Choose a disease, condition, or situation in which a patient is likely to develop malnutrition and
describe the characteristics or details of it. Note how malnutrition might develop in a patient (this
could be a result of treatments, financial issues, drug interactions, etc.) and possible
consequences of the malnutrition. In addition, discuss how malnutrition may be prevented,
managed, or reversed in the patient. Are there specific tests that can be done to determine the
nutritional status of your patient?
Older adults are more susceptible to malnutrition because they have weakened immune systems.
Dementia is a condition that affects some older adults and often increases the risk of malnutrition.
Malnutrition is often caused by too little food or not enough nutrients in the food that is being eaten (Mayo
Clinic Staff, 2014); however, the reasons for this may be more complex. There is often a combination of
physical, social and psychological factors that contribute to malnutrition (Mayo Clinic Staff, 2014). People
that have dementia may develop trouble swallowing or chewing making it very hard for them to get the
nutrients they need to avoid malnutrition (Royal College of Nursing, n.d.). The elderly are often on fixed
incomes, and living on a fixed income may compromise the food that they can afford. They often opt for
cheaper food alternatives that may not offer the same nutrients as fresh food. Furthermore, with
dementia, social contact is often decreased for the individual, and eating may not be enjoyable and may
be skipped more often for this reason (Mayo Clinic Staff, 2014). Malnutrition can weaken the immune
system making the person more susceptible to infections and also making it harder for that person to fight
off the infection (Orphan Nutrition, n.d.). Malnutrition in the elderly can also lead to fatigue, decreased
muscle function, difficulty breathing and a worsening in memory retention and confusion (Flinders, n.d.).
There are several ways to prevent malnutrition in the elderly, and in those with dementia. In order to
increase the intake of food on a daily basis, elderly should try to eat smaller meals more frequently
throughout the day. It is also helpful to introduce extra protein and calories in the types of food and drink
being ingested, such as milk, cheese and vegetables high in protein (Flinders, n.d.). Making sure foods
are nutritious high energy, well balanced and high in protein will help the elderly person to maintain a
balanced diet which helps prevent malnutrition. Furthermore, drinking plenty of fluids is essential. Other
than maintaining a balanced diet, making sure that oral hygiene is maintained may prevent malnutrition
(Flinders, n.d.). This is important so that the elderly are not kept from eating because of mouth pain.
Support systems are another important aspect of preventing malnutrition. Often times the elderly are
alone, so having friends, family or care takers around to encourage eating and nutrition or to help
cook/prepare meals is one recommendation for minimizing the risk of malnutrition (Flinders, n.d.).
If malnutrition does occur, there are several ways to manage and even reverse it. One of the most
important things is to talk to a doctor to identify the severity and determine the factors that have
contributed to the malnutrition. They may be able to adjust medications or prescribe medications if pain is
the reason that the person is unable to eat (Mayo Clinic Staff, 2014). Another thing that can be done is to
adjust the person’s diet to increase their protein and nutrient intake. Eating foods like fruits, vegetables
and nuts will help to reverse malnutrition. Increasing overall caloric intake will also help, so having
convenient, nutritious snacks readily available will make getting extra calories for energy easier (Mayo
Clinic Staff, 2014). With people with dementia having in home care or people to bring meals will
encourage eating, otherwise a person with dementia may forget to eat (Mayo Clinic Staff, 2014). Having
people around during meal time will make it more of a social event as well, which could encourage eating.
Blood tests can be done to determine the individuals nutritional status if malnutrition is a concern.
Hemoglobin and hematocrit levels can be measured, and if they fall below a certain level, a person’s
nutritional status is not good (Laboratory assessment of nutritional status, 1973). Vitamins such as
thiamine, riboflavin, niacin, and vitamin C, A, D, E, and K levels in the blood can be measured to
determine nutritional status. Other minerals and level of blood lipids can also be measured (Laboratory
assessment of nutritional status, 1973). All these together can be used to determine a person’s nutritional
status and can be used to identify malnutrition.
References
Flinders, Kate. (n.d.). How To Prevent Malnutrition In The Elderly. Aged Care Nutrition Services.
Retrieved from
http://agedcare-nutrition.com.au/resources/prevent-malnutrition-in-elderly
Laboratory assessment of nutritional status (November 1973). AJPH Supplement, Vol. 63. Retrieved
from
http://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.63.11_Suppl.28
Mayo Clinic Staff. (13 September, 2014). Senior health: How to prevent and detect malnutrition.
Mayo Clinic. Retrieved from
http://www.mayoclinic.org/healthy-living/caregivers/in-depth/senior-health/art-20044699
Orphan Nutrition. (n.d.). Impact of malnutrition on health and development. Joint Council. Retrieved from
http://www.orphannutrition.org/understanding-malnutrition/impact-of-malnutrition-on-health-anddevelopment/
Royal College of Nursing. (n.d.). Nutrition for specific groups. Retrieved from
http://www.rcn.org.uk/development/practice/nutrition/nutrition_for_specific_groups
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