Articles and Information from GA Foods

Age Well by Eating Well

Posted by Jessica Fleigle on Sep 28, 2016 11:00:00 AM

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Proper nutrition is the key to aging well, and it has many health benefits. The vitamins and nutrients in food can help you fight diseases, boost your energy and help you sleep better.

For more tips on energy boosting nutrition click here.

Senior Nutrition

Many senior citizens don’t receive adequately balanced meals, which leads to malnutrition. Malnutrition among seniors is directly correlated to the increasing diagnoses of diseases in the senior population. It is very important to consume the recommended amounts of nutrients every day in order to help your body age well.

Good Nutrition Can Prevent Disease

Consuming natural, minimally-processed foods maximizes the body’s intake of vitamins and minerals. These nutrients are necessary in order for the body to age well and fight against sicknesses and diseases. Multiple health studies have proven that some foods reduce the risk of, and may even prevent, certain chronic conditions. 

We’ve composed a list of the most common diseases among seniors as well as the healthy foods to include in your diet to help prevent them.

  1. 1. Heart disease, also known as cardiovascular disease, is the No. 1 killer of Americans. If you have heart disease, it is recommended to limit the amount of total fat, saturated fat, cholesterol and sodium you eat each day. A few heart-healthy foods include salmon, nuts, tomatoes and dark chocolate (made up of at least 60 – 70 percent cocoa).
  1. 2. High blood pressure, also known as hypertension, is often referred to as the silent killer. Over time, high blood pressure can lead to heart disease, kidney disease and stroke. Foods that are high in potassium can help reduce your risk of hypertension. Some examples are bananas, potatoes and leafy greens such as spinach, collard greens and kale.
  1. 3. Diabetes comes in two forms, type 1 and type 2. Type 1 diabetes occurs when the body does not produce insulin. With the help of insulin therapy and a healthy diet, type 1 diabetes can be managed. Type 2 diabetes occurs when there is a problem with your body that causes your blood glucose (sugar) levels to rise higher than normal. Type 2 diabetes can be prevented or delayed with a healthy lifestyle. Diabetic meals should be low in sugar and carbohydrates. Eating cherries, avocados and cinnamon are great because they are linked to reducing blood sugar levels. 

Benefit From a Healthy Diet

A healthy diet consists of a balance between fruits, vegetables, whole grains, nuts, meat and healthy fats. Every meal you eat has the potential to help your body perform successfully. Aside from reducing the risk of diseases, the nutritious meals you eat can also boost your metabolism, improve your mood and help you sleep better at night. Eating an adequate amount of micronutrients including iron, omega-3 fatty acid and folic acid will ensure a positive food-mood relationship.

Make Small Changes

You don’t have to adjust your diet all at once. Start with small changes like switching from a sugary breakfast cereal to a whole grain cereal or oatmeal. Or, snacking on fresh fruits and vegetables instead of processed foods like crackers and chips.

In addition to making small changes, set small, realistic goals to help you acheive your end result. If your end goal is to have as much energy at the end of the day as you do in the morning by three months from now, setting small goals such as getting seven hours of sleep every night, buying more fruits and vegetables when grocery shopping and drinking eight glasses of water daily are great starting points. Achieving these small goals will keep you motivated on your end result, and they'll improve your overall health.

Eating Well on a Budget

Eating healthy doesn't have to be expensive. We’ve created some helpful tips for eating right on a budget. One way to stick to your grocery budget is to create a grocery list. Creating a grocery list ensures you won’t forget any items you need for the week, and it makes you less likely to purchase junk foods, as they are not on the list.

Eating healthy takes some planning. For more information on food swaps you can make to your diet to give you an energy boost, download our energy boosting nutrition tips sheet. 
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Topics: Nutrition, Malnutrition in Elderly, Senior Health, Healthy Home Delivered Meals, Nutrition Care, Advice from Dietitians, Affordable, Healthy Foods, Healthy Meals for Seniors

The Causes of Malnutrition in Older Adults

Posted by Maureen Garner, MS, RD, LD on Apr 27, 2016 11:00:00 AM

While we often hear about children in our society not having access to a proper diet and measures being taken to try to improve their condition, we do not hear as much about the issues facing our older adult population. The fact is, as many as 50-percent of seniors are at risk for shortcomings in their daily food nutrient requirements. Evidence-based research has produced some startling facts that build a case for working to overcome malnutrition in seniors.

