Malnutrition

Given the potential consequences of FTT, recognition and diagnosis of this phenomenon are important components of care in older adults. Regardless of status, health care providers should implement and document all appropriate measures within patient goals of care. One of the key factors in lawsuits is a lack of communication with family members, who maintain that they were not informed in a timely manner about their loved one’s health status and prognosis.

The United States is one of the most litigious nations in the world, with the result that numerous medical malpractice lawsuits are initiated against hospitals and other health care facilities, as well as practitioners. Commonly, these lawsuits allege that the facility failed to meet standards of care related to management of wounds including pressure injuries, failed to provide adequate nutrition, and did not properly address issues such as incontinence.

As clinicians know, wound healing is a complex biological process that involves the migration and proliferation of cells along with other molecular events like extracellular matrix deposition. Regardless of the process for healing a wound at the cellular level, a patient’s ability to get adequate nutrition can also play a role in this healing process. It has been shown that malnutrition can cause increased levels of infection, along with a decrease in tensile strength. As a result, the lack of nutritious foods further delays the wound healing process, potentially putting a patient at risk of developing a non-healing wound.

The role of nutrition in wound healing has been heavily explored since the early part of the 20th century. Addressing the proper balance of both macronutrients and micronutrients is a crucial part of the systemic treatment plan for patients with chronic wounds. Nutrition professionals are often highly valued members of any multidisciplinary healing team. There can often be adverse consequences of malnutrition, such as compromised immune systems and increases in hospital readmission rates. As modern-day clinicians with access to advanced therapies, we may think that adding nutrient supplementation to a care regimen is a contemporary concept, but in reality it is steeped in history.