Proper nutrition and hydration are critical when it comes to maintaining good health for elderly people. Nursing homes are supposed to have policies and procedures on how to maintain correct levels of nutrition and hydration in their residents and how to respond when residents exhibit signs of malnutrition or dehydration. Unfortunately, in many nursing homes, there are not enough staff members to put the policies into effect or staff members are insufficiently trained on the very policies and procedures they are to implement.

Nursing homes are required to provide the care each resident needs.  It goes without saying that adequate food and water is a requirement.  Yet, far too often, nursing homes fail to provide residents with sufficient food and water.  If your family member is in a nursing home, you may have faced this issue.  Accessible water is often hard to find for residents.  If water is available, it is often in a large container that the elderly resident is unable to life.  For residents with dementia, water may be accessible, but nursing home employees often fail to give residents a drink.  Similarly, residents who need assistance eating are often left to fend for themselves and fail to receive the necessary sustenance.

Simply stated, malnutrition is the lack of proper nutrition. Some elderly nursing home residents often have difficulty in swallowing or present with other physical or mental challenges that compromise their ability to ingest food. Other residents have good appetites, but need assistance with eating. Nursing homes have many options at their disposal in assisting residents with eating. The easiest is having adequate staff to assist residents yet too many nursing homes staff their facilities to the point that there is little, if any, assistance with feeding.

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Nursing homes are also required to provide appetizing food and promote an environment conducive to eating. Loud dining rooms permeated by foul smells do not promote eating. Moreover, nursing home corporations often budget on average $4.00 per day for resident food, making the creation of appetizing food a challenge.

Dehydration is simply fluid deprivation. One of the easiest tasks to accomplish in a nursing home is to keep residents hydrated. Some residents are unable to access water on their own, while other residents may be on medications that require additional monitoring to avoid dehydration. Regardless, residents are often totally dependent upon nursing home staff members to give them a drink of water. Unfortunately, overworked staff members often forget to accomplish this simple task and fail to properly monitor those with additional needs.

When a resident becomes malnourished or dehydrated, they become susceptible to a host of additional medical problems, such as bed sores, infection and pneumonia.

How Can I Recognize Malnutrition Or Dehydration In My Family Member?

Sometimes changes can be subtle and if you visit your loved one every day, you may not notice gradual changes.  In addition to periodically doing a thorough examination of your loved one for bruises and wounds, you should check them for signs of dehydration and malnutrition.

     Common Signs of Dehydration

• Thirst
• Darker and more concentrated urine
• Fatigue
• Decreased urine output
• Light headedness/dizziness
• Muscle cramps
• Nausea and vomiting

      Common Signs of Malnutrition

• Significant weight loss
• Fatigue
• Light headedness/dizziness

Additional Resources

There are numerous resources available to help you if you believe your family member is receiving insufficient food and water.  Below are some links that will help you learn more about the issues and what you can do to protect your loved one.

• The National Consumer Voice For Quality Long Term Care (formerly National Citizens' Coalition for Nursing Home Reform) report on malnutrition and dehydration can be found here.
• Science Daily: Brain Malfunction Explains Dehydration in Elderly

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