16.5% of elderly citizens in several nursing homes have been found to be malnourished, according to a recent study conducted by the Grenada Food and Nutrition Council (GFNC).
Between October and November, 139 persons over the age of 65, in 7 nursing homes were assessed using the mini Nutrition Assessment. The results also showed that 46.1% were at risk of malnutrition with 37.4% of the residents scoring normal nutritional status.
Elderly citizens under 65 who were not assessed, were measured for height and weight to get their body mass index (BMI) while there were others who had not been assessed because their physical condition would not allow for an assessment with the available tools.
Executive Secretary of the GFNC Lydia Browne presented those findings to NOW Grenada, as the council prepares to conduct a follow-up assessment sometime this May. “Some of them measured at risk for malnutrition may have turned out the normal weight; so a resident could have a normal weight status but could be at risk for malnutrition, so of the 166 residents, we screened 151 for BMI and of that, we had 57.6% scoring normal or acceptable. Why? Because the GFNC decided that we would use a body mass index of 20 – 27, because it is an older population and because we recognise that very low weight in this population places them at a higher risk.”
Browne provided other data stemming from the survey. “Normal standards are 18.5% to 24.9%. Any resident who would have fallen between 19.9% and 18.5% for us would have scored [as] underweight, but based on normal standards, would have scored [as] normal weight, so we placed them in the category of acceptable.”
Browne said the highest case of malnutrition seen in any given nursing home was 8 residents, but has decided not to release the name of that institution. However, she did say that some variables must be taken into consideration in that particular case. “Bearing in mind that at that home we also had 2 residents over the age of 100, and that we had some residents that were not too long admitted, which means they would have come into that home in that condition. We cannot point out any particular home saying that this home did worse on the assessment or not, because we don’t have the information to look back on. This survey is the first time [it is] being done, so this will be baseline.”
Following the conclusion of the survey, the GFNC provided a report to each home and to the Ministry of Social Development and Desk of the Elderly. A list of recommendations that would address many of the nutritional needs of the residents was also provided to the homes. “Some of the nutritional needs would be to increase fluid intake by some of the residents, spacing fluids and foods so that the resident would not full up to fluids and cannot eat the foods, breaking meals up so that instead of having 3 square meals a day at that age, most [people] may not have the energy to eat a full meal, but may be able to eat 6 to 8 portions of small meals a day.”
The GFNC executive secretary said a number of issues which place residents at serious risk, can arise if proper nutritional guidelines are not followed.
“Some of the issues that can arise are weakened immune system leading to their inability to fight infections; it may cause residents to bruise easily at the joints and can develop a bed sore or pressure ulcer that in itself can lead to infection and amputation for some…nutritional status is not just affected by the food that is provided, but sometimes it’s challenging for [the] elderly because of mental changes. It is sometimes difficult to get them to eat, sometimes you have to remind them to swallow.”
The GFNC said they will continue to offer advice to improve the nutritional diet for residents at those homes, along with periodic assessment carried out on residents who are deemed malnourished. Also, the GFNC will attempt to conduct a similar survey for elderly residents on the sister isle of Carriacou.
The World Health Organisation (WHO) has listed malnutrition as being common among residents of homes for the elderly. In their latest Eastern Mediterranean Health Journal, the WTO stated that “Studies have indicated that nutritional status can decline within a period of fewer than 3 months. Therefore, residents who are at risk of developing malnutrition go unrecognised because the anthropometric parameters of elderly people are recorded rarely.”