The use of dietary restrictions in malnourished nursing home patients.

OBJECTIVE

To evaluate the dietary prescriptions of nursing home patients who show evidence of malnutrition.

DESIGN

A descriptive chart review.

SETTING

Four chronic care facilities in Milwaukee, Wisconsin.

PATIENTS

A total of 336 charts were randomly selected from the four facilities. Analysis was done on the 217 charts that included a recorded serum albumin.

MAIN OUTCOME MEASURES

Serum albumin, height, most recent weight, weight recorded 6 months previously, major diagnoses, and current diets were recorded. Average weight change per month and body mass index were calculated.

RESULTS

In 109 of the 217 patients, the serum albumin was less than 3.5 g/dL. 75.2 percent of hypoalbuminic patients were on some sort of dietary restriction, including caloric restriction in 18% and sodium restriction in 35%. Sixty-six of the 217 patients had an average weight loss of greater than 1 pound per month, and 59% of this group were on dietary restrictions, with 21% on sodium restriction and 20% on limited calories.

CONCLUSIONS

Malnutrition is a common problem in the nursing home population. A restricted diet is one possible factor that might contribute to this. While this study does not prove a causal relationship between a restricted diet and malnutrition, it would seem inappropriate that most patients with evidence of malnutrition are on diets that might discourage nutrient intake.