Older people's experiences of dignity and nutrition during hospital stays: Secondary data analysis using the Adult Inpatient Survey

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A number of recent studies, investigations and inquires have examine the treatment of older people in healthcare and have identified shocking evidence of poor treatment: -The Joint Committee on Human Rights (2007) raised concerns about poor treatment, neglect, abuse, discrimination, lack of support for eating and drinking, and malnutrition and dehydration. -Age UK (2010) highlighted lack of detection and treatment of malnutrition in hospital as a 'national disgrace' and called on the Government to introduce compulsory monitoring of malnutrition. -Patients Association (2011) details sixteen accounts of poor hospital care heard by its Helpline focusing on care-communication, access to pain relief, assistance with toileting, and help with eating and drinking. -The Health Service Ombudsman (2011) investigation into NHS care of older people raised key concerns about lack of assistance with eating and drinking. -The Care Quality Commission (2011a) dignity and nutrition inspection identified evidence of people not being given assistance to eat, not having their nutritional needs monitored and not being given enough to drink; staff not treating patients in a respectful way; and older people not being sufficiently involved in their care. It concluded that national minimum standards of dignity and nutrition were not being complied with in many casesn and in some cases treatment was so poor that it amounted to a violation of legal rights. -Further shocking findings were identified in the Equality and Human Rights Commission (2011) inquiry into the treatment of older people requiring or recieving home-based care and support. The new research will build up a quantitative statistical evidence base in order to produce a national statistical picture on older people's treatment during hosptial stays. We will analyse older people's responses to questiosn about dignity and nutrition using the Adult Inpatient Survey. The Adult Inpatient Survey is a national survey that the Government uses to monitor quality and performance in the NHS. Participants in the survey are adults who have stayed at least one night in an NHS hospital in England. They are asked whether they feel that they were treated with dignity and respect during their hospital stay, and whether they received the help that they need with eating during their hospital stays. The new research involves evaluating older people's responses to these questions. We will be analysing what older people have said about their treatment during hospital stays over the period 2002-2011 and whether older people are at any greater risk than younger people. The research will focus on trends in how many older people are affected by lack of dignity in treatment and inadequate nutritional support, and on who is at greatest risk. We will also be examining the links between older age and disability, and older age and area deprivation, as pathways to disadvantage and poor treatment. The research will provide new evidence on older people's treatment during hospital stays and will provide more in-depth evidence in this area than has previously been provided. It will answer important questions such as: -Has the national proportion of older people reporting not being treated with dignity and respect, or not receiving the support they need with eating, during hospital stays increased or decreased over the period 2002-2011?-Are older people more or less likely to experience not being treated with dignity and respect, or not receiving the support they need with eating, during hospital stays, compared with other population sub-groups? -Do other factors such as disability, sex, ethnicity, type of hosptial and area deprivation make a difference to older people's experiences of disadvantage and poor treatment?