While it would seem to require little effort to avoid these conditions, malnutrition and dehydration are alarmingly prevalent in California long-term care facilities. They often occur together, and if left untreated can result in serious physical harm to the individual, including debilitating weakness and significant weight loss, both of which can lead to death. Malnutrition and dehydration can also indirectly lead to other conditions, such as bed sores and renal failure.
Malnutrition among the elderly is on the rise. According to one report, roughly 60% of hospitalized elderly persons, and anywhere from 35% to 85% of those in nursing homes, are suffering from malnutrition. A recent study found that 97% of elderly patients surveyed were malnourished, or were at risk of becoming malnourished, but only 19% were diagnosed, and of these a mere 7% were referred to a dietician.
While in some cases malnutrition results from a caregiver’s intentional malicious act, in many instances nursing homes are so dangerously understaffed that nurses are unable to complete daily tasks such as delivering meals to their residents’ bedsides. In many nursing homes, staff and other health care professionals are not sufficiently trained to identify the symptoms.
The risk of malnutrition is especially acute for residents who are incapable of feeding themselves. In an understaffed nursing home, the time required to feed these patients is too costly, and trays of food are sometimes delivered to a patient’s bedside, only to remain untouched because a staff member is unable to personally feed the patient.
Dehydration results when the body loses more water than it takes in. An eight percent reduction in fluid levels can cause illness, whereas a ten percent reduction can be fatal. The elderly are extremely susceptible to dehydration due to the incremental decrease in bodily fluids that accompanies aging. Compounding the problem is the fact that the aging body can make the symptoms difficult to discern. So even in those cases where a nursing home is properly staffed, dehydration may still go undetected because a nurse may not be sufficiently trained to notice the condition.
It does not take much for an elderly person to become dehydrated. Brief periods with no water, rooms with slightly elevated temperatures, and increases in body temperature can lead to dehydration. Additionally, elderly patients are often prescribed diuretic medications, such as those for heart disease, kidney disease, and liver disease, requiring that more fluids be added to their daily intake to prevent dehydration. The elderly also sometimes lose their ability to identify when they are thirsty, and thus are unable to alert a nurse of their need for water.
As with food, water is in many cases delivered to the elderly patient’s bedside, only to go untouched because the staff is too busy to administer it to patients who need assistance with drinking. In other cases, patients are left in warm rooms, causing elevated body temperatures.