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Departments of Nutrition and Dietetics Norfolk and Norwich University Hospitals NHS Foundation Trust James Paget University Hospitals NHS Foundation Trust Nutrition Support Why do hospital inpatients have a poor appetite and dietary intake? Practical information for relatives and carers of adults This dietary advice sheet gives some general information to help you make the recommended changes to your relative’s/friend’s diet. If you need more detailed advice or if your relative/friend is following a special diet that makes it difficult to make these changes, please ask your relative’s/friend’s doctor to refer him/her to a registered dietitian. Eating and drinking during illness It is not unusual for people to lose their appetite when they are unwell. This may be because of the illness itself, the treatment or their fears and anxiety. In addition to this, being a hospital inpatient and having to fit in with set meal times is not always easy. Eating and drinking during a hospital admission is important as it will help: • • • Fight infection Maintain weight Promote healing In fact, patients will generally feel better and be home much quicker. It is best to keep trying to eat little and often when the appetite is poor. Most patients find their appetite improves/returns to normal once they are back in their usual routine at home. They should then return to their usual healthier eating. If the patient is only in hospital for a short while, their poor appetite should not cause any long-term problems. What nurses do to help Nurses work alongside dietitians and catering staff to encourage patients to eat and maintain their nutritional status. They ensure patients are positioned correctly and their food is accessible at all mealtimes. Patients will receive assistance with eating when required. Nurses identify which patients require specialist dietetic input through the recording of food charts, regular weighing and through medical team requests. Nurses will observe patients eating and notify a dietitian of any concerns such as reduced appetite and/or difficulty in swallowing. What dietitians do to help Dietitians work with the catering department to make sure that patients’ needs are met regarding the nutritional content of meals. They are also available to see patients identified by the nurses and doctors as needing specific advice for their illness or medical condition. If patients require further advice after discharge, dietitians can arrange to see people closer to where they live. Approved by: PIF Review Date: 01/03/2019 Nutrition Support Why do hospital inpatients have a poor appetite and dietary intake? Practical information for relatives and carers of adults What you can do to help If your relative/friend dislikes hospital food: • It may be useful to bring in their preferred foods (please check with nursing staff prior to doing this). • If patients are well enough they could be taken to the hospital restaurant or café for a meal. • Bring in snacks for between meals that can be kept by the side of the bed such as fruit, biscuits, sweets, chocolate, crisps, and pots of custard or rice pudding. • Ask to speak with the Ward Kitchen Manager about the availability of preferred foods. Advice for home If your relative/friend’s appetite does not return to normal, here are some practical tips to help improve their nutritional intake at home: • Encourage eating little and often, that is small meals with snacks in between. • Offer full cream milk and full fat foods instead of low fat products. • Add sugar to cereals, puddings and drinks (not suitable for people with diabetes). • Add grated cheese, cream or butter to potatoes, vegetables, soups, sauces and puddings. • Fortify milk by adding 2 – 4 tablespoons dried milk powder to 1 pint milk and use this to make drinks, soups puddings and sauces. Please note that milk and biscuits are always available for patients from the tea trolley, and that all wards are stocked with Build-up milkshakes and soups which can be given without prescription. If your relative/friend needs help with eating: Most of our wards have ‘Protected Meal Times’ so that patients can have an environment which is relaxing and will encourage and support them to eat well during their period of illness. During this time we usually ask visitors not to come to the wards, however if you would like to assist your relative or friend with their meal, you will be most welcome. Try a nourishing drink such as Complan, Build-up or supermarket own brand or make your own fruit smoothie or milkshake. If you continue to have concerns, please discuss with your GP.