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The Staggering Costs of Undernourished Older Adults

You are likely aware that malnutrition in seniors will impact their health and well-being, however, it may surprise you to learn that in the United States alone, over 50 billion dollars is attributed to the cost of disease-associated undernourishment in the aging population annually. While chronic health conditions can cause a nutrient deficiency, malnutrition also leads to more health complications, falls and hospital admissions in older adults. It is a dangerous cycle that must be stopped. Some more statistics that may astonish you include:

  • One of every two seniors are at risk of malnutrition
  • A 300-percent increase in healthcare costs is linked to undernourishment in older adults
  • Up to 60-percent of seniors hospitalized suffer from the result of malnutrition 
  • Malnutrition can increase a hospital stay for a senior by as many as four to six days

Considering the relatively low cost of ensuring adequate nourishment, it is vital that we do what we can to prevent malnutrition in seniors.

Adequate Income not the Only Way to Defeat Malnutrition in Seniors

Malnutrition in seniors is not relegated only to those with low incomes. There are several underlying causes of undernourishment in the aging population.  Most can be categorized as physiological, sociological, psychological or pathological.

Physiological Causes

During the aging process, many changes occur in the body that contribute to decreased appetite and a lack of interest in food:

  • A decrease in both the senses of taste and smell lower the desire for meals
  • Diminishes in taste and smell may lead to increased salt and sugar intake and lower the desire for adequate variety of food choices
  • Slower gastric function and decreased acid production delays emptying the system
  • Lean body mass decreases, further slowing metabolism and hunger 

While these changes are a natural progression, being aware of them and watching for signs is critical in preventing malnutrition in seniors.

Sociological Causes

Aging is difficult for many to accept and can have a serious effect on the sociological factors involved in seniors' eating habits:

  • A reduced ability to shop for and prepare food
  • Fixed income and socioeconomic status may affect food choices
  • Impairment of life skills and activities
  • Being alone at mealtimes

Outwardly you may not realize these are all factors in undernourishment, but in this class there are attainable solutions.

Psychological Causes

Concerns in this category run deeper than the social aspect of decreased appetite and should be addressed with a medical professional as soon as they are suspected:

  • Depression and a general attitude that life is meaningless
  • Loneliness and isolation
  • Grief over the loss of a spouse or friends
  • Life events that are emotionally stressful

Armed with understanding, combating undernourishment in seniors due to psychological concerns can be improved quickly through emotional support and proper medical attention.

Pathological Causes

The final category of causes is another that requires medical intervention and if symptoms are observed, should be addressed as early as possible:

  • Problems with the teeth and jaws
  • Alcoholism
  • Difficulty with swallowing
  • Underlying disease such as cancer, diabetes and thyroid issues
  • Dementia 
  • Medications that interfere with digestion or hunger

Again, these are all causes that should be addressed by a medical professional as early as possible to mitigate the effects of malnutrition in seniors. 

How We can Overcome Malnutrition in Seniors

While we we may not be able to eradicate undernourishment in all seniors, armed with this information, you can be sure your loved ones or older adults in your care are not at risk for malnutrition. Some tips include:

  • Regular nutritional assessments and follow-up on any prescribed treatments
  • Spend time together, particularly at mealtimes whenever possible
  • Consider a prepared meal service to combat apathy or poor food choices
  • Try to help your senior loved-one stay as active as possible, both socially and physically

One senior at a time, we can all help prevent malnutrition in our older adult population by focusing on those under our care and understanding the underlying causes. 

The more a senior has access to healthy foods and all of life’s necessities, the easier it will be to age-at-home. For more information on choosing a home-delivered meals provider, download our free ebook:

Download 9 Questions to Ask When Choosing a Home-Delivered Meals Provider

 

 

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Topics: Malnutrition in Elderly, Home Delivered Meals, Senior Health, Nutrition Care

Does Food Security Impact Hospital Readmissions?

Posted by Maureen Garner, MS, RD, LD on Apr 20, 2016 9:59:59 AM

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Food Security (or Insecurity) Defined!

Food security, or insecurity, is a social, cultural or economic status, whereas hunger is a physiological condition – the physical pain and discomfort someone experiences. Hunger doesn’t describe the scope of food security, or insecurity, which is when people do not have access to enough food for an active, healthy life.

