As people get older they tend to become more sedentary and their body composition changes, resulting in an increase in body fat and a decrease in lean muscle mass and extracellular fluid. The body responds to the need for less energy by decreasing appetite, a process known as “anorexia of aging”. What often occurs is that the resident becomes malnourished, eating only what is appetizing to them at the time and not necessarily nutritionally sound. There are 9 Ds of malnutrition in the elderly including:

• Dysfunction (impaired ADLs, wound healing and immunodysfunction)
• Drugs (adverse effects, reduced absorption of nutrients)
• Disease(negative effect; creates increased nutritional demand)
• Dysphagia (inability to eat, drink or swallow)
• Diarrhea (chronic discomfort/weight loss)
• Depression (decreased motivation to eat; reduced social interaction)
• Dementia (forgetting to eat, unable to prepare meals, sleep disturbances)
• Dentition (poor oral hygiene, inability to chew food)
• Dysgeusia (loss of taste)

Remember, physical findings go far and above simple weight loss. These findings usually include decreased muscle mass and subcutaneous fat, localized or generalized fluid accumulation, compromised functional status, poor wound healing, loose clothes or jewelry, dry and sallow skin and fatigue. If you are noticing any of these signs and symptoms in the residents you are caring for or they are living with any of the 9 D’s identified above, maybe it would be beneficial to have a conversation with their attending physician and a registered dietitian. To read the complete article, click the link below: