Lawyer Resources for Malnutrition

Malnutrition Problems In Nursing HomesThe following article is being contributed by the Ohio law firm of Slater & Zurz LLP. The attorneys at Slater & Zurz LLP have handled over 500 nursing home abuse cases throughout the state of Ohio.  To learn more, please visit nutrition is extremely important as we grow older and a vital part of the health and care provided by nursing homes to their patients. Unfortunately, malnutrition of patients and other dietary problems are a painful reality in nursing homes.Malnutrition is a problem in and of itself. However, it can also lead to other problems, including infections, confusion, muscle weakness, organ failure and even death. A resident of a nursing home who is improperly nourished is more likely to suffer from frailty, immobility, falls, pressure ulcers, pneumonia, and decreased immunity to bacteria and viruses. The real tragedy is that malnutrition in nursing home patients is completely avoidable. All that is required is appropriate evaluation, proper planning and delivery of nutritious foods and fluids. But, tragically, many nursing homes do not follow these simple procedures and fail to provide this basic care.

Any new nursing home patient must be evaluated for dietary and nutritional needs by a physician. Based on the nutritional assessment, the nursing home facility must take steps to ensure that the resident maintains good nutritional health and must provide a resident with well-balanced, palatable meals. Any deviation from this plan can be considered to be nursing home abuse.

There are many factors that can cause nursing home malnutrition. These can include:

Dietary Supplement In Nursing Home Patients A Connecticut nursing home has been cited by the Department of Health for discontinuing a dietary supplement without first consulting any doctors, dieticians or nurses.  The abrupt discontinuation is believed to be responsible for a sizable– 11% weight loss in a patient at South Windsor Rehabilitation and Nursing Center.  When at the facility, state inspectors discovered another patient with a similarly drastic weight loss— losing 22 pounds over the course of three months at the facility.

Incidentally, serious money troubles have plagued South Windsor over the past year and according to new reports the nursing home is now in receivership.

As a nursing home lawyer who sees many facilities focused on their bottom lines at the expense of patient care, I find these reports to be completely disgusting.  My guess is that at some point an administrator at the facility elected to stop providing the dietary supplement as a cost cutting measure.

As is we need another statistic to confirm the extensive problems facing nursing home patients, here’s some more fuel to add to the fire– 35% to 85% of nursing home patients suffer from malnourishment according to a study published in Commonwealth Fund.

In response to this epidemic, an international group of nutrition experts has released new definitions to help medical professionals better equip themselves to identify and treat malnutrition.

Nursing Home Patients Suffer From Malnourishment According to the new guidelines, adult malnutrition can now be classified in one of three categories:

Dehydration & Malnutrition In Nursing Home LawsuitA Kentucky jury is hearing evidence in wrongful death lawsuit against a nursing home that allegedly failed to provide sufficient nutrition and fluids which in turn contributed to her death.

The lawsuit was initiated by a physician who is a relative of the deceased patient.  According to information contained in the lawsuit and remarks made by attorney’s during opening statements, the woman was admitted to Woodland Oaks from May 24, 2003 to June 30, 2003 for rehabilitation from a recent hip fracture.

It was during her admission that staff failed to provide proper care and allowed her to become dehydration and malnourished. As a result of the dehydration and malnutrition, the woman developed a severe urinary tract infection amongst other medical problems that lead to her death on August 3, 2003.

Picture-812I’ve seen a significant number of cases where an Alzheimer’s patient gets admitted to a nursing home or assisted living facility only to have their health rapidly decline within a brief period.  In several cases, I’ve seen patients deteriorate so significantly that within a few weeks of their admission they needed to be rushed to a hospital due to rapid weight-loss and dehydration.

The event likely leads to a hospitals request that a feeding tube be surgically implanted in patient to provide life sustaining nutrients.  Unfortunately, further complications typically arise with the use of the feeding tube adding further problems to a typically messy situation.

A recent New York Times article, “Feeding Dementia Patients With Dignity” reinforced the obvious, feeding patients with dementia and Alzheimer’s is difficult and time consuming. Moreover, the alternative in installing a feeding tube can lead to anger in the patient and negatively impacts the patients quality of life.

