Nutrition: Unintended Weight Loss

Unfortunately in long-term care, sometimes residents lose weight. The most important step is to determine why and address that issue.

If you go to the doctor because you are not feeling well, you want the doctor to diagnosis and treat the disease, not the symptoms. For example, if you have headaches, you want the doctor to determine why. If he/she just treats the headache, without determining that cancer is causing it, you won’t last long.

Determining why the resident is losing weight determines the actions to take. Usually it is because the resident is not eating enough. Determine why the resident is not eating enough. If the resident is depressed, address that issue. If the resident is in pain, address the pain. If the resident needs more assistance, provide the assistance. If the resident’s dentures don’t fit anymore, get new dentures. If medications are causing a lack of appetite, address that. And so on, and so on, and so on….

Maybe the resident eats, but cannot consume enough at meals to maintain weight. Provide food between meals. Provide more caloric dense foods at meals. And consider smaller portions at meals. If the resident is not going to eat it, too much food can be overwhelming and cause the resident not to want to eat at all.

Sometimes a resident eats well but because of metabolic issues needs more than what is provided with meals. Consider large or double portions as well as caloric dense foods.

Adding cream, sauces, butter, gravies, etc. to food increases the calories. Sugar, brown sugar, honey, syrup, and other sweeteners added to food add calories as well. And an old-fashioned standby that still works is non-fat dry milk. It adds calories and protein to foods like hot cereal, cream soups, potatoes, and others. These foods work well both for residents that cannot handle a normal volume of food and those that require more calories.

Commercial supplements are also an option. Too often, though, these are provided as an easy solution without first investigating why the resident is losing weight and using the above approaches to address the why. It’s usually good to try to address the problems with “real food first.”