Janet Street-Porter: A first-hand glimpse of caring for the elderly

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The Independent Online

On the day this week when Age Concern published their report about old people starving in hospitals, I sat by the bed of a 90-year-old lady in Barnsley Hospital and gently tried to persuade her to eat a beaker of tomato soup. Following a stroke, she'd lost the use of her arms and was suffering a bad chest infection. As bright as anything, she preferred to chat about her 11 children and 20-something grandchildren, but was very uninterested in eating.

Emptying that beaker of soup and spoon-feeding her a small tub of ice-cream was a slow process requiring a lot of patience and my undivided attention. For two weeks, I am taking part in a television programme for Channel Five entitled So You Think You Can Nurse, a follow-up to a series I made in 2004, in which I taught a class of nine-year-olds the National Curriculum.

There's nothing like a spot of first-hand, front-line experience to bring subjects like care for the elderly into sharp focus. Age Concern reckons that over half the older patients are at risk of malnutrition in hospitals, and bearing in mind that this age-group occupies two thirds of all beds anyway, it is a big problem.

Earlier, I spent some time helping to bathe an elderly woman who had died that afternoon, having suffered a massive stroke on the very day she was to be discharged. It was a moving experience, and the nurses took a remarkable amount of care to make sure that this patient left their care looking at her best, in as dignified a manner as possible.

Back on the ward, it was meal-time, and I was plunged in at the deep end. Some patients ignored their buzzers to summon the nurse, preferring to shout. An elderly gentleman had been sick over himself and refused to allow the nurses to change his jacket. He was refusing to eat and pulled the sheet over his head. Basically, he seemed to have decided to die, and could get quite violent if food was forced upon him.

Nine out of 10 nurses out of the hundreds who took part in the survey Hungry to be Heard told Age Concern that they did not always have time to help patients to eat. In Barnsley, everyone mucks in, from students to nursing auxiliaries. I was given special training in how to approach patients to persuade them to fill in their meal card, and then shown various strategies to coax them into actually eating the stuff when it arrived on a tray. All very laudable. But, apart from the lack of time (and there can be two nurses to 28 patients, as well as auxiliaries), the problem is that many patients enter hospital malnourished in the first place - those over 80 are five times more likely to suffer from the condition than those under 50.

Age Concern wants every patient to be assessed for dietary deficiencies, and for wards to operate a "red tray" system which will identify those who need help eating. This is certainly a simple and effective way of highlighting the problem, but from my brief experience in Barnsley, there's another, even more formidable barrier - quite often the old have lost any interest whatsoever in food. They may be suffering from dementia or depression or just plain loneliness. If you are a pensioner living alone, cooking's not much fun, is it?

We need to able to deal with that mindset, because once people stop eating, they will remain in hospital even longer, occupying a bed and costing the NHS more money.

Flair on the fairway

It's good to see an ageing rock star can bring some excitement to the style-free zone that is a golf course. Walking the length and breadth of Britain you can't fail to be aware that the British countryside is fast turning into one huge, treeless putting green, with kidney-shaped blobs of sand at regular intervals. And the kit worn by golfers is nearly as abysmal. V-neck diamond sweaters shout Alan Partridge, not Dior homme. Thank goodness Alice Cooper plays golf, and has a different concept of the appropriate attire to Tiger Woods or Colin Montgomerie. Participating in the the All Star Celebrity Golf Tournament at the Celtic Resort in Wales this week, he appeared in a pale pink sweater and trousers, with matching flower-trimmed straw hat. The final touch was full sooty black eye makeup.

* Commuting to work has left us too tired to go shopping in real shops, according to the financial services group Experian. Those in the South-east who earn enough to afford expensive homes are so shattered by the travelling that they prefer to shop on-line for clothes, wine and home furnishings. Top of the home-shopping league is Barnes in south-west London, known to many of my mates as "media gulch" because of its high proportion of residents working in newspapers, magazines or television. The idea of buying clothes by post or the internet leaves me cold - part of the whole thrill of fashion is the experience of feeling fabric, comparing colours and trying things on with an assistant helping out. Home shopping reduces fashion to body covering - OK, perhaps, if you're Mr Cameron and fancy Sloane Ranger floral swimwear, but not for me.

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