The United States Department of Agriculture (USDA) has developed a validated survey with 18 questions to determine a person’s level of food security. Based on the answers to these questions, the USDA defines the levels of food security as:

  • High food security: answers “no” to all 18 questions.
  • Marginal food security: answers “yes” to one or two questions.
  • Low food security: answers “yes” to three or more questions.
  • Very low food security: answers “yes” to five or more questions in homes without children or “yes” to eight or more questions in households with children.

Food Security Among the Elderly

In the US, 48.1 million people live in households with low or very low food security. Of those people, 20% or 9.6 million are seniors. Seniors with low food security tend to have medical and mobility challenges. Per AARP, those at the greatest risk for low food security are the poor, minorities, the unemployed, the disabled, and those living in the South.

Older adults above the poverty level may also be at risk for low food security, particularly if they are unable to shop for and prepare foods.

Consequences of Low Food Security

Low food security is a strong predictor of health problems like heart disease, cancer, diabetes, and pulmonary disease. Adding to the problem, these chronic conditions increase the medical expenses of those with low food security, often forcing them to choose between paying for medical care and buying food. In turn, the chronic conditions increase healthcare expenditures paid by health plans, Medicare and/or Medicaid.

A recent study looked at the impact that low food security has on high rates of hospital readmissions. They interviewed 40 adults with three or more hospitalizations within a 12-month period. Here are their findings:

  • 30% were low or very low food secure
  • 25% were marginally food secure
  • 75% were unable to shop for food on their own
  • 58% were unable to prepare their own food 

The researchers recommend interventions that educate and connect patients with unmet food needs to community resources after discharge. 

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Healthcare professionals need to evaluate a patient’s food security level as part of the transitional care plan upon discharge from the hospital. Most transition care models don’t incorporate nutrition care, including screening for unmet food needs, after discharge. A guide from Centers for Medicare & Medicaid Services, recommends addressing food security as a strategy to avoid readmissions for diverse populations. After a hospitalization, patients generally have decreased energy, pain, weakness, and a poor appetite, putting those with low food security at an even greater risk for malnutrition, and associated poor outcomes.

Connecting low food secure patients with resources such as home-delivered meals (HDM), decreases their need for shopping and cooking after a hospitalization. HDMs provide a regular source of nutritious food for those that need it for their recovery, reducing medical costs and the risk of a hospital readmission.

 

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Topics: Malnutrition in Elderly, Senior Health, Healthcare Cost Reduction, Food Insecurity, Medicare, Food Security, Malnutrition, Medicaid

Tips for Preventing Malnutrition in Seniors

Posted by John Siegel on Jan 27, 2016 10:48:43 AM

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John Siegel is the VP of Business Development for GA Foods.  He has extensive experiencworking with healthcare organizations to optimize benefits provided to their members. Contact John at 954-732-6886 or jsiegel@gafoods.com to learn how your organization may benefit by providing these well-received services.

It may seem unbelievable, considering the abundance of food in the U.S., but malnutrition is a very real problem among the elderly. It’s estimated that as many as one out of every four senior citizens suffers from poor nutrition. This can have a serious negative impact on health, from lowered immunity to slower wound healing and exacerbation of existing diseases. It can lead to loss of weight and muscle strength, making daily activities more difficult and increasing the likelihood of falls.

Seniors with poor nutrition make more visits to doctors, hospitals, and even emergency rooms, and their stays are almost twice as long as those of well-nourished patients. Healthcare professionals and other caregivers should be aware of the warning signs for sub-optimal nutrition as they are in an ideal position to coordinate solutions with family and other caregivers before patient discharge.

Warning signs of poor nutrition

Poor nutrition can be a result of many things, from difficulty chewing or swallowing to lack of money for buying food. Being aware of the situations that can lead to malnutrition, and the warning signs that a patient or family member is suffering from poor nutrition is an important part of senior care. If your patient or family member is experiencing any of the following issues, they may be at risk:

Decreased appetite – Reduced appetite is often part of the aging process itself. The ability to taste also declines with age, making food less palatable. Decreased appetite may be a side effect of certain medications, or a symptom of depression.

Unplanned weight loss – This is usually a loss of muscle, not fat. This may be as obvious as the numbers on the scale when the person is being weighed, or you may simply notice that clothes are too loose.

Difficulty swallowing or chewing – Loss of teeth, poorly fitting dentures, or mouth pain can all cause difficulty when eating. This may also be a symptom of cognitive issues.

