Weight Loss Prevention
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RESIDENTS WITH LOW INTAKE NEED FURTHER EVALUATION
The purpose of estimating residents' food and fluid consumption is to identify individuals with low intake levels who may not be getting enough foods and fluids on a daily basis to meet their nutrition and hydration needs and prevent unintentional weight loss.
If a resident's average intake level for the six assessment meals is less than 75%, then that person should be further evaluated in a feeding assistance trial, as described in Step 2.
These at-risk residents should also be "triggered" for follow-up nutritional assessments conducted by a registered dietician according to the MDS-Resident Assessment Protocol, or RAP. These additional assessments, including assessments of food complaints, depression, pain, and health status, are intended to guide individualized care plans and appropriate nutritional interventions. The assessments are not necessary to complete our feeding assistance intervention, but we strongly recommend them. In any case, nursing homes are required to conduct them in order to be in compliance with federal standards.
To help, we developed and tested standardized protocols for assessing food complaints, chronic pain, and depression as well as for abstracting pertinent medical information from resident charts. This information is helpful for creating individualized care plans to prevent weight loss.
Please note:
Our protocols require staff to interview residents in order to assess food complaints, chronic pain, and depression. Not all residents who need these assessments are capable of providing reliable, stable responses during interviews (though often, many more residents can provide meaningful responses than nursing home staff assume).
Our research shows that residents who score two or more on the MDS-derived Recall scale are appropriate to interview about food service complaints and preferences for daily care (5,6). Furthermore, many residents with a score of 1 can provide reliable information about depression and pain.
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