why it is better to give people energy-dense foods where possible.
Under the new guidelines, each individual patient should be screened in advance taking into account their nutritional risk and severity of disease.
- Eilish O'Regan Health Correspondent
Irish Independent