Chronic illness – Those on special diets for conditions such as diabetes, hypertension, hyperlipidemia, etc. may need help with managing their diet. Special diets such as these may also exclude foods the patient prefers to eat and they may need help adapting their eating patterns.

Recent hospitalization – Lack of appetite is a common aftereffect of illness or injury. While still in recovery mode, the patient may not feel like eating or have the energy to cook.

Fatigue or limited physical function – For some, going shopping for groceries is too tiring. Going to the store, picking out foods, and bringing them home may require more energy than they have to give. Likewise, cooking a meal may be too exhausting for some. Age-related loss of muscle may limit their functional capabilities, putting both these activities beyond their reach.

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It may be difficult for those who are lacking food and most at-risk for malnutrition to ask for help, even when they have supportive friends and family; for those with no support system, the problem is even worse. They may feel that they have no options, or be ashamed of their situation. Opening a discussion and talking about the subject in a non-judgmental and unpatronizing way can be very beneficial. You can then suggest strategies for dealing with some of the more common food-related issues listed above, such as:


Eating several smaller meals per day, including snacks, and increasing activity to stimulate the appetite

Including favorite foods in meals

Using spices to flavor foods—particularly helpful for those with decreased sense of taste, or people who are restricting their salt or sugar intake

Asking family or friends to help with shopping or/and meal preparation—this may be a particular problem for those with limited support, and in some cases home health services may be available

Inviting family or friends over to eat once or twice per week—not only does this provide the opportunity to check in and keep tabs on the patient’s well-being, it also provides social interaction and helps stave off depression

Looking into home-delivered meal service—some health plans cover this type of service, and many home meal delivery services are free or charge on a sliding scale. You can use eldercare.gov to help locate services in your area. For information on how to receive home-delivered meals, click here. Providers offer varying levels of service, from one meal per day to several, and at different costs. GA Foods offers nutritionally sound “heat-and-eat” or shelf-stable senior meal options.

Caring for the elderly is a community effort. Those in caregiving professions play an important role, not just in healthcare, but in making sure that the day-to-day needs of one of our most vulnerable populations are met—and adequate nutrition is high on the list of day-to-day needs.

 If you are a health plan or other health care organization
and want more information, click below:

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Topics: Malnutrition in Elderly, Home Delivered Meals, Chronic Disease Management, Senior Health, Food Insecurity, Food Security Impact

Reduce Healthcare Costs with Home Delivered Meals

Posted by Maureen Garner, MS, RD, LD on Sep 8, 2015 12:02:20 PM

1 Out of Every 3 Patients Admitted to the Hospital is Malnourished!

Many Americans are surprised to learn that malnutrition is a very real problem among hospitalized patients in the U.S. In fact, research has shown that approximately one of every three patients admitted to a hospital is malnourished. Left untreated, about two-thirds of those patients will become more severely malnourished during their hospitalization. Approximately one-third of patients who are not suffering from malnutrition upon hospital admission will become malnourished by the time they are discharged.

Malnutrition Increases the Risk of Complications from Diseases

Malnutrition has far-reaching effects, causing impairment on many levels. Poor nutritional status impairs the immune system, delays wound healing, causes unhealthy changes in body composition, reduces muscle strength and can decrease the function and efficiency of vital organs and systems, such as the kidneys, respiratory and cardiovascular systems, and more. Malnutrition is also associated with fatigue, apathy and depression. These effects and others contribute to poor treatment outcomes as compared to well-nourished patients, including longer recovery times and increased risk of complications.

Malnutrition Increases the Length and Complexity of Care of Hospitalized Patients

Malnutrition among patients also has consequences for the medical facilities that treat them, as well as managed care organizations, health plans, and other stakeholders in the medical system. The effects of malnutrition can significantly increase the overall length and complexity of care in these patients, which substantially increases the costs associated with treatment. Additionally, poor nutrition and the poorer outcomes that come with it often mean more frequent hospitalizations – and in many cases, readmissions within 30 days of discharge. Newer reimbursement rules, implemented under the Affordable Care Act, impose financial penalties for readmissions.  Per Kaiser Health News, beginning in October, nearly 2,600 hospitals will receive lower payments for every Medicare patient.  These hospitals lost a combined total of $420 million due to the readmission penalty.  

