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6 common causes of bed sores in nursing home and hospital patients part 2
Some studies have shows that 35 to 85 percent of nursing home residents are malnourished. The causes vary as to why so many nursing home residents suffer from malnourishment. In most cases, the cause of malnourishment is not that nursing homes don’t provide proper diets; in most cases they do. Rather, the root cause appears to be an inadequate level of food intake by the nursing home resident. So, what causes nursing home residents to take in less food than they need? Cognitive and physical impairments can certainly affect a resident’s ability to eat. Swallowing disorders (dysphagia), poor oral health, medications, and changes to taste and smell can all contribute to a lack of desire to eat. However, many of these impairments can be overcome with an attentive and active nursing home staff. For example, a 1988 study of nursing home residents determined that 55% had some degree of dysphagia that affected their food intake. Yet, only 22% of those residents had been assessed by the nursing home and referred for evaluation to a speech therapist. In short, nearly 80% of those in the study found to have mild to profound dysphagia were not recognized by the nursing home staff as having any correctable problems with respect to nutrition intake. While the two may seem polar opposites, insufficient staffing within nursing homes can also have a direct effect on nutrition deficiencies of nursing home residents.
In many nursing homes, staff members fall woefully short of standards set forth in the Nursing Home Reform Act of 1987 (also known as the Omnibus Budget Reconciliation Act of 1987 or “OBRA”). While the law requires that the nutritional needs of nursing home residents be met, oftentimes, the results simply do not match the requirements.
It is well known that the lack of adequate nutrition can result in malnourishment which, in turn, can lead to a host of physical and mental problems, including increasing the risk of developing bed sores. (For more general information on bed sores, visit Terry Law Firm, LLC or visit Jonathan Rosenfeld’s Nursing Homes Abuse Blog.) In fact, according to nutritionist Janet McKee of Nutritious Lifestyles, Inc., “Involuntary weight loss of 4% or greater is correlated with negative outcomes and the development of pressure ulcers in the geriatric population.” When a person becomes malnourished, they tend to lose body fat, which provides a barrier between the skin and bone in our bodies. That barrier allows blood to freely flow throughout the body. When the body fat disappears and pressure is placed on that area of the body, the flow of blood is inhibited. When blood flow is depressed, the skin begins to die, creating the beginnings of a bed sore.
How Can Bed Sores Caused By Nutritional Deficiencies Be Treated?
When nutritional deficiencies are the likely cause of a bed sore, the best way to treat the problem is to fix the problem. Obviously, when a resident has developed a bed sore, the bed sore must be treated by a health care provider proficient in wound care. Nutritionally, there must be a thorough review of the resident nutritional needs, taking into account the nutrients being lost through the wound itself. Janet McKee states that “adequate protein intake is an essential component for skin integrity and pressure wound healing. Accordingly, protein recommendations to promote healing are 1.2 – 1.5 grams protein per kilogram of current body weight.” Only the nursing home facilities can arrange for the resident to receive a full nutritional assessment so the bed sore can be properly healed.
One of the big fallacies surrounding bed sores is that once you have one, it is virtually impossible to heal. That is simply not true. With proper nursing care and nutrition, even deep, Stage IV bed sores can be healed.