Medical Issues in Nursing Homes

Malnutrition
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 nursing home residents' lives, and is often avoidable.

Based on the nutritional assessment, the facility must take steps to ensure that the resident maintains 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 amounts of the vitamins, minerals, protein, and calories the resident needs:

Physical Causes:
Illness
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
Depression
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

Environmental Causes:
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:
Ask the following questions to determine whether your loved one is demonstrating signs of malnutrition:
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 more 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?

Source: www.nursinghomealert.com