Nursing home patients may find themselves subject to dozens of adverse conditions through no fault of their own: pressure ulcers, falls, fractures, malnutrition and dehydration are some of the more prominent injuries. In part two of this two part discussion, we will look at the issues of malnutrition and dehydration that arise in nursing homes, assisted living facilities and elder care facilities.
Nutritional well-being is an important part of successful aging. Improper nutrition or malnutrition can lead to infections, confusion, and muscle weakness resulting in immobility and falls, pressure ulcers, pneumonia, and decreased immunity to bacteria and viruses. Malnutrition is costly, lowers the quality of life of the nursing home resident and is often avoidable. The facility must take steps to ensure that residents maintain good nutritional health and must provide residents with well-balanced, palatable meals.
Many things can cause malnutrition in nursing home residents. The following are factors that may prevent a resident from receiving adequate nutritional needs:
- Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances or sleepiness
- Food and drug interactions which decrease the ability of the body to absorb vitamins and minerals
- Swallowing disorders
- Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain
- Tremors, which affect the residents’ ability to feed themselves
- Inadequate attention from staff for residents who need assistance eating
- Staff who are uneducated about malnutrition and proper ways to feed residents who need help
- Reliance on liquid supplements
- Special diets
Signs That a Resident is Malnourished
- Do clothes fit more loosely than usual?
- Are there cracks around the mouth?
- Do lips and mouth look pale?
- Has the resident complained that his/her dentures no longer fit?
- Has the resident’s hair been thinning or growing sparse?
- Do wounds seem to take longer to heal?
- Does the resident appear confused (not as a result of a disease such as Alzheimer’s)?
- Is the resident’s skin breaking down?
- Do the resident’s eyes look sunken?
- Does the resident appear to be losing weight?
If the answer is yes to two or more of these questions, the following may help pinpoint specific problems:
- Can the resident feed him/herself?
- What is the resident’s favorite meal of the day?
- When and where does the resident prefer to have meals served?
- Does it take a long time for the resident to eat?
- Is the resident rushed through meals?
- Is the resident unable to finish meals?
- Does the resident seem to eat more when someone is there to help with the meal?
- Does the resident seem uninterested in food?
- Has the resident lost his/her appetite?
- Does the resident like the food at the facility?
- Can the resident choose from a menu?
- Are snacks readily available to the resident?
- Is the resident on a special diet?
- Has the resident started taking any new medications?
- Has the resident’s weight routinely been monitored?
- Has the staff informed family members of weight loss?
- Has staff asked family members for assistance?
Dehydration should be managed through an individualized daily plan to promote adequate hydration based upon identifying the risk factors which include at least the following:
- Alzheimer’s or other dementia
- Major psychiatric disorders
- Repeated infections
- Urinary incontinence
- History of dehydration
- 4 or more chronic conditions
- Use of diuretics, antidepressants, psychotropics, or anti-anxiety medications, laxatives, or steroids
- Chronic cognitive impairment
- Inadequate nutritional status
- Acute situations: vomiting, diarrhea and/or fevers
We can help if you or a loved one has been injured due to nursing home neglect and abuse. You will need an experienced and dedicated lawyer who is willing to fight for you. To speak with an attorney at Prieto, Marigliano, Holbert & Prieto, LLC about an injury, substandard care or the loss of a loved one resulting from nursing home neglect, contact us today. Our firm has lawyers and staff members who only handle these types of cases. We have the experience, diligence and legal sophistication necessary to handle your case with the highest degree of competence and care.