Accessing hospital packaged foods and beverages : the importance of a seated posture when eating

Background: Hospitalised and community dwelling older people (65 years and over), have difficulties opening food and beverage items such as cheese portions and tetra packs served in public hospitals. Previously, the role of hand strength on successful pack opening has been explored in a seated position. However, as many people in hospital eat in bed, this laboratory study examined the differences between participants opening a selection of products both in a hospital bed and a chair. Methods: This study used a qualitative method (satisfaction) and quantitative methods (grip and pinch strength, dexterity, time and attempts) in two conditions (bed; chair) with a sample of well older community dwelling adults (n=34). Packs tested included foil sealed thickened pudding, foil sealed thickened water, tetra pack, dessert, custard, jam, cereal, honey sachet and cheese portions. Results: Honey sachets, cheese portions, foil sealed thickened pudding and tetra packs were the most difficult packs to open, with 15% of cheese portions unable to be opened in either the bed or chair posture. While grip strength was consistent for each posture, pinch grips and dexterity were adversely affected by the bed posture. Lying in a hospital bed required greater pinch strength and dexterity to open packs. Conclusions: Eating in a seated position while in hospital has been shown to improve intake. This study demonstrates that eating in a seated posture is also advantageous for opening food and beverage packs used in NSW hospital food service and supports the notion that patients should sit to eat in hospital.