Weight Loss in the Age of COVID-19 – A Situation in Need of a Solution

Anorexia of aging is a well-recognized and prevalent geriatric syndrome. This diminished appetite and nutritional intake are associated with an increase in morbidity and mortality (Morley 2012). However, weight loss can be stabilized or reversed if the causes can be mitigated. While irreversible weight loss is an end-of-life issue, associated with increased frailty and other serious chronic illnesses, when this is recognized early it can enable more targeted palliative care and quality of life. Read on for how you can prevent and address weight loss in the age of COVID. 

In a year not marred by social isolation and altered dining routines in the nursing home, many factors contribute to anorexia and weight loss:

  • Medications and mood
  • Dental or oral problems
  • Eating or enteric problems
  • Dietary restrictions
  • Behaviors – wandering, paranoia, agitation
  • Infections and swallowing problems
  • Chronic illnesses: Hyperthyroidism, Parkinson’s disease, and cancer
  • Frailty

In this year of the pandemic, these contributing factors are red flags. In addition, many new circumstances have arisen that set the stage for weight loss. For example:

  • Restricted in-person contact with support systems (family, volunteers)
  • In-room meals rather than communal dining
  • Staff shortages led to reduced mealtime help, staggered meal times
  • