Unintended weight loss in the elderly is serious business. When the body is forced to draw on stored protein for


Lorraine Englander and Christina Dinger
 
Homeland Center dietitian Christina Dinger, left, gives resident Lorraine Englander a nutritional supplement. Dinger is part of a team that ensures residents maintain a healthy weight.  

energy, the antibodies that ward off illness are diverted, and a cascade of negative health consequences can follow.

“If you have an 80- or 85-year-old who’s beginning to lose weight, that’s associated with multiple issues, and things spiral out of control,” says Homeland Director of Nutritional Services Yolanda Williams. “There can be skin breakdown, dehydration and infections because the immune system is weakened.”

Homeland’s unique approach

Spotting, preventing and treating weight loss demands true detective skills, and Homeland Center developed an individualized approach – unique to nursing homes – that’s worthy of a “CSI” episode. Instead of giving nutritional duties to multi-tasking nurse's aides, Homeland assigns a nutrition-at-risk aide to the care teams on each floor in skilled care and in the Ellenberger dementia/Alzheimer’s unit.

 “Their sole responsibility is to make sure that residents receive their supplements and are adequately hydrated,” says Williams. “They focus on the prevention of weight loss in the first place, but if a resident does lose weight, they focus on providing interventions to help them stabilize.”

The nutrition-at-risk aide tracks the weight and other indicators of each resident, watching daily for trends that signal weight loss and then investigating the causes. A variety of issues can trigger weight loss: depression, loss of appetite, loss of a loved one or conditions such as urinary tract infections. Some residents might need assistance with eating but are too proud to ask, says Williams. The key is spotting the root cause early.

“We catch weight loss before it starts causing real problems,” she says.

Eating favorite foods encouraged

Once the problem is spotted and a cause identified, the nutrition-at-risk aide works with family members and other staffers to customize a solution. It might mean adding a favorite yogurt brand to the diet to encourage eating or finding opportunities to pack more calories into every bite.

“We always focus on preferences,” says Williams. “If they want salads and like veggies, we don’t take those away, but we work in the calories elsewhere. We may have a resident who loves ice cream, so they get ice cream with their breakfast. Maybe we put five pats of butter in their oatmeal.”

Nutrition-at-risk aide Christina Dinger enjoys “being able to build a rapport with the residents.”

“I’m then able to tailor interventions to each individual resident,” says Dinger, a dietetic technician, registered, or DTR. “When we have to address their weight loss, it’s something that fits into their lifestyle. Sometimes we’re even able to prevent weight loss because we’re able to pick up on triggers before it becomes an issue. I enjoy working so closely with the residents and their families.”

 

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