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Nutrition and Hydration at Nursing Homes
One of the most important ways to ensure good health is through proper nutrition and hydration levels that meet personal requirements. Nutrition and hydration needs are unique to each person. For this reason, nursing homes are required to have individual nutrition plans for each resident. Unfortunately, some facilities fail to meet these requirements, resulting in serious or even fatal consequences for their residents.
This overview provides information about nursing home federal nutrition and hydration guidelines, the causes of malnutrition and dehydration, and the warning signs of malnutrition and dehydration so that you can monitor facility oversight and prevent any problems related to nutrition and hydration for you loved ones.
Federal Regulation
Today, most nursing homes receive federal funding. If a nursing home receives federal funding, it must comply with federal regulations set forth in the Nursing Home Reform Act. Under the federal standards, a nursing home must provide each resident with the "necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being." 42 C.F.R. § 483.25.
The standards require nursing homes to conduct a comprehensive, accurate, standardized, and reproducible assessment of each resident's functional capacity. 42 C.F.R. § 483.20. The assessment should gather information about the resident's health and functional abilities, including information about eating habits and nutritional needs.
Based on the assessment, the nursing home should develop a comprehensive care plan for each resident. 42 C.F.R. § 483.20(d). Guided by the assessment, a facility "must ensure that a resident maintains acceptable parameters of nutritional status, such as body weight and protein levels," unless it is clinically impossible to do so. 42 C.F.R. § 483.25(i). In relation to hydration, a facility must "provide each resident with sufficient fluid intake to maintain proper hydration and health." 42 C.F.R. § 483.25(j).
What Causes Malnutrition and Dehydration at Nursing Homes?
There are many reasons that residents of nursing home facilities suffer from malnutrition and dehydration. While in some cases a resident's clinical condition may make maintenance of proper nutrition impossible, many times malnutrition may be caused by nursing home neglect. In such cases, family members should intervene on behalf of their loved ones.
Some causes for malnutrition that may be classified as neglect include:
- Inadequate staff to resident ratio
- Inadequate staff attention to residents needs, such as when a resident needs assistance with eating because of a tremor or other physical impairment
- Poor nutritional value of food served
- Poor taste of food served, thus decreasing appetite
- Adverse effects of drugs on appetite
- Failure to pay attention to resident's dental needs
Warning Signs of Malnutrition and Dehydration
If family members and friends of a nursing home resident feel that he or she is not receiving the sufficient nutrition, they need to make their concerns known. There are certain warning signs that may appear if a resident is malnourished or dehydrated. These may include:
- Complaint(s) of hunger
- Weight loss
- Increased infections or other illnesses
- Increased healing time for injuries or illnesses
- Increased occurrence of pressure sores
- Thinning hair
- Confusion and/or lightheadedness
- Dry lips and skin
- Sunken-in or dark eyes
- Increased fatigue or listlessness
Conclusion
A nursing home must provide each resident with the necessary care and services needed to attain or maintain the highest practicable physical, mental, and psychosocial well-being. Unfortunately, a staggering number of nursing home residents are malnourished. Many residents are simply unable to help themselves in obtaining proper nutrition, and staff may fail to assist them or recognize problems. When a nursing facility does not recognize malnutrition and dehydration, the residents' lives suffer. Therefore, it may be up to family and friends to recognize warning signs and discuss solutions with the facility. If discussions break down it may be time for legal action. To discuss your legal options regarding care of a nursing home patient, contact an experienced elder law attorney.
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