Malnutrition in the elderly is a widely undetected health issue concerning the aging community today. People are living longer and the need for an improved screening system is the first step in addressing the issue. Preserving and protecting the aging body is no glamorous pursuit, yet it is the fundamental necessity to living not just a greater quality, but also an improved quality of life.

“I think that there are two facets to this problem,” Medical Director at Abbott Nutrition Dr. Refaat Hegazi, and an author of the feedM.E. study, told Medical Daily. We’ve been stigmatizing malnutrition as underweight but it can really happen to everyone. If we can change the definition to an imbalance of nutritional intake and nutritional need I think we can improve diagnosis. The second thing is lack of training, which correlates with the first point.”

FeedM.E. (medical education), is an awareness campaign demanding the medical community’s attention to a potentially deadly condition throughout hospitals and facilities throughout the country. Malnutrition affects nearly half of all elderly patients in the emergency room, yet it rarely diagnosed and can be prevented with proper diet and treatment follow up. FeedM.E. set up a three step process to accessing malnutrition in the elderly and Hegazi said implementing this uniform screening process could help catch risk factors early. If a patient answers yes to two out of the three questions, they are automatically at risk and the process of balancing their caloric and vitamin intake should immediately begin.

Malnutrition Screening Questions:

Have you or someone you care for…

1. Been sick, injured, or have an underlying health issue?

2. Experienced loss of appetite?

3. Lost weight without trying?

It is absolutely vital that once a family member enters into a facility, whether it be a nursing home, rehabilitation, emergency room, or general hospital admittance, they are properly assessed for malnutrition. Hegazi believes malnutrition screening and treatment is not prioritized properly. “In our hospitals, the screening for malnutrition is not urgent enough,” Hegazi said. The screening questions vary greatly from hospital to hospital and they’re just not effective enough to properly detect a malnourished patient.”

When we think of malnutrition, we usually picture a third world country, mothers’ thin arms cradling their children with round bellies and gaunt faces. You don’t picture America. Yet a recent study in the Annals of Emergency Medicine found 60 percent of elderly patients who were screened in the emergency department were malnourished and 77 percent of them said they weren’t diagnosed before then. This means malnourished patients are entering hospitals, slipping undetected through the screening process, being treated for a separate ailment, and then leaving the hospital still malnourished. This cruelly under recognized area of medicine leaves a large portion of our population untreated and in desperate need of medical attention.

“Many elderly patients are malnourished due to lack of motivation and encouragement. Becoming ill in old age is a very difficult thing to cope with,” Laura Adcock, a certified nursing assistant at John T. Mather Memorial Hospital, told Medical Daily. “Support is crucial at this time as many elderly people give in to the belief that they have lived a long life and it is their time to go. Many elderly people in hospitals without appetites are told to eat whatever they wish as long as they eat something. The moral to this statement is debatable. On one hand you have an elderly person with rights and individual desires. To deny them could be considered immoral. On the other hand, this ill elderly being is declining due to malnutrition. Should a healthcare team intervene? Or should final decisions be left to the individual? This is a constant struggle for healthcare providers and always will be.”

Approximately one-third of the elderly are going to become obese and despite their weight many of them are malnourished. They’re living facades of malnutrition, hidden beneath layers of unhealthy and life-threatening fat. Patients, despite their weight, become malnourished from of a combination of possibilities. Elderly patients could find it difficult to go grocery shopping, have financial concerns, restrictive diets, or physical factors such as difficulty chewing and swallowing foods, inability to feed oneself, appetite loss, medication side effects, diseases, or by simply forgetting due to dementia or Alzheimer’s. Many live alone and few are fortunate enough to live with a child to take care of them and watch over their diets. Home health aides are instructed by visiting nurses to be aware of any dietary restrictions and of their eating habits but they’re not responsible for keeping track of the diets. Then who is?

“I believe in bettering the nutritional health of all people in society and I do not believe enough attention is paid to it,” Adcock said. “There are too many chemical solutions to organic issues. Doctors are not all to blame for a lack of informality. Many are overworked and undereducated in the field of nutrition as it becomes increasingly significant to treating and preventing disease in present times. Protein is a nutritional healer in that it has the capability to repair torn cells and reattach preexisting tissue connections. Protein is essential to muscle and tissue repair within the body. Without it our anatomy would perish."

For those living in frequently understaffed nursing homes, they are denied a healthy share of attention and observations. Many elderly patients lie for days, developing worsening pressure ulcers known as bed sores and they need protein in order to repair their damaged tissue. But it’s also necessary they have a healthy caloric intake with a balance of protein in order to allow the body to heal properly, said Hegazi. The longer patients go without a proper balance of vitamins, minerals, proteins, carbohydrates, and fats, the longer it’ll take the body to repair itself.

“This study confirms what we already know—that there’s a problem and the elderly aren’t being screened properly,” Hegazi said. “Nutrition is such an important tool for repairing the tissue, ulcers, and wounds. Our findings concur protein repairs and synthesizes new protein development and enough calories are needed to prevent muscle degradation.”

By 2030, the Centers for Disease Control and Prevention predict one out of every five Americans will be 65 and older. We’re living longer and an aging nation needs its demands met. Nutrition assessment should be an essential part of any person’s wellbeing, but especially the elderly. Oftentimes we forget food and can be medicine and, according to Hegazi, in other countries the nutritional supplement Ensure is treated as a prescription to help treat their diagnosed. By ignoring the nutritional necessity of balance, patients are at risk for weight loss, muscle wasting, immune system impairment, increased risk of infection, and reduced physical and mental ability. It’s alarming how all of these potentially fatal health consequences could be prevented by just implementing an effective screening process from the start.