Malnutrition and Dehydration Are Signs of Nursing Home Neglect and Abuse

It’s natural to expect that seniors will have challenges in their advanced years, even while they are residents of nursing homes. What’s not natural, and what’s completely wrong, is for nursing care residents to suffer so much neglect that they fail to get the nutrition and liquids they need to stay healthy. Nutritional well-being is critical for all age groups, yet many nursing homes fail to provide these simple foundations for life.

The Nursing Home Reform Act (NHRA) establishes quality standards of care for nursing homes that receive payments from Medicare or Medicaid. The majority of nursing homes receive these federal payments. Among the many services nursing homes must provide their patients are dietary services, comprehensive care plans for each patient, nursing services, and pharmaceutical services.

What is malnutrition?

John Hopkins University defines malnutrition as the health condition that results when your body doesn’t get the minerals, vitamins, and nutrients it needs to sustain organ function and healthy tissues. Malnutrition includes people who are both undernourished and people who are over-nourished.

• Undernutrition occurs when a nursing home resident doesn’t get enough essential nutrients or when the nutrients are “excreted more rapidly than they can be replaced.”
• Overnutrition happens if a senior eats too much, eats the wrong things, doesn’t get the exercise they need, or takes too many dietary supplements and vitamins. Diets high in fat and salt are leading contributors to over-nourishment.

Nursing homes should monitor the diets of their residents. They should work with nurses and nutritionists who regularly review whether the residents are eating quality foods, not getting the healthy foods they need, or if they are eating too much junk food.

Some of the practical factors that aid in nutrition are addressing the emotional needs of the residents. Negative moods and feelings can cause residents to fail to eat or to eat too much unhealthy food. Nursing homes generally should encourage residents to eat with other residents in dining room settings if possible. Exercise, based on the cardiac and other health issues of the residents, should also be reviewed. For many residents, simply exposure to fresh air may be helpful.

Some residents may require special diets, and some residents may need to supplement their food with nutritious liquids. Nurses and staff should be aware of whether a patient has any dental, swallowing, or other oral health difficulties.

What are the symptoms and side effects of malnutrition?

John Hopkins reports that people who are suffering from malnutrition may:

• Bruise easily
• Have pale, dry, or thick skin
• Have rashes
• Suffer from achy joints and tender bones
• Have gums that may bleed easily
• Have sensitivity to light and glare

Other malnutrition symptoms include:

• Tiredness
• Fatigue
• Loose clothing
• Weakness
• Memory loss
• Weakened immune system

Treatment for malnutrition includes access to more nutritional foods, as well as ensuring the resident is eating well and on schedule. If a resident cannot take nutrients orally, then intravenous feeding through a tube in the gastrointestinal tract may be required.

What is dehydration?

Johns Hopkins defines dehydration as not having enough water in your body. Human bodies need a lot of water. Mild dehydration can affect your heart rate, blood pressure, and body temperature. Severe dehydration can cause weakness, confusion, brain damage, and even death.

Seniors may suffer dehydration from not consuming enough liquids, experiencing diarrhea, fever, sweating, or vomiting. Dehydration can lead to a lack of sodium, calcium, potassium, and magnesium. Special attention is required for seniors because many medications (like diuretics) reduce the volume of water in their bodies, increasing the risk of dehydration.

What are the symptoms and side effects of dehydration?

The signs and symptoms of dehydration include:

• Thirst
• Fatigue
• Dizziness and lightheadedness
• Dry mouth
• Muscle cramps
• Producing less urine
• Dark urine or light brown urine
• Headaches
• Dry skin
• Dry tongue
• Fainting
• Confusion
• Fast breathing
• Quickened heart rate

Other dehydration signs include infections, eyes that don’t produce tears, and clammy skin.

Signs of malnutrition and/or dehydration also include unexplained weight loss, thinning hair, and poor skin elasticity.

If dehydration is not properly treated, a resident can suffer kidney damage, brain damage, or death.

Dehydration treatments vary depending on the underlying cause, the age of the resident, and the resident’s overall health. The nurse or physician should diagnose and treat the underlying condition. Residents may require intravenous fluids. Severe dehydration is considered a medical emergency.

Johns Hopkins adds that drinking fluids helps mild dehydration. In addition to replacing water, a body’s electrolytes (such as sodium and potassium) also need replacement. Sports drinks, fruit juices, tea, and soda can help. However, residents should not drink any drinks with caffeine or alcohol – these can cause the body to lose more water.

Residents who suffer from malnutrition and/or dehydration should receive prompt medical care.

Responsibility for malnutrition and dehydration in nursing homes.

Malnutrition and dehydration are often due to understaffing. Nursing homes should have enough medical and personal staff to attend to the health needs of all their residents. Residents rely on the staff for timely meals, for the food and drink they need during the day, and for providing water easily within reach.

Other causes of malnutrition and dehydration include:

• Improper staff training
• Lack of access to food, drink, exercise, and socializing
• Intentionally withholding water or food from a resident
• Not understanding a resident’s dietary restrictions

Nursing home staff should monitor residents for the physical and behavioral signs of malnutrition or dehydration.

It helps if family members and friends also observe and talk with their parents or loved ones when they visit. For example, if they’re constantly asking for water, look like they’re losing weight, or lack energy – these may be signs of poor nutrition. Family members and friends may consider speaking with the staff.

If a resident or relative suspects malnutrition or dehydration, the best remedy is to speak with an experienced nursing home attorney. At Gainsberg Injury and Accident Lawyers, our Chicago nursing home lawyers have been protecting seniors for more than 20 years. We fight to show a nursing home facility was negligent or committed abuse. To discuss any nursing home mistreatment, call us at 312.600.9585 or use our contact form to make an appointment.