Weight Loss

In the nursing home setting, significant weight loss is defined as loss of 5% or more in the last 30 days or 10% or more in the last 180 days. Much weight loss can be prevented in the nursing home with proper care.

What are risk factors for weight loss?

Required assistance to eat or drink
Choking/swallowing problem
Refusals of food and fluids
Decreased meal consumption
Visual impairments
Poor condition of teeth that may cause pain with eating and problems chewing
Poor fitting dentures
Dementia/delirium
Depression
Chronic pain
Constipation
Medication side effects and interactions
Infections
Swallowing difficulties
Taste alterations
Smells of urine and stool in the nursing home

What can the nursing home do to reverse weight loss?

Encourage foods based on resident’s likes and dislikes
Request order for nutritional supplements that are calorie dense
Schedule weekly weights
Encourage a relaxed mealtime where intake is not rushed
Request dietitian consultation
Initiate intake and output monitoring (if not eating, probably not drinking, and some weight loss may be due to fluid loss)
Evaluate and document all meal consumption
Update the care plan with new nursing interventions
Request a dental evaluation, if necessary to treat poor condition of teeth or dentures, which may resolve chewing difficulties
Request social services to consult if depression is a likely cause
If medication side effects are a likely cause, consult with the physician or consultant pharmacist

Questions you can ask the nursing home regarding weight loss:

How does the nursing home determine the cause of weight loss in residents?
How flexible is the nursing home in tailoring meals and foods to individual preferences?
Does the nursing home have a program to rapidly and correctly notice change in nutrition?
How does the nursing home address issues that may affect the eating environment?

Resources

Evaluating and Treating Unintentional Weight Loss in the Elderly

Department of Health and Human Services – Emerging Practices in Nursing Homes

Comprehensive Multidisciplinary Assessment of the Demented Nursing Home Resident with Weight Loss

Phone: 260-420-3137 Toll Free: 866-793-6339

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