Are we failing the vulnerable?

In Londonderry a shocking eight people died from dehydration and five from malnutriton during the same period.

The figures were released to the Sentinel by the Northern Ireland Statistics and Research Agency (NISRA) following the launch of a Freedom of Information request.

Asked whether issues such as deprivation, poverty and isolation were factors, the Western Trust said yesterday it was difficult to give an accurate response based on the general statistics. But in background notes to its statement, it acknowledged that factors affecting this area in general include: a growing population; an ageing population; urban and rural areas; areas of high deprivation; unhealthy lifestyle choices; and lower life expectancy than the Northern Ireland average.

It also said many patients can be malnourished on admission to hospital and that measures were in place to identify and treat these patients.

The figures obtained by The Sentinel show that last year in Londonderry three people died of dehydration; and one of malnutrition.

In 2010 one local person died of dehydration and two of malnutrition. And in 2009 four people died of dehydration and two of malnutrition.

Across the wider Western Trust area, taking in Tyrone and Fermanagh, the figures were even higher.

Last year eight people died of dehydration in the Western Trust and one person died of malnutrition. In 2010 the figures were six and three respectively; and in 2009 the figures were 10 and two respectively.

There were no deaths by malnutrition during the same period.

NISRA provided the figures for deaths where dehydration or starvation were mentioned on the death certificate and said the data for 2011 is provisional until the 2011 Annual Report of the Registrar General due to be released in November.

In response to questions from the Sentinel on whether society as a whole had a role to play in reducing these deaths, a Trust spokeswoman said: “Malnutrition is caused by a person not receiving enough nutrients, which stops the body functioning as it should. In developing countries, this is often the result of lack of food.

“In the UK malnutrition can be caused by many different circumstances and conditions. This includes physical/medical factors such as difficulty eating due to issues with swallowing, loss of appetite due to a medical condition or other physical impairment.

“The information provided does not give sufficient detail to explore why malnutrition or dehydration have been recorded on these death certificates. For example, it is not clear whether malnutrition was a primary cause of death or a contributory factor. The information does not explain if the individuals had underlying health problems which would cause malnutrition or dehydration as a side effect.

“These factors must be considered when attempting to analyse the data released by NISRA through this Freedom of Information request.

“It is not made clear if these death certificates were for patients who passed away either in hospital, in a care facility, such as a nursing home, or in their own home, therefore, the Trust can only discuss how the services it is responsible for work towards improving the health and well-being of patients.”

The spokesperson continued: “Hospitalised patients represent a diverse group with special needs, and many can be malnourished on admission. Patients with pre-existing disease, in which diet is an essential part of treatment, can also be at risk. The Trust has a number of initiatives including screening measures in place to identify those patients most at risk. Trust staff use a standardized screening tool called MUST - ‘Malnutrition Universal Screening Tool’.

“A strategy for ‘Promoting Good Nutrition’ for all care settings was launched in 2011 by the Patient and Client Council (PCC) to support The Nutritional Standards (Get your 10-a-day) introduced by the Department of Health in 2007. The target for meeting the standards set has been maintained within the Trust and formed the foundations of a Nutritional Steering Group that has been sustained and is proactively driving forward these standards.”

As a provider of health and social care services the Western Trust has committed itself to “improving the health and well-being of our local population and protecting the vulnerable. The Trust also recognises that this is a long-term challenge for all corners of health whether it is delivered in hospital, in the community, through a GP or in a person’s home.”

It also believes that “to address this, the health and social care must look at ways to tackle the main inequalities in society which cause poor health and social harm. Individuals, communities and organisations have a responsibility for their own health and well-being and have a role in protecting the most vulnerable,” says the Trust.