National standards and state guidelines are needed to monitor assisted living residents for significant weight loss, particularly during quarantine periods, according to the authors of a new review of resident charts.
Gerontology care providers and researchers from the McGovern Medical School at UTHealth Houston reviewed the charts of 53 residents at 18 Houston-area assisted living communities and found that 40% of those residents experienced weight loss of at least 5% during the first six months of the COVID-19 pandemic. And 19% of residents lost 10% or more of their body weight.
Men were 14 times more likely to lose significant weight during quarantine than were women, but researchers are uncertain why.
“When we heard about the extreme weight loss from facilities, we looked at house call patients in assisted living facilities, where we discovered enormous changes,” lead author Maureen S. Beck, DNP, APRN, a gerontological nurse practitioner with UTHealth Houston, told McKnight’s Senior Living. “The point of our data collection wasn’t to solve a problem initially, as it was to find out what actually happened.”
Some facilities automatically flag weight in an electronic medical record if there is a certain percentage of weight change. But many facilities still are using paper charting, and not all facilities are tracking weight.
“Five percent weight loss is very significant and foretells bad outcomes for the residents,” Beck said, adding that alerting nurse practitioners or physicians to 3% to 5% changes in weight can head off problems such as osteoporosis or muscle mass loss, which can increase the risk of falling. “Weight loss is such a significant problem in our older adults,” she said.
With variability in weight monitoring existing between facilities, Beck said, the team’s goal is to improve documentation of resident weight on a monthly basis — especially during periods of isolation or quarantine — at assisted living communities, and to implement guidelines for reporting abnormal weight loss or gains to medical professionals.
Room isolation, eating off of Styrofoam plates and lack of access to therapy or group activities were cited as contributing factors to weight loss in the older adults in the communities. Beck added that the researchers saw no connection between weight loss and diagnosis of depression or dementia, nor did they find a connection to residents who tested positive for COVID-19.
Delivering meals and then closing the door, she said, prevented staff members from intervening by offering simpler options or cutting up food for residents.
Back now is alerting assisted living providers, state-level assisted living organizations and the National Center for Assisted Living about the findings as well as their recommendations for monthly weight documentation and guidelines for reporting it.
The review findings were presented at the recent Gerontological Advanced Practice Nurses Association 2022 National Conference.
