ARLINGTON, Texas — Recent research completed at two Texas Health hospitals suggests that table posture for eating supports appetite in older patients. The research study examined the effects of mealtime positioning among older adult patients, considering the impact of eating in a chair versus eating in bed. 

The research was conducted at Texas Health Harris Methodist Hospital Fort Worth and Texas Health Harris Methodist Hospital Azle by Ellen Munsterman, M.S.N., APRN, AGCNS-BC, geriatric clinical specialist, Texas Health Fort Worth; Tonya Sosebee, M.S.N., R.N., NEA-BC, chief operating and nursing officer, Texas Health Azle; Amy Penrod, M.S.N., R.N., CEN, patient care facilitator/clinical nurse leader, Texas Health Azle; and Patricia Newcomb, Ph.D., R.N. CPNPret , Texas Health nurse scientist.

Older adults living at home and in long-term care, as well as when they are hospitalized, often have poor appetites. Lack of appetite contributes to malnutrition, weight loss and poor health outcomes in many older patients. Aspiration is another eating-related concern for hospitalized older patients.

The researchers studied the relationship between upright positioning at a table for patient meals and meal consumption, length of stay and injury. The study included 155 older adult medical-surgical patients who ate meals in bed or sitting upright in a chair. For seven months, care on the study units was reorganized to facilitate cooperative patients being helped to sit in a chair for eating their meals. Meal consumption, length of stay and injury were then correlated with the patients' eating positions.

Results of the study showed that, controlling for frailty and other variables, eating while sitting in an upright position in a chair did not shorten length of stay.

But eating in a chair did have a significant positive impact on the amount of food consumed by patients at meals. This suggests that sitting up in a chair to eat meals supports a better appetite.

In the study, no injuries were associated with either meal position; transitioning from the bed to a chair for meals was not associated with falls and eating in bed with the bed up was not associated with aspiration among older patients without cognitive impairment.

Results of the study also suggest that eating in a chair at a table may also increase patient satisfaction. At discharge, only 11% of patients in the study said they preferred eating in bed.

The primary recommendation from the study is for nursing staff to organize care so that they can assist patients to sit in a chair for their meals, if they have no contraindications for being moved into a chair.