A PROSPECTIVE-STUDY OF THE USE OF LIQUID ORAL DIETARY-SUPPLEMENTS IN NURSING-HOMES

OBJECTIVE: To investigate the use of liquid oral dietary supplements a mong nursing home residents who were eating poorly and losing weight. DESIGN: A prospective, descriptive, anthropological study. SETTING: Tw o proprietary nursing homes with 105 and 138 beds. PARTICIPANTS: Purpo sive sampling was used to select 40 residents from among the 100 resid ents who were not eating well. Dietary data were collected on this sub -sample of 40 residents. MEASUREMENTS: Participant observation, in-dep th interviews, event analysis, bedside dysphagia screenings, oral heal th ex-aminations, body weight, body mass index (BMI), and chart review were used to collect data. Dietary data were collected over a 3-day p eriod, and data were gathered on how supplements were ordered, served, and consumed. RESULTS: Supplements had been ordered for 29 of the sub sample of 40 residents. Only nine of 29 residents were served the corr ect number and type of supplements as ordered by their physicians, and only two residents consumed the full amount of supplement as ordered. The overall mean percentage of supplement consumed compared with that ordered was 55.1%. Although supplements were ordered primarily to pre vent weight loss and to facilitate weight gain, nearly half (n = 14) o f the residents continued to lose weight. Supplements were ordered wit hout investigating the underlying factors contributing to weight loss, such as inadequate staffing and lack of supervision at mealtime, undi agnosed dysphagia, and poor oral health. Without evaluation of these f actors, it is unknown which residents might benefit from oral suppleme nts. CONCLUSION: Findings indicate that supplements were used nonspeci fically as an intervention for weight loss in nursing home residents w ithout regard to dose, diagnosis and management of underlying problem( s), amount of supplement consumed, and outcome. Further research is ne eded to establish when supplements should be ordered, how to ensure th at they will be taken, and whether they are effective.