Home Delivered Meals Maximize Patient Outcomes and Minimize Costs

Providing home delivered meals after a hospitalization or as part of the treatment plan for chronic disease management can reduce complications and readmissions. For more information, read this article about MANNA in Philadelphia and how they reduced healthcare costs with home delivered meals. 

Our white paper, Reduce Healthcare Costs and Improve Patient Outcomes with Post-Discharge Meals, reviews the body of evidence that shows how post-discharge meals can maximize patient outcomes while reducing healthcare costs.  Download our white paper now to learn more about nutrition care during the post-discharge period and how nutrition care will improve your outcomes as a hospital, managed care organization or health insurer.

Download White Paper - Reducing Healthcare Costs and Improve Patient Outcomes

 

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Topics: Malnutrition in Elderly, Healthcare Cost Reduction

The Dangers of Dehydration in Seniors

Posted by Joann Pierre, MS, RD, LDN on Jul 16, 2015 2:20:08 PM

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Dehydration in Seniors

Dehydration_Home_Delivered_MealsDehydration is a common reason for hospitalization in seniors. One reason seniors tend to become dehydrated is the ability to sense thirst declines with age. Drinking enough fluids is necessary to regulate body temperature, help kidneys transport waste, and maintain normal bowel function.

Seniors within home health care services or eldercare services are frequently reminded by caregivers to drink fluids. Home delivered meals that include juice and milk are another good way to ensure seniors receive adequate fluids.

Seniors need to be aware of the signs of dehydration.  If they begin experiencing any symptoms, they need to increase their fluid intake.  If the symptoms persist, they need to seek medical attention.

Water is the best choice to drink to keep the body hydrated. However, other beverages like juice, decaf tea, decaf coffee, and milk will also help. In addition, fruits and vegetables are good sources of fluids. Tomatoes, cabbage, watermelon, celery, oranges and spinach contain 85-95% water.  

Adequate Fluid Intake

To determine the amount of fluids someone should drink each day, divide their body weight in half. That is the number of ounces you need. For example, if the senior weighs 150 pounds, he or she should drink 75 ounces of fluids per day. Their body may need more if they live in a hot climate, are physically active, or have diarrhea, vomiting or a fever.

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Seniors should not wait until they are thirsty to drink fluids. Encourage them to drink fluids with every meal and snack. They should also drink water before, during, and after being out in the sun or engaging in physical activity. Make sure they keep a bottle or glass of water within reach and drink it throughout the day.  Medications should be taken with an 8 ounce glass of water.

Download a free copy of our Nutrition Education for seniors on this topic by clicking on the image below!

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Topics: Nutrition, Malnutrition in Elderly, Home Delivered Meals, Chronic Disease Management

Hospital Malnutrition and Discharge Planning

Posted by Maureen Garner, MS, RD, LD on Mar 4, 2015 1:10:00 PM

This is the fourth of a 5-part series, Impact of Nutrition Care on Patient Outcomes.  In this series, we will review original research that shows the impact nutrition care has on patient outcomes.

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Malnutrition is a common health issue

Hospital malnutrition in developed countries is more prevalent than most realize. Here are some statistics1:

- It is estimated that one-third of patients are malnourished upon admission to the hospital.

- If left untreated, approximately two-thirds of these patients will become even more compromised during their hospitalization.

- Roughly one-third of patients not malnourished at admission will become malnourished during their hospital stay.

Malnutrition in the frail and elderly is an important area of concern, because it has been correlated with many poor outcomes2:

- Increased risk of pressure ulcers
- Impaired wound healing
- Increased infection rate
- Muscle wasting
- Functional loss, resulting in more falls
- Longer hospital stays
- Higher readmission rates
- Higher treatment costs
- Increased mortality

Nutrition care improves clinical outcomes

Most of these adverse outcomes are preventable or can be improved with nutrition intervention. The Alliance to Advance Patient Nutrition has developed a model for interdisciplinary nutrition care. (Figure 1) 

static_abbottnutrition_com_cms-prod_malnutrition_com_img_Alliance_Care_Model_2014_v1_pdf Figure 1:  Source:  www.malnutrition.com

The Steering Committee of the Alliance published a call to action that outlines the comprehensive model from hospital admission through discharge.  Their sixth principle, Develop a Comprehensive Discharge Nutrition Care and Education Plan, ensures that nutrition goals achieved in the inpatient setting are not compromised once a patient is discharged1. 

