Elderly people are being left to go hungry on NHS wards, a report said.
Those who enter hospital malnourished can get worse during their stay or become malnourished under the care of NHS staff.
The report from the charity Age UK found almost one in three nurses believe their own relative could enter hospital with nobody noticing they were malnourished.
The study - Still Hungry To Be Heard - builds on previous research which showed some elderly people receive no assistance with meals despite struggling to eat.
Those who have difficulty swallowing are sometimes put at risk of choking by not being given pureed food, while others have their food trays placed out of reach at the end of beds or on tray tables that are too high.
The charity has also heard of elderly people receiving no help with cutting food into smaller pieces or opening lids on containers.
Food trays are also sometimes taken away untouched without any questions, according to the charity.
The study found fewer than half of hospitals screen older patients for malnutrition on admission to hospital and only a third screen patients during their stay.
Just 5% screen on discharge, despite evidence showing good nutrition both in and out of hospital helps people get better.
The report found many hospitals are largely ignoring guidelines which say people should be screened.