A Client’s wife told me of her experience with the delivery of meals to patients in a hospital setting. Mrs “Smith” spent her days in hospital by her husband’s bedside. He was elderly, was diagnosed with dementia and had recently had a stroke. Mrs Smith spent long days in that hospital room which housed four patients and had this observation to share about the meals.
She said that the meal trays would be delivered to the patients by the kitchen staff. Sometimes the trays would be placed outside of the reach of the patient in the bed. Often no one came to assist the patients with their meals. She took on that responsibility for the four. The patients in the room could not reach the trays without assistance, nor could they open the containers holding the meal items.
Most days, she said, no assistance was offered to these patients, and very often they did not get to eat the food on the tray. She recalled the day that the four trays arrived, each with a lovely, whole orange. Being that none of the patients could manage to peel and eat an orange without assistance, the unfinished meals, along with the lovely whole oranges, were collected by the kitchen staff, carted off and likely placed in the garbage.
In this scenario, a Dietitian would be overseeing the menu that was supposed to ensure that patients in the hospital get nutritious meals. The Dietitian would have wanted patients to receive the benefit of fresh fruit.
The Nurses, who would have created a careplan to outline the care needs of patients, charted that the patients required assistance with their activities of daily living, and the reports they created for Ministry of Health would have indicated that this was a Unit with patients who had heavy care needs.
The Doctor would wonder why the patients were failing to respond to treatment, why their weights were in decline, (if the monthly weight chart was even consulted), the Physiotherapist would wonder why the patient was so fatigued that they were unable to participate in an excercise program, (and they would soon give up offering a physio session).
The Pharmacist would supply a multivitamin due to the deconditioned nature of the patient, the Dietitian would order an expensive meal supplement….and the fresh fruit on each patient’s tray would go uneaten day after day….
I’m sorry to say that this is not a made up scenario. It is a scene played out day after day in various hospital settings, where older adults require more assistance than they are receiving in order to benefit from the treatments offered and even at a more basic level, to avoid other pitfalls of being hospitalized; malnutrition in seniors, becoming deconditioned, dehydrated and ill.
A caregiver’s role in an acute care setting is to assist Patients with all activities of daily living, to advocate for Patients with the clinical staff and to remind the staff of the particular care needs of the Patient.
Sometimes that means peeling a couple of oranges…..