Her best lipstick applied and napkin at the ready, meals in the dining room at Helen’s assisted living facility were always the highlight of her day.
With the recent COVID-19 concerns on the top of the priority list, Helen and the other residents in the facility have had to eat alone in their rooms in order to stay safe. Staff have noticed residents aren’t eating as much. They started asking each of them about their appetite, Helen always softly states, “I’m just not hungry.”
Many of us are aware that social isolation can lead to depression. Depression unfortunately can lead to a decrease in appetite and eating less which will result in a decline in nutritional status. Changes in a person’s weight are a direct reflection of how well they’re eating and their ability to meet their nutritional needs.
Unplanned Weight Loss Can Impact Health
Unplanned weight loss is a red flag that shows that the needs of the body aren’t being met. Our nutritional status is directly tied to the health of our immune system. Protein foods break down into the building blocks of the structures we make to fight infection and repair skin injuries. Without essential trace minerals coming from the diet the ability to fight infection can decline.
Unplanned weight loss is not desirable, even for those who are overweight. When weight is lost, so is muscle. A decline in muscle can put residents of any weight at risk for falling, a high-risk issue in community based care. It’s important to recognize that malnutrition can occur at any size.
Have Any of Your Residents Had Unplanned Weight Loss?
Check the last time that your residents were weighed. Regular weight checks are easily overlooked because the implications of weight change are not understood as well as other disease processes. Add a pandemic and resident weights may not be being measured at all. When weights are measured make sure to use an appropriate scale, one that can be calibrated and is consistent in measurement.
If you notice a resident is losing weight start weighing them and notify their provider.
How to compare weight changes
Compare current weight to past weight measurement to find out how much weight loss or gain has occurred.
- Step 1: Find the last weight that was checked.
- Step 2: Subtract their current weight.
- Step 3: Divide by their last weight.
- Step 4: Multiple by 100.
This formula shows the percent of weight loss the resident has had.
Here’s an example:
Cathy currently weighs 151 pounds.
Last month she weighed 162 pounds
Subtract her current weight from her weight last month. Then divide by her weight last month.
162- 151= 11/162= .068
Multiple by 100 and you realize that Cathy has had a weight loss of 6.8% in one month.
Is the Weight Loss Significant?
Once you have calculated the weight change compare it to these standards. Weight loss equal to or greater than the following percentages indicate significant weight loss.
- 10% in 6 months
- 7.5% in 3 months
- 5% in 1 month
- 2% in 1 week
If unplanned weight loss has occurred there are several things we can do.
What Can Be Done to Stop Malnutrition?
Start to make a difference by monitoring how much residents are eating at their meals.
Is there a registered dietitian available to consult with your facility that can assess the resident?
Relax any diet restrictions that aren’t needed.
Try to make mealtime as enjoyable as possible for residents. Are there volunteers that could make words of encouragement to place next to their plate? Can you play happy music to accompany dinner?
Encourage small feedings between regular meals. Snacks don’t have to be a specific type of food but offer part of meals in smaller servings can be a good source of nutrition.
Make beverages count. Offer dairy beverages, 100% juice, and fortified coffee beverages between meals to boost overall calorie intake.
Check that dentures and other dental appliances still fit if unplanned weight loss has occurred.
Once you identify unplanned weight loss you can try to stop it’s impact on your residents.