MALNUTRITION, ARE YOU AT RISK?

The Dreaded Scale

The Dreaded Scale

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.

1 in ever 4 adults is medical deficient in food

1 in every 4 adults is medically deficient in food

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.
  • Loss of Interest In Food Due to Isolation and/or Illness.

    Loss of Interest In Food Due to Isolation and/or Illness.

    Disability limiting mobility.

  • Lack of interest in preparing food, leaving the residence or even planning a menu.
  • Depression.
  • 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.

 

 

 

 

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About Sheri de Grom

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B and N. Concerned citizen of military drawdown. Currently involved in mental healthcare reform, health care strategist and actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare at their own discretion without losing tertiary healthcare benefits. Monitor and comment on Federal Register proposed legislation involving Mental Health, Veterans Affairs, Health and Human Services, Medicare and rural libraries. Licensed OSHA Inspector to include Super Fund sites. Full time caregive to Vietnam era veteran. Conceptualized, investigated possible alternatives, authored, lobbied for, and successfully implemented Title X, Section 1095 (known as the Third Party Collection Program of Federal Insurance).
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51 Responses to MALNUTRITION, ARE YOU AT RISK?

  1. I’m in Canada, but the same goes here. My elderly mother lives on her own and I check in regularly because even though she’s a retired nurse, I know she doesn’t eat a hugely varied diet like she used to. This is an excellent reminder!

    • Thank you for stopping by. It’s difficult to know when food stops being a delightful part of ones’ day and when it becomes a necessity. I argue with myself more often than I like.

  2. J.Rockwell says:

    I enjoyed reading your post and I looked forward to reading more. I started a blog 2 weeks ago. Can you help me get followers?

  3. inesephoto says:

    Sheri, it is a very important information that so many people don’t even think about. Elderly patients just wither and die, and not always because they have no money. Old age is such a challenge.

  4. SMB Health says:

    Thought provoking post 🙂

  5. Patti – I’ve tried to copy and post my response to your comment several times but either I’m not smart enough to do it or something is up with WP. Therefore, I’ll copy and send to your e-mail. When I copy my response, it sends your comment to be posted a 2nd time. This has happened to numerous postings. Gurr. Love with lots of hugs. Sheri
    P.S. Wish I were close and we could have a cuppa coffee and watch the sail boats having fun bouncing along, oh the people on the boats should be having fun also.

  6. Patti – I commented on your response the day you posted it. For whatever reason it has never moved over from the reader. I’m trying to move it by copy and paste but so far that hasn’t worked. It’s happened with several other bloggers that left comments and I’m still trying to figure out the problem. If I can’t figure out a way to move your comment, I will send my response to you in an e-mail. As always, I so appreciate your reading with me and always leaving a thought provoking comment.

  7. I’m amazed at the statistics Sheri but I agree if you do eat in most Hospitals,it’s because you can reach the food but yes if your limited to being in bed that’s not often.

    After being sick much more than once this year and also having an Accident on my Mobility Scooter recently, I have been loosing weight but not trying to, I have mouth ulcers, I eat much less than I use too, I’m often tired but I’m just not interested in food anymore, I’m sick of vegetables and chicken and have never been a big meat eater, I can’t even walk to exercise or to feel fit because of my disability…. yes I think I have problems but I didn’t feel motivated to seek help until I read your message… Thanks Sheri.

    Christian Love Always – Anne.

    • Anne, I knew I wrote this for a reason other than I’m interested. Tom and I understand what you are saying. Our interest isn’t simply there.
      I’m so sorry to here about your Scooter accident. Taking those hits are hard on us. Please know you are in my prayers and in my heart.
      Thank you for reading with me and your continuing Christian fellowship and friendship. Sending 💗&🙏.

  8. What you shared is so shocking–both the statistic and the inattentiveness to a patients’ inability to feed themselves in facilities.

    • I see it over and over, John. Each time Tom is admitted I’m shocked all over again. I keep thinking now this hospital is going to be different, but then it’s not. I’ve made it a habit to check on patients when Tom doesn’t need me. We have so many Americans in hospitals Who cannot care for themselves. It angers me that hospital administration has become ignorant of what it is so obvious. I brought the subject up with Tom’s care team yesterday and their excuse was they didn’t have enough help. I told them that was no excuse at all.I also advise them I would be helping other patients eat their meals until Tom was discharged. They seem to think if someone wanted help with meals then the family should either be there or the family should hire someone to be with the patient.

      • What’s their “solution” for a patient who has no family?

