Mention the word malnutrition and the mind likely jumps to images of starving children in third world countries.
Where it probably doesn’t go is to hospitals across America where older adults are often malnourished or at high risk of becoming malnourished, a condition that significantly increases a patient’s risk of complications and even death.
If this surprises you, consider these facts from the Malnutrition Quality Improvement Initiative:
- 1 in 2 hospitalized seniors is malnourished or at risk.
- Malnourished patients are 5 times more likely to die during their hospital stays.
- Malnourished patients are more than twice as likely to be readmitted to the hospital within 30 days.
- Only 7% are diagnosed with malnutrition during their hospital stay, leading to millions of undiagnosed and untreated cases, longer lengths of stay and higher cost of care.
- Many patients continue to lose weight after discharge.
Let’s take a closer look at malnutrition and what it does to older adults.
Exactly what is malnutrition? The textbook definition is a lack of proper nutrition caused by not having enough to eat, not eating enough of the right things or being unable to process the food that one does eat.
Among seniors, malnutrition can be tied to an inadequate intake of protein and the vitamins and minerals essential to health. It’s not always obvious that a person is malnourished. A diet composed of low quality, high calorie, high fat processed foods can result in a person who is obese and malnourished. Although older adults require fewer calories, they continue to need a balanced diet of the right foods.
Malnutrition takes a significant toll on the health of older adults. Over time, malnutrition contributes to chronic diseases, acute diseases and infection rates. The lack of sufficient nutrients diminishes immune response, slows wound healing and leads to increased infection rates. Ongoing malnutrition impacts bone density and muscle mass, leading to an increased risk of falls, compromised mobility and loss of independence.
Why is this happening?
There are many factors causing the silent epidemic of malnutrition. The aging population has unique nutritional requirements that go unrecognized and are subsequently not addressed. Chronic diseases such as cancer, stroke, diabetes, heart disease, GI issues, and pulmonary issues and their treatments can change how and what people eat. These conditions can also affect how the body processes food so nutrition is not completely or efficiently absorbed.
Conditions like Alzheimer’s, dementia, and depression can cause an older adult to refuse food or forget to eat. Dysphagia inhibits the ability to swallow, limiting diet but also making an older adult fearful of choking and thus avoiding healthy foods previously eaten without a problem. Dental issues also inhibit food intake. Those on antibiotics often experience issues with their digestive system.
The risk of malnutrition increases during hospitalization. What a person can eat may be limited due to tests, treatments and conditions. The food served can be unappealing. Supplements, which can taste medicinal or are otherwise not palatable, aren’t always consumed. Food and supplements that aren’t consumed are ineffective!
Malnutrition is costly to Amerca’s healthcare system.
Malnutrition is a terrible public health and quality of life concern, but it also hurts the healthcare industry where it hurts: in the wallet. Higher rates of complications, falls, readmissions, and longer lengths of stay associated with malnutrition increase the cost of care up to 300%. Average hospitals costs are double those of a well-nourished patient. This doesn’t include the financial impact of readmission.
When you add up the cost of direct medical costs, morbidity, and mortality associated with disease-related malnutrition, the total economic burden in the U.S. is $157 billion, of which $51.3 billion is associated with adults age 65 and older.
This is an unsustainable situation.
How do we solve this silent epidemic?
Despite the evidence showing how proper nutrition promotes healing, recovery and chronic disease management, there remains a gap in nutritional care. The healthcare industry realizes this gap, which has led to the creation of organizations like the Malnutrition Quality Improvement Initiative (MQii), a project of the Academy of Nutrition and Dietetics. MQii is designed to help healthcare organizations improve malnutrition care and achieve better outcomes.
From Thrive for Healthcare’s perspective, we believe it’s time for a “nutritional intervention” that will require hospital and senior care leadership, clinical and dietary professionals to conduct a thorough evaluation of current nutritional strategies and products used to support those strategies. Pay particularly close attention to supplements traditionally employed – up to 50% of these go unconsumed. Could this be an Achilles’ Heel?
In our next blog, Thrive will take a look at what’s currently being served to bolster diets in hospitals and other associated healthcare environments and important new options that are shaking up the healthcare industry. Don’t want to wait for more information, visit our website here.