WEIGHT GAIN AND PROTEIN MAINTENANCE IN DEBILITATED NURSING HOME ELDERLY Y. LEVINSON, T. DWOLATZKY, A. EPSTEIN, B. ADLER, L. EPSTEIN NEVE SIMCHA GERIATRIC.

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Presentation transcript:

WEIGHT GAIN AND PROTEIN MAINTENANCE IN DEBILITATED NURSING HOME ELDERLY Y. LEVINSON, T. DWOLATZKY, A. EPSTEIN, B. ADLER, L. EPSTEIN NEVE SIMCHA GERIATRIC HOSPITAL AND HADASSAH MEDICAL ORGANIZATION

Nutritional Maintenance in Nursing Homes Previous studies have shown a general inability to maintain weight and protein status of elderly nursing home patients Previous studies have shown a general inability to maintain weight and protein status of elderly nursing home patients

Nutritional Maintenance in Nursing Homes “ Uncontrolled weight loss is almost inevitable in later stages (of Alzheimer ’ s disease ) despite quality of care ” “ Uncontrolled weight loss is almost inevitable in later stages (of Alzheimer ’ s disease ) despite quality of care ” JADA 89: 392, 1989

Nutritional Maintenance in Nursing Homes “ Adequate energy and protein were provided, but (elderly) subjects lost weight and had severe depletion of lean and fat body mass … weight loss was associated with longer time on tube feeding and more pressure ulcers ” “ Adequate energy and protein were provided, but (elderly) subjects lost weight and had severe depletion of lean and fat body mass … weight loss was associated with longer time on tube feeding and more pressure ulcers ” J. AMER. COLL. NUTR. 11: 309, 1992

The Nutritional Management of Elderly in Nursing Homes Problems Weight loss Worsening of protein status Pain and weakness Pressure sores Severe appetite loss Solution Nutritional support Formula feeding

In-house formulas In-house formulas Commercial formulas Commercial formulas

In-house low cost formula Description Description high protein, milk-based high protein, milk-based 250 cc/ serving 250 cc/ serving 380 calories 380 calories 15 grams protein 15 grams protein Available as Available as Milkshake Milkshake Pudding Pudding Tube feeding Tube feeding

Nutritional Maintenance in Nursing Homes

In-house formula study patient characteristics 143Number of patients 61/39Gender women/men (%) Age range (years) 83Mean age (years) 26.6 %Age group 60 – 79 (years) 55.9 %Age group 80 – 89 (years) 17.5 %Age group 90 + (years)

In-house formula study patient characteristics %Diagnosis 66Dementia 43CVA 37Heart disease 20Diabetes 22Fractures Patients may have more than 1 diagnosis

In-house formula study

In-house formula study all available weights

In-house formula study only subjects with all weights

In-house formula study

In-house formula study summary of results Overall increase of 5 kg in mean weight Overall increase of 5 kg in mean weight Mean serum albumin maintained above 4 g% Mean serum albumin maintained above 4 g%

In-house formula study conclusions  It is possible to increase weight and maintain protein status of debilitated elderly in nursing homes

Nutritional Maintenance in Nursing Homes Questions ?