Researchers talked to 200 older adults in Australian hospitals about their eating and drinking experiences. Almost all patients said eating and drinking was important for getting better, but many faced real challenges. Problems included not feeling hungry, difficulty using utensils, not getting help from staff, uncomfortable seating, and meal times that didn’t work for them. The good news? When staff helped, family visited, and patients had food choices they liked, eating improved. This study shows hospitals need to make mealtime care better by involving doctors, nurses, and other staff working together to help older patients eat well.

The Quick Take

  • What they studied: How older adults experience eating and drinking while staying in the hospital, including what makes it hard and what helps
  • Who participated: 200 older adults aged 65 and older staying in 20 different hospital wards across 12 hospitals in Queensland, Australia
  • Key finding: Nearly all patients (98%) understood that eating well was important for recovery, but most faced multiple barriers including loss of appetite, difficulty with physical tasks, lack of staff help, uncomfortable positioning, and inflexible meal schedules
  • What it means for you: If you or a loved one is in the hospital, speaking up about eating challenges and asking for help is important. Hospitals are learning they need better systems to support older patients during mealtimes, which may improve recovery and health outcomes.

The Research Details

Researchers conducted face-to-face interviews with 200 older hospital patients across 12 different hospitals in Australia. The interviews asked patients about their experiences eating and drinking, what made it difficult, what helped, and their suggestions for improvement. This was part of a larger quality improvement program called ‘Eat Walk Engage’ that ran from 2019-2020. The researchers used a special framework called the Theoretical Domains Framework to organize and understand patient responses, grouping similar ideas together to identify patterns in what patients experienced.

This mixed-method approach combined structured questions (which give numbers and patterns) with open-ended conversations (which capture personal stories and details). Trained hospital staff conducted the interviews, which helped patients feel comfortable sharing honestly about their experiences. The researchers then carefully reviewed all 200 interviews to find common themes and create summary statements about what matters most to older patients during hospital mealtimes.

Understanding what patients actually experience is crucial for improving hospital care. Rather than assuming what problems exist, researchers asked patients directly. This approach helps hospitals design solutions that actually work for the people they serve. By listening to older adults’ perspectives, hospitals can make changes that address real barriers instead of guessing what might help.

This study has several strengths: it included 200 participants across multiple hospitals (not just one), used trained interviewers to ensure consistent data collection, and employed a recognized framework for organizing findings. The large number of interviews and multiple hospital sites make findings more reliable and applicable to different settings. However, all participants were from Australian public hospitals, so results may not apply exactly to private hospitals or other countries with different healthcare systems.

What the Results Show

Nearly all patients (98%) recognized that eating and drinking was important for their strength and recovery. Most patients appreciated the quality and variety of hospital food options available to them. However, patients experienced challenges at three different levels that interfered with eating well.

At the personal level, patients struggled with reduced appetite, nausea, pain, difficulty swallowing, weak hands, and other physical symptoms that made eating harder. At the mealtime care level, patients reported not getting enough help from staff, being positioned uncomfortably in bed, and feeling rushed. At the hospital system level, patients faced inflexible meal times that didn’t match when they felt hungry, portion sizes that were too large or too small, and limited ability to get food when they wanted it.

The study identified 18 key beliefs patients held about eating in the hospital, organized across seven important areas. These beliefs showed that patients wanted to eat well but needed support from multiple sources to succeed.

Several enabling factors emerged that helped patients eat better: their own motivation and determination to recover, encouragement and hands-on help from nursing staff, visits and support from family members, having choices about what to eat, and access to familiar foods they enjoyed. Patients also suggested practical improvements like better communication about meal times, more flexible scheduling, smaller portion options, and easier-to-use utensils and dishes.

This research confirms what previous studies have shown: older adults in hospitals often don’t eat enough, which can slow recovery and lead to complications. However, this study adds important new information by directly asking patients what they experience and what would help. Previous research often focused on what doctors and nurses thought was the problem, but this study centers patient voices, revealing that solutions need to address personal, care-related, and system-level challenges all at once.

All participants came from public hospitals in one Australian state, so findings may not apply to private hospitals or hospitals in other countries with different systems. The study only included patients well enough to participate in interviews, so it may not represent the experiences of the sickest patients. Additionally, the study was conducted in 2019-2020, so some findings may have changed as hospitals adapted to new challenges like COVID-19.

The Bottom Line

Hospitals should implement multi-level improvements to support older patients’ eating: (1) Train staff to provide hands-on help during meals and position patients comfortably, (2) Offer flexible meal times and portion sizes, (3) Involve family members in mealtime support, (4) Provide familiar food choices, and (5) Create systems where patients can easily request food when hungry. These recommendations have moderate to strong support from patient feedback and align with quality improvement principles. Confidence level: Moderate to High—based on direct patient input from 200 people across multiple hospitals.

Hospital administrators, nurses, doctors, and nutritionists should use these findings to improve mealtime care. Older adults and their families should advocate for better mealtime support when in the hospital. Policymakers can use this research to set standards for hospital nutrition care. This research is less relevant to younger, healthier hospital patients who don’t face the same eating challenges.

Improvements in eating and nutrition support could show benefits within days to weeks of hospital stay, with better nutrition potentially speeding recovery. However, implementing hospital-wide changes takes months to years, so patients admitted soon may not see all improvements immediately.

Want to Apply This Research?

  • If using a health app during or after hospitalization, track daily food and fluid intake (meals eaten, snacks, water consumed) along with appetite level (1-10 scale) and any eating difficulties (nausea, pain, trouble swallowing). Note which foods were eaten successfully and which weren’t, helping identify patterns.
  • Before hospital admission, discuss eating preferences and challenges with your doctor. During hospitalization, communicate clearly with staff about appetite changes, positioning comfort, and food preferences. Ask family to help during meals if possible. After discharge, continue tracking what helps you eat well to support recovery.
  • Set a daily reminder to log one meal and note appetite level. Track weight weekly if possible (sudden drops may indicate inadequate intake). Monitor energy levels and recovery progress. Share this information with your healthcare provider to adjust nutrition support as needed. If appetite remains poor after discharge, discuss with your doctor whether nutritional supplements or dietitian consultation would help.

This research describes patient experiences and suggests improvements for hospital mealtime care, but it is not medical advice. If you or a loved one is hospitalized and experiencing difficulty eating or drinking, please inform your healthcare team immediately, as this could affect recovery. Individual nutritional needs vary, and a doctor or registered dietitian should assess specific dietary requirements. This study was conducted in Australian hospitals and may not apply to all healthcare settings. Always consult with your healthcare provider before making changes to your diet or nutrition plan.