Importance of Proper Nutrition and Hydration for Michigan Nursing Home Residents

Nursing homes must provide good nutrition and hydration to residents. Poor diet and lack of water are among the most common forms of nursing home abuse and neglect. Some of the health problems associated with malnutrition and/or dehydration include:

• Increased risk of infections
  
• Confusion
  
• Muscle weakness (possible immobility and increased risk of falls)
  
• Pressure ulcers or bedsores
  
• Pneumonia
  
• Increased risk of becoming ill from exposure to bacteria or viruses

Nursing homes should conduct regular nutritional assessments and provide residents with well-balanced, palatable meals. When you consider a nursing home for a loved one, you may wish to ask to sample a random meal at the facility. Also, ask to speak to the staff dietician about the factors he or she uses to develop meal plans for the facility.

The following is a list of reasons why an individual may suffer from malnutrition and/or dehydration:

Personal causes of malnutrition:

• Illness
  
• Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness
  
• Food and drug interactions that 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 or shakiness, which affect residents' ability to feed themselves
  

Environmental causes of malnutrition:

• Inadequate staff attention for residents who need help to eat
  
• Staff who lack training about malnutrition and the proper ways to feed residents who need help
  
• Reliance on liquid supplements
  
• Special diets
  

Signs that a resident is malnourished:

• Clothes fitting more loosely than usual
  
• Cracks around the mouth
  
• Pale looking lips or mouth
  
• Dentures that no longer fit
  
• Hair thinning or getting sparser
  
• Wounds that take longer to heal
  
• Confusion (which is unusual for that individual)
  
• Skin breaking down
  
• Sunken eyes
  
• Weight loss
  

The following questions may help you pinpoint the reason for a particular person’s problems with nutrition or hydration:

• 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?
  
• Is the resident's weight monitored on a regular basis?
  
• Has the staff informed family members of weight loss?
  
• Has staff asked family members for assistance?

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