Picture-158Sad but true, many nursing home patients are suffering from malnutrition.  While we often associate malnutrition amongst the homeless or people living in a third-world country, some studies suggest that between 35% and 85% of nursing home patients are malnourished. As attorney David Terry points out in his blog post, “How Does Poor Nutrition Affect the Development of Bed Sores in Nursing Homes?” the rampant malnutrition can be associated with an increased risk of developing bed sores. Poor nutrition results in a deterioration of body functioning.  Over extended period of time, patients without adequate nutrition tend to have organs that begin to fail and critical body functions begin to deteriorate and lose effectiveness. As the largest organ of the body, your skin is one of the first places where the consequences of inadequate nutrition may be visible.  Malnutrition can result in the deminished effectiveness of the skin’s natural resiliance to pressure and other factions that contribute to the development of bed sores (similarly described as pressure sores, pressure ulcers, or decubitus ulcers). In addition to malnutritions reduction in the effectiveness in the skins natural resilancy, malnourishment of nursing home patients may also lead to other medical problems that contribute to the development of bed sores:

Reduction in Energy Levels: Malnourished people have less energy and consequently are unable to move on their own– resulting in a more time spent in one position.

Reduction in the bodies natural cushioning: A long-term consequence of malnourishment is loss of fat, muscle and tissue– that provide necessary padding particularly in bed-bound patients, the less padding the more pressure that is put directly on the body– thereby resulting in increased rate of bed sores. Inadequate Nutrition & Hinderance of The Bodies Natural Healing Properties David makes a great point regarding the important role nutrition plays in not just bed sore prevention, but also healing bed sores.  One of the most overlooked aspects of bed sore treatment is assuring that facilities provide additional calories and protiien for patients with advanced bed sores. A nutritional consultation should be brought in for patients with open wounds (stage 3 or 4 bed sores) so the specific nutritional needs can be tailored to the patient need.

Picture-321In times of need, locating necessary information regarding the legal rights and resources for nursing home patients can be difficult and imposing.  In this respect, we are proud to introduce a new resource for patients, families and practitioners looking for a concise compilation of information regarding nursing home laws.  Nursing Home Injury Laws, provides every states’:

  • Nursing Home Laws
  • Medical Malpractice Laws

iStock_000003942322XSmallDeciding whether to have an autopsy performed on a loved one is indeed a very personal decision for a family to make following a death.

An autopsy can help a family get answers to not only the cause of death, and in the case of potential nursing home negligence, what– if any, errors may have been made by a medical facility that may have caused the death.

After reading a news article about how a disabled nursing home patient may have ‘choked to death‘ on his lunch I was reminded by how valuable autopsies can be where a death may occur in a nursing home or hospital setting that is insulated from the public.

feeding-tube1Many nursing home residents require feeding tubes because of illness or weakness.  In order to maintain a resident’s strength and health, a feeding tube can be used to either supplement eating by the mouth or completely replace a resident’s meals.

Good nutritional habits are especially important for residents who are already suffering from illness, trauma, or weakness.  Eating a well-balanced diet gives residents strength and may help them fight infection.

 When a nursing home resident’s dietary needs cannot be met by eating a well-balanced diet, the resident might be placed on alternative means of nutritional support such as a feeding tube.

Picture-84A nutritious, balanced, and appetizing diet is important for all nursing home residents.  But it becomes essential for those suffering from pressure sores.  This is because a person with pressure sores needs to consume more calories per day that their healthy counterparts.

Facilities need to calculate each patient’s total energy expenditure (TEE) in order to meet their nutritional needs.  TEE is composed of three components:

  • basal metabolism, that is the number of calories needed to maintain a body at rest, which depends on age, sex, and body size;

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Jonathan did a great job helping my family navigate through a lengthy lawsuit involving my grandmother's death in a nursing home. Through every step of the case, Jonathan kept my family informed of the progression of the case. Although our case eventually settled at a mediation, I really was impressed at how well prepared Jonathan was to take the case to trial. Lisa
After I read Jonathan’s Nursing Home Blog, I decided to hire him to look into my wife’s treatment at a local nursing home. Jonathan did a great job explaining the process and the laws that apply to nursing homes. I immediately felt at ease and was glad to have him on my side. Though the lawsuit process was at times frustrating, Jonathan reassured me, particularly at my deposition. I really felt like Jonathan cared about my wife’s best interests, and I think that came across to the lawyers for the nursing home. Eric
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