Most people know that malnutrition is a major contributor to increased morbidity and mortality. But, did you know that nutrition can be a contributing factor for hospital readmissions? Because of this, home health agencies and other post-acute care settings can play a key role in identifying patients with malnutrition or hydration related issues. Staff education on nutrition interventions can have a tremendous impact. For instance, it can help ensure that patients are consuming nourishing foods to prevent further decline. The Academy of Nutrition and Dietetics and The American Society of Enteral and Parenteral Nutrition (ASPEN) developed a standardized set of diagnostic characteristics used to identify and document malnutrition.
How to identify malnutrition
For frail older adults, unintended weight loss, malnutrition, sarcopenia, and frailty are genuine concerns. This is because these conditions can lead to reduced functional ability and increased dependence. So, preventing these complications is critical. Approximately 45% of the older adults in the U. S. have sarcopenia, the progressive loss of muscle mass, function, quality, and strength due to the aging process. As a result, this can lead to diminished strength and decreased activity levels. With less strength comes mobility issues, osteoporosis, falls, fractures, frailty, and more.
What protocols should you follow?
To ensure high-quality nutritional care, home-care organizations should develop key parameters and protocols. These should measure nutrition and dehydration status as well as provide appropriate tools and guidelines for caregivers to screen and monitor patients. If implemented correctly, can result in improved outcomes and reduce hospital readmissions. Wound care, congestive heart failure, diabetes, and renal disease specifically include nutrition as part of the care planning process. As such, be sure to discuss nutrition management and malnutrition evaluations routinely with patients upon each visit.
Screening questions for each visit
Incorporating some of the questions listed below into your screening and evaluating process can help your organization keep nutrition on the forefront:
- Food security – For example, is the patient able to secure and prepare the appropriate amount of food needed to sustain nutrition parameters?
- Intake – Does the current intake of food groups meet nutritional needs based on USDA Dietary Guidelines? Are they consuming enough fluids?
- Weight – For instance, has weight loss occurred, and are there ongoing weight evaluations accurately? Is there an insidious unplanned weight loss?
- Education – does the client understand the importance of nutrition in resolving related issues? Does your staff know how to provide proper education?
Health care professionals should use a validated nutrition screening tool to identify individuals at risk of malnutrition. If the nutrition screening process determines that a patient is at high risk of malnutrition, a referral should be made to Registered Dietitians to follow the nutrition care process.
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