Keeping a Watchful Eye
Family members and friends can look for a number of signs to help prevent residents of nursing homes from suffering from malnutrition and dehydration:
* Visit at mealtime to observe the food service and how the nursing aides interact with the person.
* If the person doesn’t like food that’s served, ask the staff for a substitute.
* Some residents with chewing problems may be able to eat soft foods such as cream soups, Jell-O, cottage cheese, yogurt and ice cream, instead of pureed foods, which are unappealing to some people.
* If you suspect a resident isn’t eating well, request between-meal snacks, especially at bedtime.
* Make sure the person is being served liquids, especially drinks, with meals.
* If you suspect dehydration, look for signs of a dry mouth or dry lips. Urine should be pale and clear. Urine that is dark yellow can be a sign of dehydration.
* Make sure that visually or hearing-impaired people are wearing their glasses or hearing aids at mealtimes.
* Anyone who is helping to feed the resident should sit at eye level. Allow residents to feed themselves to the best of their ability, but provide cues as needed. Seniors with dementia often have trouble remembering to lift a fork or spoon to their mouth. The person giving assistance should speak in a friendly, not authoritarian, tone.
* If the person coughs while eating, it may indicate a swallowing disorder that should be evaluated by a speech therapist.
* If you’re concerned that someone isn’t eating properly, ask to look at their chart and check the percentage of meals they’re finishing daily.
* Ask nurses what the resident’s monthly weight is. If he or she is losing weight, request weekly weighings and notify the doctor.
* Put all concerns about the resident’s nutrition and hydration in writing, and keep a log of them.
* If you believe that the person is getting inadequate care, contact the facility’s director of nursing, then the facility’s administrator. If concerns persist, call the doctor. If all else fails, contact the state of California’s long-term care ombudsman program (see above, “Where to Go for Help,” for phone numbers).