It is a well documented problem that dementia patients in hospital often do not get the necessary help and support they need to keep adequately fed and hydrated. In unfamiliar surroundings without the comfort of their normal routine, many simply forget when they last ate, or struggle to feed themselves.
In response, the dementia care team at Imperial Healthcare NHS trust have developed an innovative approach to help ensure patients with dementia get the support they need.
NoSH - Nutrition Support in hospital pathway
Christened NoSH, the dementia Nutritional Support in Hospital pathway aims to provide a model of care tailored specifically for the needs of those with dementia in the hospital.
The NoSH model has 3 levels. All patients with a diagnosis of dementia are placed automatically on the first level of 'Core Support' when they are first admitted to hospital. Their weight is measured, and food and fluid intakes are recorded regularly by the nursing team to ensure they are getting what they need. Sugar-free squash drinks and Bento Boxes, containing healthy and nutritious snacks, are also on hand to tempt patients to eat and drink freely outside of meal times.
'Enhanced' and 'Intensive' levels of the programme have then been designed for those patients who need additional support. Two healthcare support workers (HCAs), funded by the Imperial College Healthcare Charity, have been recruited to help the nursing team provide a range of other support measures :
- one to one support for those who struggle to feed themselves and drink adequate amounts of fluid
- daily reviews by the NoSH team
- the development of personalised eating and drinking goals with the support of family members and the nursing team
- use of music proven to stimulate appetite during meal times
- provision of 5 smaller meals a day rather than the usual 3.
Good nutrition is a vital part of dementia patients' recovery, and goes hand-in-hand with treating their medical needs.
Our new patient centred approach to nutrition and hydration allows us to keep a close eye on patients' intake while they are on the wards, which aids a speedy recovery so they can return to their own home sooner.
Dementia Care Lead at Imperial NHS Healthcare Trust
NoSH is the latest in series of measures the Trust have taken to improve the experience of dementia patients and their families. Supporting John's Campaign, the trust was one of the first in the country to introduce Carer's Passports, allowing carers to stay with dementia patients outside of normal visiting hours. New activity packs have been introduced to help keep dementia patients relaxed and occupied while they are in hospital, and at St Mary's Hospital, Witherow Ward, has been redeveloped to meet the specialist needs of those with dementia.
