Malnutrition

Malnutrition is a very prevalent condition resulting from an incomplete diet. There are several indicators of malnutrition including weight loss declined protein status. Protein, fat, carbohydrate, vitamins and minerals are necessary components of every diet. When a diet is incomplete in any category, malnutrition can occur.

Involuntary weight loss is often an indication of failure to thrive. Dietary managers and dietitians use it in long term care centers as a dietary measuring stick. There are defined parameters of weight loss used to indicate the severity of malnutrition (5% in 30 days, 7.5% in 90 days, or 10% in 180 days). When weight loss meets the parameters, long term care centers must develop specific interventions to show that they have addressed the condition.

Interventions for involuntary Weight Loss

• Monitor meal time intake
• Offer snacks at all activities
• Provide six small meals per day
• Use high calorie high protein shakes between meals
• Follow a medication pass program that delivers calorie dense means of delivering medications
• Keep an updated list of likes and dislikes
• Assure proper table side positioning at meals

Pressure Ulcers

Pressure Ulcers, Decubitus Ulcers or Bed Sores are all different names for the same problem. Pressure ulcers are an on going battle in many long-term care centers. Risk factors are numerous and each pressure ulcer needs to be reviewed by an interdisciplinary team. Obesity, incontinence, protein malnutrition, dehydration, and reduced mobility are just a few of the common factors for pressure areas.

The law of pressure ulcers is clear ---Prevention is much easier than correction.

Watch for pressure ulcer risk factors:

• Obesity
• Incontinence
• Reduced ability to reposition limbs or body in bed
• Weight loss
• Dehydration
• Eats less than 50% at meals

Interventions for pressure areas

• Include a nurse, dietitian and physical therapists on observation of resident and environment
• Include at risk residents on hydration at risk list
• Reposition resident frequently
• Change linens and keep bed free of food and crumbs
• Include at risk resident on weight loss tracking
• Use caution when assisting and moving at risk residents to avoid causing a skin tear