Rising Costs Grim for Malnourished Elderly

By Tom Hunt, Nelson

June 4, 2008

New Zealand

A hidden epidemic of malnourishment is plaguing the elderly, with rising living costs set to make the problem worse.

But the true extent of the problem will probably never be known, as it is going unnoticed by even the most caring families, Nelson Grey Power president Gordon Currie says.

Rising living costs, combined with the Government's desire to keep the elderly in their own homes, was only going to exacerbate the problem, while pride and an unwillingness to be a burden on the system meant elderly people were unlikely to seek help, Mr Currie said.

Only the worst cases were being picked up, when elderly patients went to hospital for other problems but had to stay for extended periods due to malnourishment, he said.

Figures from the Nelson Marlborough District Health Board show that during the past five years, the number of patients treated for malnutrition at Nelson Hospital has fluctuated, from nine in 2003, rising to 10 in 2005 and again in 2006, and dropping to six last year. So far this year, two people have been treated for malnutrition at the hospital.

Mr Currie said he knew of people being delivered meals by the Meals on Wheels service but keeping half of each meal in the freezer "just in case".

Almost invariably, families were unaware of the problem and were "absolutely gobsmacked" when they found out, as elderly people tended to deny that there was a problem, he said.

Nelson Nursing Service dietician Annette Nistor said it was a "major issue", which would be placing increasing pressure on health services by contributing to falls, poor wound healing, dehydration, depression, confusion, impaired immune systems and adverse reactions to prescribed drugs.

She was coordinating a Ministry of Health-funded programme aimed at improving nutrition and physical activity for the elderly in Nelson and Marlborough.

Workers who already visited homes were being trained to encourage elderly people to eat and do simple exercises, while gathering information for the programme, she said.

Cost, a fear of wasting food, having no way of getting to the shops, and appetite loss due to life problems were the major contributing factors, while "socially isolated" people were most at risk.

Nelson and Marlborough had a higher-than-average elderly population, and the number of people in the region aged over 65 was expected to reach 25 percent in the next 14 years.

A study of how widespread the problem was had not been carried out in New Zealand but studies in Britain, the United States and Australia signalled that it was ``daunting'', she said.

Heaphys Home Support general manager Pat Heaphy said home support workers were trained to look out for signs of malnourishment, and there were times when staff had taken elderly people meals ``out of the goodness of their heart''.

The death of a spouse often caused people to lose their appetite, while elderly people regularly kept food past its expiry date, he said.

Health board secondary services nurse consultant Marion Elvy said all hospital inpatients were questioned about their diet and assessed for the risk of malnourishment.

Body mass index, weight loss and appetite were monitored and appropriate action was taken when necessary.

Nelson Bays Primary Health Organisation chief executive Andrew Dobbs said carrying some extra weight in old age could have health benefits.

``We often hear the message about eating less because of obesity but it is important to realise there are people who need to eat more for health benefits but cannot afford to,'' he said.

A spokesman for Health Minister David Cunliffe said the Ministry of Health was investigating the issue and an announcement was expected this week.

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