Signs or Symptoms of Abuse or Neglect
Sudden Change in Weight or Unexplained Weight Loss
Unanticipated weight loss can be a serious risk to an elder’s health and wellbeing. Unintentional weight loss is a serious and correctable problem in our long term care system. As the referenced study makes clear, providing residents with feeding and fluid assistance, while requiring significant staff time, is effective in promoting weight gain. Poor nutrition also increases one’s risk for the development of pressure sores and also adversely impact a patient’s ability to heal from a wound or other injury.
In the nursing home context, a clinically significant weight loss episode is defined as a loss equal to or greater than 5% within a 30-day period or 10% within a 180-day period. A recent study including 900 NH residents showed that 48% experienced at least one weight loss episode equal to or greater than 5% of their body weight within 30 days, and 18% experienced this magnitude of loss more than once based on seven consecutive monthly weight values. This study also showed that a weight loss episode equal to or greater than 5% within 30 days was associated with an increased risk of death.4Sullivan DH, Johnson LE, Bopp MM, et al. Prognostic significance of monthly weight fluctuations among older nursing home residents. J Gerontol A:Bio Sci Med Sci. 2004;59A:633–639.
Nutritional levels can also be assessed by labs looking at albumin (protein) and total protein levels. You should insist on such labs being undertaken every 6 months for patients who may be nutritionally compromised.