Poor Nutrition In Older Adults

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Nutrition is often considered the foundation of health and an important indicator of well-being. Older adults living in the community are particularly at high risk of poor nutrition due to social isolation, frailty, cognitive impairment, poly-pharmacy, reduced functional status and financial instability. Older adults receiving skilled home health may also be at risk for poor nutrition as the Outcomes Assessment Information Set (OASIS), the Centers for Medicare and Medicaid mandated home health assessment, does not contain items specifically related to nutrition assessment, leaving this important aspect of health potentially neglected. In the popular and empirical literature there is a plethora of knowledge on what older adults should be eating. …show more content…

All of these risks can be complex to resolve and often result in reduced nutritional intake further increasing the risk of weight loss and malnutrition.14 Poor appetite in particular is a common problem among older adults and can stem from physiological, psychosocial, and pharmacological causes. Physiologically, older adults may experience pain, reduced functional status, dental problems, constipation, sensory impairment such as changes to smell, taste and vision, and the impact of multi-morbidity that all may lead to decline in food consumption.14 Psychosocially, an older adult's appetite can be greatly influenced by their changing environment and limited opportunities for socialization. Furthermore, limited access to adequate and healthy foods can be particularly challenging for this population.15 Pharmacologically, most older adults take at least one medication,16 many of which can cause nausea or alter the senses of taste and smell leading to reduced appetite.17 As older adults lose their appetite and consequently eat less, body mass index (BMI) decreases to a point that calls for critical intervention. Prior research indicates reduced BMI increases risk for death18 and many older …show more content…

The OASIS C-2 also addresses intervenous, parenteral or enteral therapies received (M1030) and managed (M2102) by a home health recipient, unintentional weight loss of 10 pounds or more within the previous 12 months (M1033), encourages but does not require the completion of a separate pressure ulcer assessment including nutrition as a risk factor (M1300), and a care recipient’s ability to feed themselves (M1870).23 The OASIS C-2 however, does not contain any additional assessment items related to the adequacy of a home health recipients’ nutritional intake or status which could potentially lead to a missed or inadequate assessment and identification of learning needs among older adults vulnerable for poor nutrition. Moreover, there is a lack of evidence based practice information on nutritional interventions most effective for older adults.24 Therefore, it is unclear how nutritional assessment, education and recommendations are provided to skilled home health recipients or if nutrition status is routinely included in the home health comprehensive assessment. To address this gap, we conducted a review of the literature related to nutritional assessment and education among older adults living at

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