Malnutrition
or
Dehydration
Malnutrition and Dehydration in Nursing Home Residents Can be a Sign of Nursing Home Neglect or Nursing Home Malpractice or Nursing Home Abuse.
What is malnutrition and what are the health consequences of malnutrition in nursing home residents?
A person is malnourished when he or she is not getting enough nutrients. It means not only a lack of food but not getting enough vitamins and minerals into the body. Malnutrition can be caused by insufficient, missed or non-nutritious meals. Taste, smell and appetite decrease in old age.
Depression and dementia occurs frequently in nursing home residents and that can contribute to weight loss. In addition, medications, gastrointestinal problems and swallowing disorders interfere with nutritional well-being. The consequences of under-nutrition for elderly nursing home residents can be very serious. Malnutrition is associated with infections, especially urinary tract infections and pneumonia, pressure sores, anemia, weakness that can result in immobility, hypotension, confusion and memory loss, impairment of organ function, decreased wound healing, hip fractures and death.
Undernourished nursing home residents become weak, fatigued, bedridden, apathetic, and depressed. Compared with well-nourished hospitalized nursing home residents, the undernourished have a five-fold increase in mortality in the
hospital.[1]
Malnutrition can weaken the immune system and cause an elderly person to become frail.
What is dehydration and what are the health consequences of dehydration in nursing home residents?
Inadequate hydration occurs when a person’s loss of body fluids is more than the intake of fluids. A nursing home resident can become dehydrated when the body loses too much water either through illnesses such as severe or prolonged attacks of diarrhea and vomiting, high fevers, or sweating in hot weather.
Inadequate hydration occurs when a person’s loss of body fluids is more than the intake of fluids. A nursing home resident can become dehydrated when the body loses too much water either through illnesses such as severe or prolonged attacks of and high fevers, or sweating in hot weather.
Nursing home residents are at greater risk of becoming dehydrated and it can be particularly dangerous for them. The propensity for dehydration is particularly high for elderly nursing home residents because of their decreased thirst sensation. Dehydration can worsen existing health problems. Dehydration can lead to delirium, electrolyte abnormalities, dangerously low blood pressure, renal impairment, and ultimately to death.
Signs of dehydration include persistent fatigue, muscle weakness, lethargy, dizziness, nausea, confusion, or an increased heart rate. Dehydration is one of the most frequent causes of hospitalization after age 65.
Can Malnutrition and Dehydration be a Sign of Nursing Home Neglect or Abuse?
Dehydration and malnutrition can be indications of neglect and abuse in nursing homes. Part of the Nursing Home Reform Act of 1987 makes it federal law for nursing homes to provide adequate nutrition for nursing home residents. Nursing homes must frequently assess the nutritional needs of residents and ensure residents have “well balanced, palatable meals.” In spite of this mandate, malnutrition and dehydration is an “ominous skeleton lurking in the nursing home
closet.”[2]
Studies show that 35 to 85 percent of the elderly living in the nation’s more that 17,000 nursing homes residents are malnourished.
[3]
Nursing home employees must be able to recognize the occurrence and consequences of malnutrition and dehydration. Malnutrition and dehydration lowers the quality of life for nursing home residents and it is usually completely avoidable. There are many factors that can cause malnutrition and dehydration in nursing home residents:
- Insufficient staffing or inadequately trained staff - one of the most common reasons is that too few staff are available to ensure nursing home residents are getting enough to eat and drink. In addition to ensuring that adequate numbers of staff are available, it is imperative that the staff is appropriately trained in proper feeding techniques. Neglect may be unintentional. A caring aid who is poorly trained may not know how to provide proper assistance. This important task is often left to overworked staff whose background and training may not prepare them for the complications that can arise related to the feeding of nursing home residents. In addition to insufficient staffing, there is a 93 percent per year staff turnover rate in nursing
homes.[4]
- Failure to provide supervision over staff or nutritional services. A nursing home may fail to provide supervision over those who are providing nutritional services or it might fail to provide the proper education for nursing assistants on nutrition and feeding techniques.
- Poor Eating Environment. Some nursing home environments can contribute to a nursing home resident’s lack of proper nourishment. Noise levels, impersonal staff, institutional food that doesn’t allow for food preferences or choice, uncomfortable seating and over-reliance on liquid supplements can all contribute to malnutrition. As many nursing home residents require some form of eating assistance, often it is easier for the nursing home staff to offer liquid supplements instead of sitting with the resident during meals to make sure they eat enough food to get the vitamins and minerals they need.
Preventing malnutrition and dehydration in nursing home residents requires time, effort and adequate staffing. Nursing homes that accept patients who are at risk for dehydration and malnutrition must be equipped to provide the skilled help necessary to prevent it. When an assisted living facility or nursing home accepts residents whose need or acuity levels exceed the staff’s skill or training then it can be liable for nursing home neglect and nursing home abuse.Our firm represents persons injured or killed as the result of negligence committed by nursing homes, assisted living facilities and other health care providers.
Our Nursing Home Neglect and Nursing Home Abuse lawyers have years of experience pursuing cases involving the neglect and abuse of this vulnerable segment of our population. If you or a loved one has experience nursing home abuse or nursing home neglect, perhaps we can help.
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Sources:
American Health Care Association, Facts & Trends,
Washington D.C. -1998
Burger, Sarah Greene Jeanie Kayser-Jones, and Julie Prince, “Malnutrition and Dehydration in Nursing Homes: Key Issues in Prevention and Treatment” , National Citizens’ Coalition for Nursing Home Reform, the Commonwealth Fund, July 2000.
Cohen, Donna, “Dementia, Depression & Nutritional Status,” Primary Care 21 (March 1994) 107:117
Cope, Kathy, “Malnutrition in the Elderly: A National Crisis,” U.S. Government Printing Office, 1997.
Kayser – Jones, J., Schell, E., “Factors Contributing to Dehydration in Nursing Homes: Inadequate Staffing, and Lack of Professional Supervision.” Journal of American Geriatrics Society. 1999, 47(1187-1194).
Richardson J.P. Preventive Health care for Nursing Homes, Am J. Geriatric Soc. 1998 Jan; Vol(1) 118.
http://www.nccnhr.org/ National Coalition for Nursing Home Reform
(“NCCNHR”).
[1] Burger, Sarah Greene, Kayser-Jones, Jeanie and Prince, Julie, “Malnutrition and Dehydration in Nursing Homes: Key Issues in Prevention and Treatment”, National Citizens’ Coalition for Nursing Home Reform, The Commonwealth Fund, July 2000
[2] Sullivan, Dennis, “Impact of Nutritional Status on Health Outcomes of Nursing Home Residents.” Journal of the American Geriatrics Society, 1995, 43, p.95
[3] Abassi, A. and Rudman, D., “Undernutrition in Nursing Homes: Prevalence, Consequences, Causes and Prevention in Nursing Homes.” Nutrition Reviews (1994):133-122
[4] Malnutrition and Dehydration in Nursing Homes
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