84LUNCH CLUB ON THE HIP FRACTURE UNIT: SOCIABLE DINING TO IMPROVE NUTRITIONAL INTAKE IN POST-OPERATIVE ELDERLY PATIENTS

Abstract

Topic Elderly patients with hip fractures often consume significantly less than their recommended nutritional intake (Whitelock G, Ramis MA, JBI Library of Systematic Reviews, 2011, 9; 48). This is associated with delirium, infections, and impaired rehabilitation (Avenell A, Handoll HHG, The Cochrane Database of Systematic Reviews, 2005, 8(1); 94). Limited studies suggest social interaction may improve nutritional intake in the elderly (Brush K, Meehan R, Calkins M, Alzheimer's Care Today, 2002, 3(4); 330-338). Sociable dining was introduced on our Hip Fracture Unit (HFU) to enhance the patient experience. We aimed to audit whether it improved nutritional intake. Intervention: We included all female post-operative patients on the HFU aged over 60 and able to eat in a chair. Meals were weighed before and after lunch, initially eaten at the bedside (group 1: 94 meals), and then, following introduction of sociable dining, at a communal table (group 2: 94 meals). Both groups had similar age (mean age 84) and cognitive status (mean AMTS 6.0 vs. 6.5). Results were analysed using linear regression, allowing for clustering within individuals. Improvement: Across both groups (188 meals from 50 patients) lower consumption was observed in older patients (age > 80, -104g per meal, p = 0.02) and in dementia (-66g per meal, p = 0.02). Mean intake was similar overall between groups 1 and 2 (239 g vs 245 g, p = 0.73). However, older patients aged over 80 ate more at the Lunch Club (mean intake 202 g vs 247 g, p = 0.06), suggesting a systematic improvement with sociable dining. We also observed increased social interaction, reduced agitation in patients with delirium, and improved functional rehabilitation. Additionally, it enhanced staff morale and received excellent feedback from patients and relatives. Discussion: There was a trend towards sociable dining improving nutritional intake in our oldest patients, and numerous other benefits were also observed. Larger studies are required to evaluate the true nutritional impact.