Nutrition is always important to health, but it becomes even more important for the elderly. This goes double for folks who are in assisted living facilities or nursing homes. When nutrition falls short, a person’s health can suffer, and they might even die.
Inadequate nutrition plans at nursing homes are a form of neglect just as bad as overt elder abuse. If you’re worried about protecting the rights of a loved one, it is important to understand how an inadequate nutrition plan leads to decline.
How Proper Nutrition Sustains Nursing Home Residents
One of the biggest challenges for aging people is that they often consume fewer calories while having more specific nutrient requirements. For example, Vitamin D and calcium are essential for bone density, especially when it comes to women with osteoporosis or other fracture risks. Getting those extra nutrients requires planning when a person is often consuming less.
Many nursing home residents have specific nutritional needs related to health concerns, too.
- Immune function and wound care benefit from zinc, vitamin C, and protein.
- Cognitive health is better sustained with steady glucose, B vitamins, and omega-3 fatty acids.
- Mobility and strength are easier to maintain when calorie and protein intake are sufficient.
Many issues also compound in nursing home settings. For example, social isolation can lead to depression in long-term care. This subsequently often leads to a decline in calorie consumption, which undermines nutrient intake.
Interactions between multiple drugs, food, and appetite can also present major nutrition challenges. Some drugs reduce the absorption of specific vitamins, for example. This can lead to unseen attrition that leads to a resident wasting away. Other drugs may reduce appetite. Worse, the interactions of drugs can trigger surprising nutritional outcomes. Throw in concerns with patients who have trouble swallowing, and this is a formula for malnutrition in a group of people who can least afford it.
What Amounts to Adequate Nutrition?
The law requires a standard of care, and this underlines what counts as negligence. However, it might feel a little difficult to legally define something like adequate nutrition.
Federal regulations, however, do answer this question very well. Guidelines for nursing homes include requirements for residents to receive a well-balanced diet that’s nourishing and palatable within the limits of their special dietary needs. Medicare and Medicaid also require facilities to employ or contract a qualified dietician who has to be involved in resident care.
Nursing homes must also perform a comprehensive nutritional assessment within 14 days of admitting a new resident. Likewise, they need to regularly update it and make adjustments as a resident’s condition changes.
An individualized plan needs to address and document the baseline for a resident, such as their BMI, dietary history and needs, and related lab results. The nursing home also has to account for specific dietary needs with meal plans, such as low sodium for individuals who have suffered heart failure or carbohydrate restrictions for those with diabetes.
Facilities need to additionally address cultural and religious requirements. Similarly, they should make an effort to accommodate individual food preferences.
Nutritional plans extend to hydration, too. Elderly residents often have hydration issues, and a plan needs to be in place to make sure they stay hydrated.
Staff members are responsible throughout this entire process. Nursing aides need to be present to execute the plan, including assisting those who can’t self-feed and teaching proper technique to individuals who struggle with eating. Nurses also need to document refusals to eat, signs of weight loss, and changes in appetite so the dietary staff can address concerns.
How Facilities Fail
Many nursing homes treat meal service as a formality rather than an individualized plan. This leads to problems like insufficient protein or calorie intake, poor hydration, or rushing meals. Staff also sometimes fail in monitoring things like dry mouth, blood urea levels, and loss of muscle mass.
Worse, residents may weaken as this all happens. What looks like a fall due to deteriorating condition, for example, might be fundamentally the result of inadequate nutrition.
Malnutrition is also a major contributor to bed sores. Skin integrity breaks down, and healing is slower. The worst cases can lead to skin abscesses and even gangrene.
Immune system decline also frequently occurs and is ignored. An individual might suffer low white blood cell counts, for example, because of malnutrition. People often dismiss this as an elderly person just being sickly. Instead, the person could experience respiratory infections, UTIs, wound healing problems, and even sepsis due to malnutrition.
Cognitive decline often follows inadequate nutrition, too. Disorders like Wernicke’s encephalopathy, a B vitamin deficiency more commonly seen in alcoholics, can appear. Peripheral neuropathy issues, such as tingling fingers and toes, may indicate a B12 deficiency. Dehydration triggers delirium. Malnutrition can also accelerate Alzheimer’s and other types of dementia.
Unintended weight loss often happens rapidly. Medicare and Medicaid define this as a 5% loss in one month or 10% over six months. They require an investigation and a change to the resident’s meal plan.
What Can You Do?
More than anything, document what is happening. Take pictures and ask questions. All authorized representatives, usually meaning family members with legal powers, are entitled to access records related to everything from weight to care plans. You can share your concerns with a nursing home abuse lawyer to learn whether the situation constitutes neglect or is the product of natural decline.
Make sure to formally complain, too. Report concerns to the facility’s Director of Nursing. Likewise, every state has an agency that oversees nursing homes.
Do not accept the notion that infections, weight loss, and other forms of decline are just part of aging. You have the right to question whether a facility’s nutrition plan was adequate. Failures can rise to the level of neglect and abuse, and you have the right to demand compensation and justice. By filing a lawsuit, you can help hold facilities that are negligent accountable, and help protect nursing home residents across the country.