Elderly Starving in Their Homes - Doctor

Many elderly people living in their own homes are starving, an Auckland hospital geriatrician says. 

Dr Graham Davison's comments follow concerns raised by a visiting Canadian academic over the number of malnourished elderly people living in the community. 

"Starving is an emotional word but it reflects the fact that people do not get enough food to maintain their weight," said Davison. 

Auckland pensioner Shirley Duguid, 82, has experienced the debilitating effects of not eating. 

After coming down with a skin disorder around Easter last year, Duguid found her appetite disappeared and she sank into a state of depression-like lethargy, with no desire to get up, eat or do much at all. 

"I used to throw out my meals on wheels, I just could not eat. I was in bed most of the time even though I had my sick husband with a bad heart to look after. It was ghastly." 

Duguid said she went months without eating properly before Auckland Hospital nutritionists got her taking dietary supplement drinks and she slowly rebuilt her physical and mental health. 

Dr Heather Keller, associate professor at Guelph University in Ontario, who was in New Zealand this month, said a screening tool developed in Canada found up to four in 10 elderly people living in their own homes were at risk of malnutrition. Half were at high risk. 

"These are the people I'm most concerned about. They need some specific intervention because the older adult does not have the same capacity to recuperate it can take them two to three months to recover from the flu and this is exacerbated by a poor diet." 

Keller said the main risks occurred when elderly people had difficulty shopping, cooking and living alone. 

"Someone living alone may not want to sit down and cook a meal. If they're not eating well because they're not cooking or don't have a good diet, their body deteriorates rapidly." 

There was also evidence that good diet and a healthy body weight reduced the risk of dementia, said Keller. 

Davison said a survey of elderly people admitted to Auckland hospital geriatric wards found 31% were significantly malnourished. 

"In Christchurch Hospital, a survey of elderly people coming in with fractured hips found 42% were significantly malnourished. We don't have good local data for the true numbers, but internationally five to 10% of older people in their own homes are starving." 

In rest homes, the number of malnourished elderly was likely to be as high as 25%, he said. 

"Their need is not so much nutritional supplements or more food but the quality of the ambience. Things like having a tablecloth, flowers on the table, sitting down with other people or not having a vacuum cleaner going in the background during meal times." 

Davison said elderly people often simply lacked the appetite to eat more. 
"Older people are not so likely to feel hungry," he said. "Their stomachs are perhaps a little smaller and they feel satiety earlier, so they need to eat more frequently and eat food with higher calories and good quality fats."