Ahmed, a 65yr old married man, is a voluntary inpatient in the Acute Mental Health Unit. He has been admitted for assessment and treatment of severe depression. Ahmed moved to England from Southern India 20yrs ago with his family. On admission, Ahmed is found to be underweight and he reports a moderate loss of appetite (anorexia), which has increased during his stay on the Unit and been present since his depressive symptoms have worsened. During his stay on the ward, on open questioning, it is established that Ahmed enjoys eating his wife's homemade curry but dislikes hospital food on the whole, which seems to have contributed to a steady, continual loss of weight.
You are the health worker on duty. You have spoken to Ahmed and encouraged him to fill in his daily menu choice, to allow him to choose what he would like to eat. Ahmed continues to be unmotivated and seems disinterested but fills the form in anyway. Ahmed has also been referred to the dietician for advice by the Registered Nurse on duty.
At meal time, that evening, you notice that, as usual, Ahmed has not eaten any of the food which has arrived from the kitchens, and despite encouragement, asks you to take his tray away, with his food untouched. You report this to the nurse in charge and document your evaluation in Ahmed's notes.
At visiting time you are surprised to notice that Ahmed is sat with his wife and is visibly eating curry and rice with his hands, in front of everyone, in the day room. Some of the staff and patients verbalise feeling uncomfortable as a result of this behaviour, saying it is 'unhygienic' and 'repulsive'. These statements are made, despite the fact that Ahmed, as part of his culture, sees nothing wrong with eating his curry with his hands: as he says, 'it tastes better' and his family regularly eat in this way at home, as do well over 1 billion people around the world.
It is evident that Ahmed's wife has snuck food in for him, against the hospital policy, which states that due to legal obligations, to comply with the Foods Safety Act 1990 and associated legislation and the risks of food poisoning, relatives and patients are unable to bring in meals containing cooked meat as they may support the growth of pathogenic bacteria.
What would you do in this scenario?
Do you agree with the proposal below?
(Case originally posted by Vanessa Peutherer)
It is proposed that you continue to allow Ahmed to consume his wife's curry with his hands, in the communal area