Case Management, Elder Care Management, Life Care Plan

Take Malnutrition Off The Menu

 May 17, 2016

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

You’re having breakfast with friends on a Sunday. Everyone is scarfing down bacon. One of your friends is excitedly telling the group how, within a short span of time, his neighborhood has gained four new fast food joints. The conversation jumps around to topics such as the newest buffalo wing flavors or methods of bacon preparation. It never deviates from the general theme of food and not just any food. These are average Americans caught up in the reverie of a beloved past time: questing after the next fried, fatty fast food over-indulgence. Nutrition doesn’t quite occur to anyone when the goal is to spend some hard-earned money and eat away at the stress caused by earning said money. It never has a moment to sink in when raising a family. Let’s not even get into the fact that bad habits are probably already being passed on to children. All of this can only explain how a danger as plain and simple as malnutrition still manages to cost the United States billions of dollars a year. That’s right, we’re talking about poor nutrition. It’s not just a matter of minding ingredients and eating your green veggies. It is overall imbalance in intake, good old-fashioned American excess.  Factor capitalism into this discussion and you have a solid case for the argument that malnutrition is systemic. Let’s have a look at some cause and effect.

Basic Facts

One in three patients admitted to hospitals suffer from malnutrition; just as many experience a decline in nutrition during their stay. Let’s just say further prognosis can’t be too good. In fact, malnutrition has been known to increase the length of hospital stays by four to six days. Health advocates are already pushing for malnutrition treatment plans so the problem can be caught early and monitored with an appropriate follow-up prescribed.

Early Care

When it comes to short term effects, malnutrition can inflict major damage on young children. After all, so much growth occurs in the earliest years of one’s life. A nutrition deficiency means denying the growing process the fuel it requires to do so. What sort of effects are we talking about?

Malnutrition’s Effects on the Immune System

This would have to be the most obvious. Certain vitamins strengthen the immune system. Without them, the immune system weakens and becomes susceptible to infectious disease.   Just imagine the work a child’s immune system is faced with while pretty much every other part of the child is growing exponentially. Do you think nutrition deficiency impacts that growth? You bet it does. It begins with a gastrointestinal infection and only gets worse from there. Such an infection then prevents further nutrients from being absorbed properly. A terrible snowball effect can lead to stunting of growth. Deficiency in some vitamins can cause conditions that lead to deficiency in others. It is a compounding effect.

Malnutrition’s Effects on Growth & Development

What are the long term effects of malnutrition on the growth of a young person? Considering what may have occurred in terms of bone growth and development, being of low height for a certain age could be the least of concerns.  Nutritional deprivation most certainly results in cognitive impairment and brain development as well. That means interference with motor skills, in addition to the cognitive complications. Specific delays can be traced back to malnutrition:

  • Attention deficit disorder
  • Impaired school performance
  • Decreased IQ scores
  • Memory deficiency
  • Learning disabilities
  • Reduced social skills
  • Reduced language development
  • Reduced problem-solving abilities

Elder Care

Let’s talk about older folks. What is the most common fear as long as elders are up and walking about? You probably answered “falling” but you also probably blame that on diminished balance or coordination.  Did you know that malnutrition reduces muscle mass? The condition is known as sarcopenia. Malnutrition has been known to lead to sarcopenia which in turn has been linked to higher risk of falling among older adults. So how can those of us in elder care management prevent this all from coming to pass? Here are some ideas:

Make them a fan of healthy eating!

Start with their food choices, encouraging those that are full of nutrients such as fruits, vegetables, whole grains and lean meats. Limit solid fats, sugars, alcoholic beverages and salt. Present healthy options in snack form, between meals. Most importantly, make it taste good! One does not need to be an elder to know that healthy eating has a reputation for blandness. It is even anticipated. Cut this off at the pass by preparing food with flavoring such as herbs and spices. Just avoid the salt.

Add supplements!

Nutritional supplements are also an option. Many elders have diminished appetites. You may not always be able to fit the amount of nutrition that you wanted into their meals or even their snacks. A doctor or nutritionist can recommend supplements in pill or even shake form.

Keep them on their toes!

Our elders may tire more easily or find themselves able to do less than they used to. This is still no excuse to leave them to a sedentary life. You don’t need to start them on a weight-lifting regiment or sign anyone up for a marathon. Just maintaining the semblance of an active, social life ought to do the trick. If your loved one is home with you, keep them in touch with friends and take them to social events such as dinners, lunches or family gatherings. As long as he or she is walking from the house to the car to the destination and back again, you are giving them a reasonable amount of exercise.

Care Management

Ever since the passing of the Affordable Care Act, further progress has been pursued in terms of inclusion of coverage for previously disregarded conditions. It would be perfectly reasonable to push for malnutrition screening and therapy to be covered by basic health insurance. Furthermore, nutrition records and malnutrition status can be included in electronic health records.

Care managers are medical experts that devote the sum total of their knowledge and experience to filling in the blanks and picking up the slack when a client needs help caring for a loved one. The care managers at Advanced RM have extended their services to individuals suffering from:

  • Physical Disabilities Accident Injuries
  • Developmental Disabilities
  • Brain Injury
  • Spinal Cord Injury
  • Mental Health Problems
  • Chronic or Serious Illnesses
  • Dementia and Age Related Problems

Aside from accidents and injuries, malnutrition could very well play a part in a number of those, based on what we’ve discussed here. Our experience tells us that there are factors at play in what we do that predate our involvement, quite possibly by many years. Part of our focus must be preventative. We must think about causality. The elders we care for may feel a long way off from their formative years. That doesn’t change the fact that those formative years are what formed many of the health concerns they now face. It goes without saying that if malnutrition can be addressed in early years of development, a deadly domino effect can be avoided.

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