Get Help Monitoring Dad
Q: My dad has been in a nursing home for about 8 months and, in that time, he has lost about 15 pounds -- weight he could hardly afford to lose. I suspect his nutritional needs aren't being met, but I'm not sure what to do. He's picky, and it takes a lot of patience to get him to eat. I've spoken to the staff, and they insist he's eating. Do you think I should file a complaint?
A: Congratulations to you for keeping a close eye on your dad; this is a must when a patient is in a nursing home. Weight loss is sometimes attributed to something as simple as the patient not liking the food, but it can also be an indicator of something far more serious.
My recommendation would be to review his chart to look for any signs of depression, any medications that reduce appetite, or documentation regarding how much your father is eating during the various mealtimes. Such a review of the documentation will help you get a feel for the type of questions you might want to ask the caregivers. Also, be sure to ask your dad if he likes the food, if he is hungry during the day, and what he ate during the previous meal. This may help you understand how much he is eating or why he is not eating.
The next step is to contact the physician overseeing your father's care to discuss his weight loss. You will also have the opportunity to request an assessment by a registered dietitian.
One option is to hire a private company to provide a registered nurse to visit your father on a regular basis so that he or she can monitor his eating habits and perform a chart documentation review to help identify any reasons he may not be eating. Such companies also perform extensive physical assessments, which may alert the visiting RN to some reasons your father may not be eating. Since most people are not able to visit their loved one as often as they would like, they aren't always able to really know what is happening throughout the day.
If you still aren't receiving a response that you consider satisfactory, a good next step would be to contact the long term care ombudsman in your county. This person can help you resolve issues, but can also assist with filing a complaint. It would be wise to have a log of the various people you spoke with, when you spoke with them, and what their response was. Also, be sure to continue to monitor any further changes in his condition so that you can report the specific reasons for your concern.
For more information about contacting your local ombudsman, go to www.ltcombudsman.org.
-- Danielle Philipson, SentryCare: Safeguarding the Healthcare of Your Loved Ones, www.sentrycare.org
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Good Advice...Added Comments
I'm not sure of the nursing home protocols, but if they have more than one physician visiting patients, you might also opt for changing the physician that sees him.
My father (93 yrs. old), became rather sick quite suddenly...sleeping all the time, wouldn't eat, listless. We finally convinced him to see a different physician than the one he had been seeing for years.
The new doctor immediately took him off six of his medications, leaving him with only taking two. Within 3-4 days, he was back to his old self, eating good, and driving down to the local pool hall once or twice a week.
Grant you, the doctor put him back on one additional med, but three medications are far easier for him to handle and keep track of than eight!
Another thing one of my siblings has been doing since she lives closest to him, is when she makes dinner, she always makes sure she has enough to make him a plate and she will take it over to him and visit with him while he eats. This almost guarantees that he's getting proper nutrition and a good meal. Surely the nursing home couldn't object if from time to time a loving family member opted to do the same thing by bringing in one of his favorite meals. This way he/she not only gets something they like, but also gets someone to dine with them.
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