12:42, November 28 318 0 theguardian.com

2018-11-28 12:42:07
Care homes, cameras and euthanasia

Thank you for reporting on the appearance of malnutrition on the death certificates of care home residents (Report, 26 November). This is an incredibly serious issue that requires further investigation, but let us not lay all the blame on care home workers.

Our Nutrition Screening Week survey in 2015 showed that most care homes reported having policies on nutritional screening and nutrition care planning in place. There is of course room for improvement, but the wider problem lies in the failure to join up different parts of the health and social care system.

Our figures show that 35% of people are at nutritional risk when they first move into a care home. We need better training for GPs to identify disease-related malnutrition, so that care home staff can proactively support the nutrition and hydration of their residents.

There is also considerable work to be done to improve communication about nutritional care needs across the continuum of healthcare, especially when older people are discharged back to residential care after a hospital admission. The prime minister last week committed to appointing more healthcare professionals into care homes, with the aspiration to improve care and speed up discharge from hospital. We will watch these developments with interest.

The number of older people will rise by nearly 50% over the next 20 years. We need to take action to improve integration between primary care, secondary care and social care services if we wish to stop older people dying because they are malnourished.

Dr Trevor Smith

President, Bapen (Malnutrition and Nutritional Care in the UK)

Another care sector horror story (Scandal of UK’s worst care homes revealed, 24 November). Despite these repeated identified failings it seems the industry remains reluctant to adopt technologies to address such shortcomings. Independent polling research confirms there is substantial support from the public for the use of camera surveillance in care facilities to safeguard their loved ones.

Cameras in care settings will never be a substitute for adequate staff numbers, supervision or training. However, daily independently, monitored cameras can highlight both good and poor practice that can then be addressed to improve standards of care.

Combining the use of state-of-the-art surveillance technology with the judgment of independent health and social care professionals need not be a “Big Brother is watching you” scenario but something that families, staff and commissioners embrace as key to offering peace of mind, transparency and high quality care.

Ben Wilson

Care Protect

Contrary to Elsa Woodward’s letter (27 November), at least in Belgium where euthanasia is (regrettably) legal in some circumstances, mere old age is not one of those circumstances. I believe this is also true in the Netherlands. An incurable terminal disease causing “intolerable” suffering is the justification in Belgium – old age is not (yet) considered a disease on its own. Of course, the law is sometimes not respected, but that’s another matter. The letter also suggests that legal euthanasia is relatively common, when in fact only a tiny minority of countries and US states have legalised it. Hopefully that will continue to be the case.

Sara Lewis

Molenbeek, Brussels, Belgium

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