Access to food is an important part of discharge planning

One area the Steering Committee suggests be addressed in the discharge plan is access to food.  This is one area that is frequently neglected in care transition planning and of particular concern for the frail and elderly.  Providing access to food through home-delivered, post-discharge meals allows the frail and elderly to regain their strength and energy sooner.  It also helps reduce unplanned hospital readmissions.  Proactive hospitals and health plans are providing post-discharge meals as part of transition care planning.  The GA Food’s home-delivered meals program allows the frail and elderly to have nutritious, easy-to-prepare meals and remain independent in their homes.

For more information on the benefits of post-discharge meals, see this blog post.

Contact John Siegel at GA Foods

Download free ebook on questions to ask when choosing a home-delivered meals provider.

1Barker, LA. Et al. Int J Environ Res Public Health. 2013; 8(2):514-527.

 2Tappenden, KA, et al. J Parenter Enteral Nutr 2013;37:482-497.

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Topics: Malnutrition in Elderly, Home Delivered Meals, MCO ROI

Do Home-Delivered Meals Affect Surgical Outcomes?

Posted by Maureen Garner, MS, RD, LD on Feb 18, 2015 2:46:00 PM

This is the third of a 5-part series, Impact of Nutrition Care on Patient Outcomes.  In this series, we will review original research that shows the impact nutrition care has on patient outcomes.

Surgical diagnoses added to CMS readmission penalties

The first post of this series discussed the readmission rates of Medicare patients and the impact readmissions have on healthcare costs.  As part of the Hospital Readmissions Reductions Program (HRRP), CMS is reducing payments to hospitals with excess readmissions rates for certain diagnoses. Readmission is defined as an admission within 30 days of a discharge.  In FY 2015, chronic obstructive pulmonary disease (COPD) and total hip or knee replacement surgeries are being added to the list of diagnoses.  This is the first year that surgical procedures are included.Surgical_pt_LR

Malnutrition is a common reason for readmission after surgery

In anticipation of surgical procedures being measured, researchers at Emory Hospital examined factors associated with a hospital readmission within 30 days of discharge for general surgical inpatients.  Since most of these surgeries are planned, the suggestion is there is an opportunity to intervene preoperatively to decrease the risk of readmission after surgery. 

 According to their study1, the most common reasons for readmission were:

  • Gastrointestinal problems/complications (27.6%)
  • Surgical infections (22.1%)
  • Failure to thrive/malnutrition (10.4%)

It is estimated that one-third of patients admitted to hospitals are malnourished.2 While in the hospital, all patients are screened for nutrition risk. If a patient is found to be malnourished, nutrition intervention is provided while hospitalized.  However, nutrition intervention needs to begin earlier for those undergoing planned surgery and needs to continue after discharge.

Proper nutrition improves patient outcomes

Providing home-delivered meals is a great way to ensure adequate nutrition prior to and following surgery, particularly for older adults.  Many live on a fixed income and their food intake decreases with age. Per the Academy of Nutrition and Dietetics, the elderly have a lower intake of micronutrients and calories3.

Proper nutrition for those at risk improves patient outcomes following surgery or a hospitalization.  Many health plans are adding home-delivered meals to their supplemental benefits.

For more information on GA Foods’ home-delivered meals, click below.

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1 Kassin, MT, et al. J Am Coll Surg 2012;215(3):322-330
2 Tappenden, KA, et al. J Parenter Enteral Nutr 2013;37:482-497.
3 Kamp, B, et al. J Am Diet Assoc. 2010;110:463-472.
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Topics: Malnutrition in Elderly, MCO ROI

Does being underweight lead to unplanned hospital readmissions?

Posted by Maureen Garner, MS, RD, LD on Feb 2, 2015 9:19:00 AM

This is the second of a 5-part series, Impact of Nutrition Care on Patient Outcomes.  In this series, we will review original research that shows the impact nutrition care has on patient outcomes.

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Predictors for Rehospitalizations

Last week's blog post focused on a study that identified risk factors for avoidable hospital readmissions. This week, we will review a study1 that evaluated factors that could be used as predictors for unplanned readmissions. As the authors point out, very few studies have reported predictors of readmissions. The ones that have been published, focus on demographic and disease characteristics. While these studies help identify populations at high risk, they do not provide a basis for developing strategies for individual intervention.

