Care of the Malnourished Elderly Patient

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Abstract………………………………………………………………………………………...2 Chapter 1 / Introduction
Origin of the Problem……………………………………………………………………….5 Significance or Importance of the Problem for Nursing……………………………………6-8 Problem Statement…………………………………………………………….…………….8 Purpose of the Study……………………………………………………….………….…….9 Hypothesis- Null and Research………………………..…………….…………………..…..9 Definition of Terms..……………………………………………………………………….9-10 Assumptions………………………………………………………………………………....10 Summary………………………………………………………………………………..…....10 Chapter II/Review of Literature

Review of Literature……………..…………………………………………………11-16 Chapter III/Methodology and Research Design
Research Design…………………………………………………………………………….17 Variables………………………………………………………………………….………17-18 Selection of Subjects and Research Setting……………………………………...….…....18-19 Data Collection Instruments …………………………………………………….…..…...….19 Statistical Analysis………………………………………………………...….....…....….….20 Data Collection Procedure ……………………………………………….………........…….20 Limitations…………………………………………...………………………….....………….21 APPENDICES

A.Request for Permission to Survey Participants……………………….….……..…....….22 B.Nutritional Assessment Survey………………………………….…...…...……....…23-26 REFERENCES .……………………………………………………………… ……………27-28

Chapter I. Introduction
Origin of the Problem
In our society, malnutrition and under-nutrition is a rising problem for the older adult population. Approximately 35%-85% of residents living in a long-term care facility, 60% of hospitalized older adults, and an estimate of 5%-10% of older adults living in community settings are malnourished (Maher and Eliadi, n.d.). These statistics sadly show that hospitalized and long-term care patients are more likely to become under nourished compared to the elderly population in the community. According to the Joanna Briggs Institute (JBI, 2007), malnutrition can lead to serious or adverse health outcomes. Malnutrition has been linked to lengthy hospital stays with higher complications, morbidity, mortality, and frequent visits to their general practitioner (JBI, 2007). There are several risk factors (i.e. physical, psychosocial, social, and medical factors) that lead to malnutrition (Maher & Eliadi, n.d.). It is predicted that by 2030, the elderly population in the United States will double in size and exceed 70 million people. In light of these predictions, addressing the nutritional needs of the elderly will reach epic proportions and become a complex issue. Based on clinical observation, the signs and symptoms of malnutrition and under nutrition are often overlooked. Observing residents in a clinical setting at a local long- term health care facility precipitated our interest in this problem with malnutrition. The majority of elderly people living in care homes either have dementia, suffer from some form of physical disability, or have difficulty swallowing, which restricts them from adequately hydrating and nurturing themselves. With dementia, they usually do not remember how to eat or how to chew. With various physical disabilities, such as upper extremity contractures, their ability to feed themselves is often limited. In the event of swallowing difficulties, their food preference is often altered to prevent choking or aspiration. This often discourages them from eating due to the texture of the diet ordered. With the issues fore-stated, the residents often have to rely on the staff to assist them with meals. Caregivers often contribute to the problem of malnutrition because not enough time is devoted to assisting and supervising the residents to ensure they are eating properly. It is our job as caregivers to know the signs of malnutrition and risk factors that lead to malnutrition so that it can be detected and reported to the physician or dietitian early, before major problems occur....
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