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Malnutrition Mistaken as Illness in Seniors?

Posted by Dr. Joseph F. West on Oct 13, 2016 3:00:00 PM

Healthy eating is important at any age. Giving the body the right nutrients and maintaining a healthy weight can help one stay active and independent. Older patients with chronic conditions such as diabetes, heart disease, or stomach problems, however, must be very deliberate about their nutrition and dietary planning. Diet plays a vital role in the effectiveness of medications, physical therapy, and mental health.

Malnutrition is due to under nutrition, nutrient deficiencies or imbalances. Unfortunately, for a variety of reasons many older adults are not eating as well as they should, which can lead to poor nutrition or malnutrition, easily being mistaken as a disease or illness. Nearly 3.5 million older adults are malnourished. Healthcare providers should be aware of signs of malnutrition such as loss of appetite, weight loss/gain, general malaise or lack of overall interest in health and wellness.

The meaning and examples of healthy eating changes with aging as metabolism slows down and digestion of certain foods become more difficult. For example, older patients with cognitive impairment or trauma are especially at risk of malnutrition. Alzheimer or cancer patients may need more of certain nutrients. Other changes in body function may impact nutritional intake, such as dentition, or the makeup of a set of teeth (e.g. number of teeth, loss of teeth and/or ill-fitting dentures). Gastrointestinal changes such as chronic gastritis, delayed stomach emptying, constipation and bloating may lead to avoiding healthy foods, such a fruits, and vegetables.

With aging and managing chronic conditions it’s increasingly important to choose foods that provide the best nutritional value and that align with medical restrictions and therapies. Chronic Care Management (CCM) and Transitional Care Management (TCM) teams can conduct the right assessment of older patients informing healthcare providers of risks for malnutrition. Care Managers can work with older patients and their caregivers reminding them monthly of the importance of meeting dietary needs and adhering to any dietary restrictions.

Care Managers can help monitor weight loss/gain, remind patients to stay hydrated, and even discuss financial concerns that affect food purchasing. For example, many older patients may be eligible for food and nutritional assistance programs such as Supplemental Nutrition Assistance Program (SNAP) which can provide much-needed help buying food. Adults over 65 years old can receive $113 each month on average in SNAP benefits.

Nutritional needs change as we age. Some of this may be due to loss of a spouse or family member, diminished interest in cooking, concerns about eating alone or limited mobility affecting shopping and food access. Nursing facilities, or hospitals that do not ensure adequate nutrition may also pose a risk to older patients with chronic conditions. CCM and TCM Care Managers can support providers and patients alike in ensuring adequate nutrition necessary for health, vitality, and quality of life.

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Topics: TCM, CCM, Nutrition, Malnutrition, Dietary Restriction

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