46 Geriatric Nursing 2001 • Volume 22 • Number 1 Clinical Guidelines to Manage Malnutrition in Nursing Homes Malnutrition is a major problem in long-term care (LTC) settings and even has been characterized as the “skeleton in the nursing home closet.” Although several methods for improving nutrition among elders have been published in the past decade, they seldom are used, leaving residents with treatable causes of malnutrition without appropriate treatment. The Council for Nutritional Clinical Strategies in Long Term Care has established a clinical guideline to manage malnutrition and involuntary weight loss at residential settings.This guideline, based on a 3-year study, was published in the December 2000 Journal of Gerontology: Medical Sciences. The clinical guide for physicians, pharmacists, and dietitians focuses on differential diagnosis. The impor- tance of reporting medical conditions and declines in activities of daily living is emphasized, as well as the cognizance of delirium, depression, and mood disorders in residents. The guideline also notes that delirium re- versal may result in appetite resumption. Depression is a major cause of weight loss in LTC settings, accounting for up to 36% of residents who lose weight. The study also noted that many drugs have been found to cause weight loss and therefore suggests, in consultation with a pharmacist, that clinicians discontinue all drugs that potentially aggravate anorexia. Medications that stimulate appetite are available and may reverse malnutrition. The study acknowledged that certain causes of malnutrition may be irreversible, but proper care, orexigenic drugs (appetite stimulants), and enteral feeding may help. For more information, contact the Gerontological Society of America at (202) 842-1275, (202) 842-1150 fax, or www.geron.org. Move over bananas—prune juice is also a great source of potassium. In fact, prune juice qualifies for a new Food and Drug Administration authorita- tive health claim that links potassium-containing foods for the prevention of hypertension and stroke. Substantial scien- tific evidence indicates that the risk of stroke-related deaths is inversely related to potassium intake. Nutrition

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46 Geriatric Nursing 2001 • Volume 22 • Number 1

Clinical Guidelines to Manage Malnutrition

in Nursing HomesMalnutrition is a major problem in long-term care

(LTC) settings and even has been characterized as the“skeleton in the nursing home closet.” Although severalmethods for improving nutrition among elders havebeen published in the past decade, they seldom areused, leaving residents with treatable causes of malnu-trition without appropriate treatment.

The Council for Nutritional Clinical Strategies in LongTerm Care has established a clinical guideline to managemalnutrition and involuntary weight loss at residential set-tings.This guideline, based on a 3-year study, was published inthe December 2000 Journal of Gerontology: Medical Sciences.

The clinical guide for physicians, pharmacists, anddietitians focuses on differential diagnosis. The impor-tance of reporting medical conditions and declines inactivities of daily living is emphasized, as well as the

cognizance of delirium, depression, and mood disordersin residents. The guideline also notes that delirium re-versal may result in appetite resumption. Depression isa major cause of weight loss in LTC settings, accountingfor up to 36% of residents who lose weight.

The study also noted that many drugs have been foundto cause weight loss and therefore suggests, in consultationwith a pharmacist, that clinicians discontinue all drugs thatpotentially aggravate anorexia. Medications that stimulateappetite are available and may reverse malnutrition.

The study acknowledged that certain causes of mal-nutrition may be irreversible, but proper care, orexigenicdrugs (appetite stimulants), and enteral feeding may help.

For more information, contact the GerontologicalSociety of America at (202) 842-1275, (202) 842-1150 fax, orwww.geron.org.

Move over bananas—prunejuice is also a great source ofpotassium. In fact, prune juicequalifies for a new Food andDrug Administration authorita-tive health claim that linkspotassium-containing foods forthe prevention of hypertensionand stroke. Substantial scien-tific evidence indicates that therisk of stroke-related deaths isinversely related to potassiumintake.

Nutrition