Mudge and her colleagues studied 142 inpatients that were 50 years and older that had 2 or more unplanned hospitalizations within a 6 month period. Patients admitted from long-term care facilities or with a terminal illness were excluded. Patients with language or cognitive difficulties were also excluded.  

Being Underweight has a High Probability

The presence of a chronic disease had the strongest correlation to predicting unplanned readmissions.  Heart failure, renal disease, and diabetes were associated with a higher risk of readmission when present as a primary diagnosis or co-morbidity. When the data was analyzed using odds ratio, being underweight had the highest probability of unplanned hospital readmissionsThe risk of readmission was also increased in patients with depression.  The below chart summarizes the probability of different factors predicting readmission. 

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Factors that did not predict probability of unplanned readmissions include age, sex, medication adherence, length of hospitalization, and functional status impairment.

Post-discharge Meals as a Transition Care Strategy

The researchers concluded that post-hospitalization programs that address management of chronic disease, nutritional status, and depression have the potential to reduce hospital readmissions.  Including nutrition interventions in the transition care plan after a hospital discharge impacts both chronic disease and being underweight.

The need for nutrition intervention is further supported in the Academy of Nutrition and Dietetics' position paper2 on food and nutrition for older adults:

  • Five of the eight causes of death in adults 65 and older have a known nutrition effect.
  • In 2007, 68% of people needing home health care had chronic disease conditions, such as diabetes, heart disease, COPD, and hypertension. All are nutrition-related diagnoses and could be improved with appropriate diets.
  • Quantity of food and caloric intake decreases with age and can result in malnutrition, worsening of health conditions, and frailty.
  • Caregivers may lack the information and skills needed to adapt a diet to meet recommendations for chronic diseases.

Health plans are responding to these findings and many are adding post-discharge meals and chronic disease management meals to their supplemental benefits. The GA Foods' home-delivered meals program allows members to have nutritious, easy-to-prepare meals and remain independent in their homes.  The great news for the health plans adding home-delivered meals, is the return on investment is 3 to 1!  

Contact John Siegel at GA Foods

Download free ebook on questions to ask when choosing a home-delivered meals provider.

1Mudge, AM, et al. J Hosp Med. 2011;6(2)61-67.

2Bernstein, M, et al. J Acad Nutr Diet. 2012;112(8):1255-1277.

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Topics: Malnutrition in Elderly, Home Delivered Meals, MCO ROI

Malnutrition in Older Americans

Posted by Maureen Garner, MS, RD, LD on Sep 16, 2014 1:09:00 PM

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Most people know that malnutrition is prevalent in developing countries, but most don’t realize malnutrition is also common among the elderly in the United States. This is a growing problem, as the Census Bureau predicts there will be 92 million people over age 65 by 2060. Malnutrition in our elderly population is a serious issue, due to the associated adverse outcomes.

 The causes are multifactorial, but studies have shown nutrition care leads to better outcomes and saves money. 

At-risk individuals that receive nutrition care during and after a hospitalization are 3 times less likely to die.1

Nutrition care can reduce hospital stays by two days.2

Maureen-GarnerIndividuals with weight loss are at a higher risk for avoidable hospital readmissions. The greater the weight loss, the greater the probability of readmission.3

Malnourished patients have 2-3 times more complications than those not at risk for malnutrition.4

Malnutrition was found in 1/3 of inpatients and resulted in poor hospitalization outcomes and survival.5  

59% percent of patients identified with malnutrition risk, were unable to be discharged home with self-care.6

Hospitalized patients discharged with malnutrition are older and sicker. Their inpatient care was 2 ½ times more expensive than those without malnutrition.7

Being underweight is the strongest predictor for hospital readmissions.8

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Post-discharge meals reduced hospital readmissions by 39% in a CMS pilot in Florida.9
 
MCO paid $12,000 per month less for HIV/AIDS members receiving home-delivered meals than comparison group without home-delivered meals.10
 
Nutrition care is an essential element to support the independence of older Americans, reduce their hospital admissions, and postpone nursing home placement. Home-delivered meals have shown to be effective in preventing and treating malnourished individuals. Something to consider when the cost of a single day in the hospital is 200 times the cost of three home-delivered meals.

1 Feldblum I, et al, J Am Geriatr Soc, 2011;59(1):10-17. 
2 Barker LA, et al, Int J Environ Res Public Health, 2011;8(2):514-527.
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9 FMQAI, Florida’s Medicare Quality Improvement Organization, under contract with CMS.

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