MALNUTRITION, ARE YOU AT RISK?
Hidden Epidemic/Older Americans/Medical 2016
By – Sheri de Grom
The media reminds us daily of every diet available and agencies report the numbers of how many people are dying from complications of too much food.
At the same time, the CDC, Centers for Disease Control, reports one in two Americans over the age of 70 is at risk for malnutrition. I find this an unacceptable number.
Malnutrition is often thought of as a killer in developing countries. It’s also a problem for the elderly in the United States, according to research published in the May 2016 issue of Annals of Epidemiology.
These hidden epidemics of malnutrition can jeopardize the health and independence of older adults.
The Alliance on Aging notes several reasons a person might suffer from malnutrition:
- Older adults living alone or widowed.
- Social isolation.
- Have digestive problems related to aging that can stem from certain medications, trouble chewing due to dental issues, problems swallowing or difficulty absorbing nutrients.
Disability limiting mobility.
- Lack of interest in preparing food, leaving the residence or even planning a menu.
- Limited Income.
A number I found not only shocking and appalling reported by the CDC alerted me to the fact that between 2,000 and 3,000 adults over the age of 70 dies in hospitals of malnutrition each year.
I first recognized this problem in 2007 after my hospitalization. I’d had 2 surgeries in 2 days and my meals of Jello-O and Sprite were left on my hospital table. The cover was never removed from the plate and my drink never had the protective covering removed or the straw inserted. Never mind that I couldn’t reach my tray even if everything had been set up for me. I remember someone asking me once if I didn’t like the food, and I replied something to the effect, “I didn’t know, I could never reach it.”
Rarely awake to ask anyone for help, I slept most of the time. When I did wake up, I couldn’t help myself. Two surgeries in 2 days had left me feeling defenseless.
I’ve always referred to that hospitalization as the forced 15-pound weight loss diet! In my early 60’s then I cannot blame anything on Medicare.
After experiencing the same treatment two more times in another hospital, I took notice of meal trays being delivered to other rooms. No help being offered patients, young or old. The covers are no longer being removed from plates. Drink covers are not removed or even placed where patients might reach them. This chore is left to a family member or someone sitting with the patient [if the ill person is fortunate enough to have someone at their side as an advocate].
In 2012 I was hospitalized for several days and weak after a lengthy surgery wherein I lost half my blood. I slept for hours on end. This particular hospital had chefs on staff and I could order anything I wanted from the menu any time of day or night. My biggest problem; I flat didn’t care whether I ate or not. I had no desire for food and no one on my medical team was monitoring my food. I didn’t call for a tray and therefore 3 days went by and I didn’t have anything brought to my room to eat or drink.
When friends dropped by and asked if I would like anything I would ask for a diet coke or bottled water. I knew they would do anything for me; I didn’t want to bother them. [A fatal flaw in my personality].
I was 67 during the above-described hospitalization and other than losing over ½ of my blood, I went home severely anemic and Tom was too ill to care for me. Medicare dismissed me to home without a caregiver or even Home Health. I had no choice but to care for myself when I had an acquired hospital infection, my right arm had suffered severe nerve damage during a 6-hour surgery that was to last 1 ½ hrs at the most. This may sound dramatic to some but this was when I started believing in the Medicare Death Squad. There was no skilled nursing facility that would take me as I was too ill! You may read my blog, Medicare, I Hate You, here.
I’d never thought malnutrition would be an issue for me or Tom and here we are. Tom is anemic and it’s taken me all this time to build my blood supply back to the level it’s supposed to be. I bounce back and forth between being anemic and not. It’s a struggle.
Tom’s hospitalization from January through March, not one hospital delivered a tray to him wherein they removed the cover of his plate, placed drinks where he could reach them and so on . . . that is until I asked them.
Tom was critically ill when admitted to Baptist Hospital in Little Rock, January 2016. I asked all 5 doctors in charge of his care to please order nutrition more appropriate for Tom. He could not eat from a regular menu because he could not swallow. The hospital had the latest results of his swallow test and they knew [if they read their own reports] that Tom could not swallow. The only nutrition available for Tom existed by adding something to one of his various IV drips. I continued to beg but nothing changed. Tom was a patient at Baptist Health, Little Rock for 10 days and the only nutrition he received was from smoothies I carried into him and fed him one tiny spoonful at a time, once he regained his ability to swallow.
Is it any wonder elderly people die of malnutrition in the hospital? The yearly average is far too high. Nutrition in the elderly receives little attention and as one author remarked, “People get old, they’re expected to pass on and others don’t think much about the cause of it at that point.”
We experienced the exciting pleasure of working with one hospital that ranks above all the rest in Arkansas. I would like to thank River Valley Medical Center and their compassionate staff for having someone beside Tom at every meal. The staff made sure Tom’s meals were liquids and then soft to the point of being unrecognizable. A staff member always noted how much he consumed. His care at River Valley Medical Center reached far beyond exemplary. I’ll discuss the time he spent at this medical center in the near future. He would never have had the admissions to three more hospitals if Baptist Hospital in Little Rock had done their job to begin with.
The Mayo Clinic web site has several articles geared toward the caregiver and how to prevent and detect malnutrition:
- Observe your loved one’s eating habits.
- Watch for weight loss.
- Be alert to other red flags. [poor wound healing, easy bruising and dental difficulties].
- Know your loved one’s medications.
- Medicare pays for nutrition counseling, ask the patient’s primary physician to write an order for the patient to consult with a nutritionist.
- Plan between meal snacks.
- Make snacks ahead and leave them for your loved one.
Our current status: Tom’s in the hospital, again. We have another doctor added to his team and we’re thrilled he agreed to accept Tom as a patient.
Thank you for taking the time to read with me. I so appreciate your loyalty as I’m still stumbling my way back into blogging. At night when the house is still, I enjoy touching bases with many of you as I read your blogs. Thank you for being there.