JEAN RAFFERTY

She swings between extolling God and execrating the hospital, in language saltier than the soup the patients all complain about. She often says the doctors are poisoning her. 'We were invited here by letter and this is how they treat us,' she declares, though in fact, like my mother, she broke her hip in a fall. One of the huge problems for older people in hospital is that they get confused - the anaesthetic, the drugs and their changed surroundings mean that many fail to recognise where they are. Annette the rebel has several times asked me where she is though she's been on the ward for some weeks. 'Is this my house?' she says, in her wispy little voice.

 

On the day of revolution in the ward, she said the soup was cold. The food often is because the nursing auxiliaries come in with plates of whatever's on offer and ask the patients to choose on the spot. In the main hospital they are given a menu the day before and asked to tick their choices, but the staff in the geriatric unit say the patients get confused and don't want what they've ordered. This may be true, though it seems strange to predicate a system on its failures.

Annalena Winslow, the press officer for NHS Greater Glasgow and Clyde, says that the practice in my mother's geriatric unit is to offer patients a choice of food. 'This is kept hot via a heated food trolley while patients choose. Once the choice is made the food is immediately delivered directly to the patient. It should never be cold, as all meals served comply with legal temperature requirements. If anyone has any concerns we would encourage them to speak to staff.'

 

I did, and was told that Annette's soup could not be reheated in the microwave for 'health and safety reasons.' They could add some hot water to it. Given that she wasn't sure where she was, it's doubtful that she would have grasped the concept of legal temperature requirements. The food is certainly kept on a heated trolley but it comes from another hospital over seven miles away, so is presumably already less appetising than where it is produced. The staff do not keep it on the trolley. They waft uncovered meals in front of the patients' noses, asking them to choose what they want. Some clearly find the idea of a client-driven service exasperating. One day this week a manager on the ward put up a notice about patient choice. 'Make sure they all see it,' she said. When she'd gone, the nurse shrugged her shoulders and muttered, 'Patient choice,' as if the very idea was ridiculous.

 

Most of the patients, being elderly, don't really want much at all. Mollie, my mother, often nicknamed 'Mops' despite her lifelong distaste for domestic chores, is the fittest in the room. She puts her makeup on every day and has started doing the word game in her daily paper again while the others sit staring into space, too tired to move. I think that's because one of us is almost always there to cajole her into eating the soup and usually some of the main course. Her staple over the first couple of weeks has been little pots of yoghurt with fresh fruit which we bring in from home. We also brought in Fruit and Fibre, prunes and bananas to keep her regular. She forgot it was there one day and the auxiliary didn't notice. When I asked one of the staff about it she dismissed the whole question of dietary fibre and roughage. 'Rice Krispies are just as good,' she said.

 

Age Concern's report urges all hospital staff to become 'food aware.' In England the government takes this so seriously they asked Lloyd Grossman and various other celebrity chefs to have a look at changing hospital food. Lloyd may have gone over the top in suggesting dishes such as navarin of lamb with couscous and grilled vegetables, but in Scotland they're still serving gruesome food like Forfar bridies. 'Menu compilation is not about a particular item being therapeutic,' says Annalena Winslow of NHS Greater Glasgow and Clyde in a fine example of corporate statement of the obvious. 'The entire intake of a patient during his or her stay in hospital is taken into consideration.'

 

In my mother's ward, someone goes round every day measuring what the old ladies have eaten for lunch, but there is no consistent effort that I can see to ensure they are properly nourished. On any given day there is always someone who doesn't feel like eating at all. 'We can't make them eat,' the staff protest and of course legally they can't. Maybe they simply don't have the time to sit there and wait while Beth's wavering hand flutters and hesitates on its way to her mouth; they don't have the time to sit and chat long enough with the feisty Betty to galvanise her into eating. Everything is done to a timetable so there is little chance for anything other than a diffuse and sometimes distant kindness, though there are always exceptional members of staff who make a real connection with individual patients.