Malnutrition is poor nourishment resulting from improper diet or from some defect in metabolism that prevents the body from absorbing adequate amounts of vitamins, minerals, protein, and calories. Studies have shown that 35 to 85 percent of nursing home residents in the United States are malnourished, and in some nursing homes, 30 to 50 percent are underweight. Malnutrition is one the leading forms of elder neglect that lowers the quality of nursing home residents’ lives. Residents at higher risk for malnutrition, mainly due to dental problems, limited mobility, and dementia, should be more closely assessed and monitored during their stay.

Signs of Malnutrition

Loss of 10 pounds of more without intent is a clear sign of malnutrition. Other symptoms of malnutrition include: weight loss, bloated abdomen, dry skin, fatigue, dizziness, joint ache, fragile bones, swollen and/or bleeding gums, scaling and cracking of the lips and mouth, disorientation, decreased organ function, and etc.


For many reasons, nursing home residents’ food intake is often inadequate. Lack of individualized care, inadequate staffing, and lack of mealtime supervision by nursing staff are among the major factors that contribute to poor nutritional intake because residents are not adequately assisted in consuming all food, fluids, and supplements that they need. Other factors that may prevent a resident from receiving sufficient nutrients include:

Physical Causes:

  • Illness
  • Adverse drug effects that include stomach sickness, vomiting, diarrhea, psychological disturbances, or drowsiness
  • Food and drug interactions which decrease the body’s ability to absorb vitamins and minerals
  • Depression (8 to 38 percent of residents suffer depression which often lead to weight loss)
  • Swallowing disorders (Dysphagia) due to conditions such as dementia, stroke, or Parkinson’s disease (40 to 60 percent of nursing home residents are affected)
  • Poor dental health such as tooth loss, dentures that do not fit properly, oral lesions, and oral pain
  • Tremors, which affect the residents' ability to feed themselves

Environmental Causes:

  • Inadequate care for residents who need assistance eating
  • Uneducated staff regarding malnutrition
  • Reliance on liquid supplements
  • Special diets


Malnutrition can lead to many health problems, including death. Malnourishment often leads to infections, confusion, impaired cognition, and muscle weakness that can lead to poor mobility and falls, bed sores, pneumonia, and reduced immunity to bacteria and viruses.


To restore adequate nutrition, a clinical nutritionist or registered dietician needs to assess the causes and effects of malnutrition and formulate diets that will deliver adequate nutrients to the residents. Based on the nutritional assessment, nursing homes must take steps to ensure that they provide residents with well-balanced, palatable meals. Residents who need assistance with eating should have a CNA helping them to eat adequate amount. Varieties of oral supplements in the form of liquid drinks or power added to food can also provide residents with additional calories and protein. Those who are unable to eat or to benefit from nutrients taken by mouth may be fed through feeding tubes.

As with most other injuries, including dehydration, malnutrition can often be traced to inadequate staffing levels at a skilled nursing facility. If your loved one has shown any signs of malnutrition, you should immediately notify the nursing staff. If your loved one has suffered a significant weight loss or any complications due to malnutrition, your loved one may have been subjected to elder neglect, which is a form of Elder Abuse. Please Contact Us immediately so that we can help protect your loved one’s best interests and hold the responsible parties accountable.

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