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Nutrition: Making up for hospital shortfalls. (NH News Notes).

Some food for thought: A recent study found that more than 91% of patients admitted to a subacute care facility were malnourished or at risk of malnutrition. David R. Thomas, MD, the study's lead author, had also examined nutrition in long-term care in a previous study, and says all the findings show that "The problem [undernutrition] is bad when patients are admitted to hospitals, it gets worse in hospitals, and when the patients come out and go into long-term care or subacute care, they are profoundly undernourished by common standards." Thus, Dr. Thomas says, "nursing homes and long-term care facilities are playing catch-up with these people."

Dr. Thomas plans additional research examining undernutrition in healthcare facilities, including the factors in the hospital environment that might contribute to patient malnutrition. He is quick to point out that a lack of food is not necessarily the problem; he says disease can cause patients to lose weight, even if they are receiving enteral feedings: "There is this mythology that anyone who is undernourished is not getting enough food. So consequently there are huge numbers of strategies aimed at trying to increase the amount of food or increase staffing or increase feeders and so forth. Those are all valuable and useful interventions. But if the problem is that the patient's undernutrition is really due to disease, we're not going to make it better [by simply providing more food]," a point that Dr. Thomas says regulators and surveyors often don't understand.

Although there is no "gold standard" for determining undernutrition, Dr. Thomas believes healthcare facilities need to do a better job of identifying patients who are nutritionally at risk-including focusing on more than just weight loss.

The study on malnutrition in subacute care facilities was published in the February issue of The American Journal of Clinical Nutrition (www.ajcn.org); the study examining malnutrition in long-term care was published in the July/August 1991 issue of the Journal of Parenteral and Enteral Nutrition (www.clinnutr.org/publications/journals/ index.html).

For more on nutrition in long-term care, see Nursing Homes/Long Term Care Management February 2002, p. 36.
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Author:Edwards, Douglas J.
Publication:Nursing Homes
Article Type:Brief Article
Date:Apr 1, 2002
Words:353
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