It is the staff’s duty to notify the physician of signs and symptoms of an infection so that appropriate treatment orders can be entered. It is also staff’s duty to implement the treatment orders. When staff fails to timely notify the physician of an infection, or fails to timely and consistently implement the treatment orders, the infection can spread and usually results in serious consequences to the patient.
IV. Malnutrition and Dehydration
The risk of malnutrition and dehydration among the elderly and the sick is well known. Malnutrition and dehydration are two of the most common signs of nursing home neglect. When a nursing home resident suffers from malnutrition or dehydration, it is often because the nursing home staff has failed to adequately address the nutritional and hydration needs of the resident.
Inadequate hydration, or dehydration, occurs when a resident’s loss of fluids is greater than his fluid intake. As a person ages, his risk for developing dehydration increases. Thus, nursing home residents are usually more susceptible to dehydration. It is therefore vital that the nursing home staff take preventative measures to ensure that the residents, who are at increased risk for dehydration, are adequately hydrated. This can be as simple as assisting a resident with drinking; encouraging fluids during meals and between meals; monitoring for symptoms of dehydration; timely notifying the physician; and providing IV fluid replacement when necessary. Tip: Look for a pitcher of water on the resident’s night stand. If the nursing home does not provide one, bring in your own and monitor whether staff keeps the pitcher filled with water.
When staff fails to implement measures to help ensure the residents are adequately hydrated, dehydration can occur, which in turn can lead to serious medical complications, including urinary tract infections; pneumonia; bedsores; disorientation; and confusion. Dehydration can also cause an electrolyte imbalance which can lead to seizures. Reduced blood flow is another complication of dehydration, which can lead to organ malfunction, coma and even death.
Malnutrition, or lack of proper nutrition, can also be life-threatening to elderly residents. Malnutrition includes not only inadequate food intake, but also the failure to receive necessary vitamins, minerals and supplements. According to statistics, about half of all nursing home residents require staff’s assistance with eating. Many times, however, the nursing home lacks sufficient staff to feed all the residents who need assistance. Or, the staff is not adequately trained in meeting the nutritional needs of the residents. Tip: If your family member needs staff’s assistance with meals, try visiting during lunch or dinner and see whether staff is providing that assistance. A full tray that is left untouched well after mealtime is over is an indication that the staff is not providing assistance with meals.
A resident who is malnourished usually suffers from increased weakness as well,
which can result in falls and injuries. Residents suffering from malnutrition are also at increased risk for developing bedsores, pneumonia, urinary tract infections, confusion and memory loss. Malnutrition can also lead to serious medical problems, including organ malfunction, a weakened immune system, loss of muscle mass, anemia and even death.
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