        • I asked three different sources about their “solution” and then presented the statistics of what the Center for Disease Control found in their latest study regarding patients over 70 dying of malnutrition in hospitals. The Chief of Nurses told me they didn’t have enough staff to cover the issue and medicine always took priority over making sure patients ate. [Again I was appauled at her answer]. I made an appointment and met with the administrator of the hospital. We’ve had so many go-rounds, I think he was afraid I would write a letter-to-the-editor again if he didn’t meet with me. He acted concerned but, that’s always his method of operation. Finally, I asked the Chaplin. The facility is a faith-based hospital and pride themselves on such. The Chaplin advised me patient comfort had become a low priority in taking care of elderly patients. John, you could have blown me over. I couldn’t believe he actually admitted openly the seriousness of the situation although I already knew it was true. He told me he starts making the rounds as best he can and he spends more time ministering while feeding those who cannot feed themselves than any other act of his ministery in the hospital. He’s taken on intern Chaplains to help him aid more patients.
          We have more volunteers at the Little Rock VA than what they have at Baptist Hospital.

  9. Prayers for better health care and better nutrition for all elders. Thank you for bring this important issue to our attention. My parents were extremely thin when my mother had her stroke. Now my father has gained back weight and looks much healthier. My mother’s stroke-induced dysphasia required special diet and monitoring to prevent aspiration pneumonia.

  10. Fatma Amin says:

    Valuable post . Thank u so much for sharing

  11. Roos Ruse says:

    What a very interesting and fact packed post, Sheri. The scenarios you mention, the uncovered, untapped trays at hospitals screamed at me too for attention over the years. My heart went out to people who didn’t have someone looking out for them. For too long I didn’t either. I didn’t suffer with pain from acute diverticulitis (directly attributed to malnutrition). Fortunately my doctor noticed my dramatic weight loss when nobody else did. Great article and best regards to you and your husband. ❤

  12. Elyse says:

    I wouldn’t know this without reading your blog, like Patricia. Usually when I’m in the hospital, I’m not allowed to eat, but I never would have thought this was the case. Shocking! There are lots of solo people out there, who can’t do for themselves. We have become a foolish society.

    • Elyse – I was scrolling through the comments and was surprised to see my comment to you still hadn’t shown up. I know I didn’t say anything earth shattering but nevertheless, I expect my comments to show up where they belong. I still haven’t been able to get Patti’s comments to move over and yours are stuck in the same que.
      I thought the statistics were relevant to all of us, not just those facing these realities on a daily basis. I do hope you world is spinning nicely.
      I always appreciate you stopping by and commenting.

  13. Patrice says:

    Thanks for writing these words that need to be said. A caution, waring to us all if in the future we too find ourselves in hospital.
    All the BEST! to you and Tm ❤

  14. Another eye opening post Sheri….my best to you and Tom!!

  15. GP Cox says:

    How long has Tom been in the hospital? No wonder I haven’t heard from you. I can fully understand a malnutrition problem at your house – you being so busy and Tom having trouble swallowing, his sleeping, etc. I do hope you try to improve taking care of yourself, and someone else take the reins on helping others for a little while.

    • Hi, G.P. It’s good to see you again. Tom was admitted on the 6th. We have high hope for this new addition to his team. The doc leading everything is a physiatrist. I wasn’t aware we even had this specialty in Little Rock and he has an entire team working with him. I have a case management meeting with all of them tomorrow. He’s the only doctor that’s called me back within 30 minutes with the exception of Dr. Kuo AND Dr. Smith [the new doc] is including me in the decisions regarding Tom’ care, the same as Dr. Kuo. That rates high with me me.
      The ratio of nursing staff to patient is 3 to every patient so yes, I’m getting lots of me time. I haven’t had this much sleep since I can’t remember when.
      The grasshoppers ate all the leaves from the climbing rose that practically covered Bailey’s look-out window and he was bummed for a couple days. Since then a couple tiny sucker frogs have found the window and he has such a good time with them. He thinks they are better than the birds. I’ve set up a sprinkler system for them to ensure they’ll hang around [interesting what we’ll do to amuse ourselves!

  16. Gallivanta says:

    Malnutrition is a problem here, too, Sheri, especially among the elderly, including those in hospital. And malnutrition can happen just as easily at home as in any place else. My mother despite devoted care from my sister lost a lot of weight over several months. We needed to bring in a nutritionist to help us work out how to increase her weight. She is now a healthy weight but it requires considerable effort by the family to keep her at that weight. I am sorry to hear Tom is in hospital again. Sending you love and support.

    • Thank you so much for the love and support. You are so right about the malnutrition. I used to think it only happened with extreme poverty but many days I simply forget I haven’t eaten until someone asks me. If someone would have asked me 20 years or even 10 years ago if I would ever be in that category, I would have told them NO WAY.
      Now I set an alarm and have 6 meals of 200 calories each consisting of 1 protein serving and 1 carbohydrate serving. It’s the easiest way to keep things balanced.
      With Tom and all of his swallowing problems it’s difficult no matter what nutrition we’re using.
      Bailey, on the other hand, at 3 years would eat everything I gave him and have to be careful. He’s at the maximum weight for his body size. He gives me the cutest look when I go to the kitchen for a drink or something trying to convince me he deserves just one more treat. He’s started doing his tricks without command hoping I’ll give in and give him a treat for effort. I’m so glad I got him before Tom became so ill. He’s been a real life saver for me.

