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Hidden in plain sight: Malnutrition in the elderly



The incidence of malnutrition is widespread among institutionalized seniors, ranging from 23% to 60% of all patients. However, malnutrition is often hidden in plain sight since its symptoms can be mistaken for other conditions.


It’s important to identify and treat malnutrition as soon as possible, as it can have serious consequences in elderly patients. First, it can lead to a general decline in health and function. Malnourished seniors are more likely to experience falls, fractures and hospitalizations. They also have a higher risk of developing pressure ulcers, dementia and depression. Therefore, early detection is of the utmost importance.


The use of risk assessments is essential in the early detection of malnutrition and can signal the need for intervention before symptoms such as weight loss and lab changes occur.


Initial and ongoing nutritional risk assessments are vital in combatting malnutrition in elderly nursing home residents. Many nursing homes no longer have a full-time dietitian, and therefore it may be hard to thoroughly assess and identify changes in every resident.


The use of simple yet informative risk assessments that can be completed by nursing staff and then discussed with the interdisciplinary team ensures that facilities do not have to depend on the dietitian to identify or address risk factors.


Many electronic medical record software programs contain a variety of such nutritional risk assessments, including the Mini Nutritional Assessment – Short Form (MNA®-SF) developed by Nestle Nutritional Institute.


Identification of malnutrition and those at risk of malnutrition can also impact Medicare reimbursement and Quality Measure outcomes, making these assessments all the more essential.


When I started in the long-term care industry 20 years ago, nutrition wasn’t really on the forefront of my mind as a staff nurse and didn’t often take time to think about the effects that malnutrition could have on my residents.


As our industry has changed, it is important that every member of the interdisciplinary team understand the effects malnutrition can have on our beloved residents and our facilities, as well as ways to identify those most at risk of developing malnutrition so that early intervention can occur.


Veronica Birch is a dedicated nurse with over 20 years in the long-term care industry which included roles as Director of Nursing Services, MDS, and Licensed Nursing Home Administrator. She is currently a Healthcare Consultant and owns GEM Health Care Consulting LLC.


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