One of the most critical tasks in a nursing home is making sure the residents are getting proper nutrition and hydration. Good nutrition is keyed to overall health, mood, cognitive functioning, and wound healing. Additionally, eating is one of the very last pleasurable activities that someone with significant physical restrictions can do. The lawyers at Davis & Brusca are proud to be the nursing home dehydration and malnutrition lawyer New Jersey residents trust. Our lawyers have spent years working to serve the interests of nursing home residents in New Jersey, and we have come to know just how important good hydration is to virtually every one of the body’s various functions.
Unfortunately, feeding and drinking are some of the most labor-intensive tasks for the certified nurse aides who serve at the front lines of care in a nursing home. If the nursing home is understaffed, the vitally important task of insuring residents are fed correctly and receive enough fluids invariably falls by the wayside. There simply aren’t enough hours in the day for the aides to complete this task when the facility is understaffed. As a result, residents at understaffed facilities commonly suffer from malnutrition and dehydration. And the results are nothing short of catastrophic. Residents at these facilities frequently suffer significant weight loss, pressure wounds, kidney failure, and even death. As a result, it is critical that residents have a caring loved one who understands these conditions and their symptoms, and who can serve as a good advocate for the resident.
What is malnutrition? As top Nursing home dehydration and malnutrition lawyers in New Jersey, the lawyers at Davis & Brusca explain there are 2 parts to malnutrition: 1) Insufficient caloric intake; and 2) Inadequate types or combinations of food. The first part is simple: the patient is simply not getting enough calories in their daily diet to meet their needs. When a dietitian is called in to assess a resident who is at risk for malnutrition, their first response is generally to set a daily “target calorie rate.” The facility’s CNA staff will then track how much the resident is eating to insure this “target” is met. Where the resident needs intensive help, the nutritionist or dietitian may also recommend an order for a “calorie count.” This is typically done over a multi-day period where close monitoring is performed to see exactly how much the resident is eating over the set time. As noted, however, malnutrition is not simply caused by a caloric deficit. It can also arise if the person has a poor balance of food and nutrients in their diet.
“Malnutrition” can also develop if a person is not getting the right kind of foods. Put simply, our diets are broken down into different types of food, such as proteins and carbohydrates. The body needs a mix of these materials to function and uses them in different ways. For example, when a person is suffering from a bedsore and the body is trying to heal that wound, their body’s need for protein may increase, as that is a key nutrient for the “repair” of the damaged tissues. So when one uses the term “malnutrition,” it really means there is a potential deficit in one or both of these key areas. They are not receiving the right amounts and/or the correct types of food.
Dehydration is another basic area where nursing home residents frequently suffer. Put simply, a person will become dehydrated if they do not receive enough water. Human beings are mostly made up of water, and water is absolutely critical for our bodies and organs to function. Water can be received in many forms including juice, teas, protein drinks, and other electrolyte drinks. The amount of water required to sustain a person will be different for each individual. When individuals are not getting enough water, the results can be catastrophic. Making sure residents are drinking enough water also typically requires intensive CNA support.
A person’s nutritional and hydration status can be further compromised when they suffer from Alzheimer’s disease or some form of dementia. These residents are at high risk for malnutrition and dehydration because they may forget to eat and drink, or because they fail to understand the sensation of hunger and thirst as an cognitively intact person would. Through our years of experience as nursing home dehydration and malnutrition lawyers in New Jersey, the lawyers at Davis & Brusca have seen many cases in which residents with dementia were simply unable to effectively convey the fact that they were hungry or thirsty to the staff members charged with their care. As such, the obligation of anticipating the residents’ needs and preventing tragedy falls to the nursing home’s staff .
The best way to look for signs of malnutrition is to closely monitor the resident’s weight. Many residents will have an a medical order requiring their weight be checked at least once a month. However, this is not a strict rule and doctors can order weights done more frequently, including daily or weekly. Having an accurate weight as a reference point can be more valuable than visual observation of the person’s body. Visual observation may be restricted or inaccurate, as one’s view may be partially obscured by a resident’s clothing or bedding. As such, this manner of monitoring weight often fails to catch important changes in a reliable manner. Further, it may be difficult for family members or staff to visually notice a difference in a resident they see every day.
As New Jersey nursing home dehydration and malnutrition lawyers, we at Davis & Brusca also know that another important monitoring tool for malnutrition is a calorie count. A dietitian or nutritionist can work with CNA’s and nurses in order to track a patient’s intake, usually for a three day interval, in order to closely assess the type and quantify of food a resident is consuming.
Dehydration monitoring is done in a similar manner. Basically, the facility’s staff will monitor how much a person takes in and how much output there is (urine output). Monitoring for dehydration also relies on other signs, such as the skin turgor test. This is done by gently pinching and releasing a person’s skin in order to see how long it takes for the skin to return to its normal position. Dehydration will slow the amount of time it takes for the skin to return. Other symptoms of dehydration include confusion and disorientation as well as unresponsiveness. Observation of the tissues in the mouth can also be important, as color changes may occur with dehydration. In severe states, a person’s tongue may actually turn black from dehydration.
Monitoring your loved one for malnutrition and dehydration is incredibly important. Both conditions can lead to serious injury and death. Understanding the symptoms and signs are key in order to being a good advocate for your loved one. If you believe your loved one is suffering, talk to Davis & Brusca, LLC., the nursing home dehydration and malnutrition lawyer New Jersey trusts, today.