  17. ksbeth says:

    this is shocking, sheri. it makes perfect sense when you explain it all. unfortunately the elderly, ill, and vulnerable patients are least able to advocate for themselves. i’m glad to hear that tom has a new doctor who you feel good about –

  18. You need to be in charge of Medicare.
    Another reason our elderly don’t eat, they forget. I’ve seen so many folks with even the earliest stages of dementia, they just forget to eat. Or thought they have eaten. And yes, I think the loss of socialization at meal times is a huge impact on our elderly.

    I’m voting for you.

    • Colleen – you are indeed a funny woman. [First I was responding to your comment on my cell phone and accidentaly sent the send button so decided I best drag out the lap top. WP doesn’t want me to reply directly to the blog and that concerns me.
      Bottom line, Medicare and the powers that be wouldn’t have me. It’s an appointed position and believe me, considering how out-spoken I am, neither of the presidential candidates would spend 1 minute listening to me either.
      I don’t think I have dementia but I do forget to eat. I have a friend who calls me and one of her first questions will be to ask me if I’ve eaten that day. She will go so far as to ask what I had and then tell me what I still need more of. And, I’ve studied nutrition for years.
      On the socialization side, I understood my Dad didn’t like eating at home after my mother passed. I kept running tabs for him at his favoirite restaurants [places where he’d always run into old friends and he could eat and linger over coffee]. I loved going with Dad when he went to his regular stops when I was home for a visit. A dozen or so retired ranchers [most in their late 80s to late 90s] met at the same long table every morning for coffee and then in the afternoon if they wanted. I never saw another soul at that particular table. Those days are gone as the restaurants are both gone. It makes me really sad.

      • Oh Sheri, because of these reasons you SHOULD be running Medicare! Presidents SHOULD be listening to someone like you.

        And I should have clarified what I said. You are correct about the not eating, it does not have to be dementia based. When people ‘lose’ the norm of their life (work schedules, family meals, spouse meals, having to keep a routine) all kinds of things can play into them forgetting to eat.

        Well, I have no power other than common sense. So I will take it upon myself to appoint you to run Medicare!!!! God bless!!!!!

  19. I had no idea. I am rarely in the hospital. The one time I was, my husband never left my side. And he’s not shy about making sure everything works for his family. I guess I’m blessed.

    • Jacqui – I’m certain I answered your comment and now it’s not showing up here so maybe I’ve lost it or Word press is being weird with me. You are indeed blessed that your husband is healthy and can be at your side whenever you need him. Tom was the same way until he became ill those years ago and then our roles changed. It’s times like this that it’s hard being a 2 person family.
      More and more facilities are cutting staff in the interest of profit and this results in fewer services all around. The other thing I see happening in health care is that hospitals are desperate to get the higher ratings and thus are requiring all LPNs to become RNs or they will be replaced by RNs within 3 years. Then when you have an RN in what used to be a LPN slot, that person believes ‘services and not medicine’ couldn’t possibly be included in their job description.

  20. Elaine says:

    Wow! The level of hospital care for the elderly is appalling! At age 70 I am fortunately still relatively healthy and not experienced this, so it was an eye-opener for me. Thanks for sharing your experiences with us so we become aware.

    • Elaine – I never believed in the ‘death squad of Medicare’ until this year and I’ve fought tooth and nail for every ounce of care Tom has received and the sheer humane treatment he’s received. I have such high hopes by his current specialist. The doc is great and most of the staff is terrific.
      You are so right, the assistance the elderly receive while they are in the hospital for those that cannot help themselves is appauling and it’s no wonder so many don’t make it out alive. Both times I mententioned for myself in this blog, Tom was not well enough to care for me and I had to count on myself.
      I have this quirk of wanting to be left alone when i’m sick but I found out and that’s not the best course of action. Tom cannot be at the hospital with me continually. We are a family of 2 thus I must learn to accept graciously when friends offer to help. I’m still learning how to do that. It’s hard to transfer from being a woman that could do it all to one that needs to ask for assistance. Should you need the assistance, please, for yourself, don’t be shy of having a group of friends lined up to help you recover and to also be at the hospital. They will be able to tell you more about your care than all the doctors combined. If you have surgery, ask a friend to be your ears for you as you may not remember everything. I now have a special friend who goes with me when I need a second set of ears.
      I’m 70 also and haven’t been in the hospital all that much (it’s just the examples I gave happened to be back-to-back) and they left me with my eyes wide open. Thank you for reading with me and taking the time to comment. Sheri P.S. I particularly enjoyed reading your last post!

  21. I would never know this had I not read your blog. This is just deplorable.I remember when my father in law was in a skilled nursing facility and had we not all been there a majority of the time, I’m sure he would not have eaten much or drunk much since we’d have to ask for things constantly. What they heck? And it’s like $6,000+ a month to stay in one of these places?
    AACK! Thanks for teaching us so much, Sheri.
    Hello to Tom from me.
    Patti

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