MDS Alert

Dietary Assessment:

Resident Dropping Pounds Or Not Eating Well?

Published on Tue May 10, 2005

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These MDS items may hold the answers.

The MDS can red-flag residents whose nutritional status is in jeopardy - or help explain why a resident is shedding weight.

Assessment parameters to identify residents at risk of significant weight loss include the following:

Section K. K4a looks at whether the resident complains about the taste of the food. K4c flags a resident who leaves 25 percent or more of her food uneaten at most meals. "K5 looks at therapeutic diets, mechanically altered diet, etc.," says Norma Jean LaPoint, RN, MDS coordinator for United Helpers Nursing Home in Ogensburg NY.

"Also look at Section K1 to see if the person has a problem with dentures, mouth sores or pain," LaPoint advises.

Section E. Behaviors and mood coded in this section can be a risk factor for poor meal intake. Dementia is a risk factor for poor nutrition.

Section G. Limitations in functional status, especially ability to eat independently, can cause a resident to miss out on adequate meal intake, if she doesn't receive adequate assistance.

Pain in Section J. Pain can interfere with a resident's appetite or ability to eat.

Section I (diagnoses). "Sometimes a person with cancer will eat normally and still lose weight," says LaPoint. Other diagnoses associated with potential for poor appetite and/or weight loss include depression, CVA with dysphagia or dysphasia, hyperthyroidism, renal failure, COPD, diabetes mellitus, recurrent pneumonia, congestive heart failure, arthritis or liver disease.

Section O (medications). "If the person isn't eating well or is losing weight, we look to see if the physician has added or stopped a medication recently," says LaPoint. "Some psychotropic medications can cause weight loss or gain. Yet sometimes we do a psychotropic med reduction, and find someone becomes more resistant to eating due to anxiety or behaviors."

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