Malnutrition and Dehydration in Nursing Homes

Nursing homes are required to provide well-balanced meals to residents and have adequate personnel to feed those that need assistance in eating and drinking. Residents with dementia are sometimes difficult to feed because they do not want to eat or refuse help from certain people they do not have a special bond with. Some residents eat so slowly and it is hard for some staff members to be patient.

Residents who do not receive adequate nutrition and hydration are at a higher risk for the development of pressure ulcers, infection, weakness leading to immobility, weight loss, renal failure, urinary tract infections, falls Malnutrition and dehydration make it more difficult for existing pressure ulcers and infections to heal.

There are a variety of factors which can lead to malnutrition and dehydration. Depression, an increasing problem among the elderly, is a potential cause of malnutrition and dehydration because individuals suffering from depression have a tendency to eat and drink less and in turn to do not receive appropriate vitamins and minerals to prevent malnutrition or dehydration.

Other causes of malnutrition include dementia, difficulty swallowing, and adverse drug effects such as vomiting and diarrhea. Nursing homes often fail to take steps to prevent malnutrition and dehydration by not monitoring resident food & water intake and output, not assisting with meals, not providing the appropriate diet, not providing a comfortable environment to promote eating and not providing food that is appetizing.

Increasing fluid intake in the elderly is very important. The nursing home should implement a hydration program for anyone who might be at risk for dehydration. The plan should include assisting the person with drinking, offering fluids at mealtime and in between meals, looking for signs and symptoms of dehydration, notifying the physician if such signs and symptoms are present, recording the resident's fluid intake and intravenous fluid replacement when the physician deems it necessary.

Malnutrition can lead to a variety of health problems, such as:

• Dull eyes
• Pale skin, lips or mouth
• Poor skin elasticity
• Confusion and disorientation
• Swollen arms and lower legs (edema)
• Swollen lips, gums and/or dry tongue, cracks around the mouth
• Thinning hair
• Weight loss
• Falls
• Wounds that take longer than usual to heal

Dehydration can lead to a variety of health problems, such as:

• Confusion and disorientation
• Urinary tract infections
• Bedsores
• Pneumonia
• Death
• Renal failure
• Weight loss
• Stroke
• Weak, rapid pulse


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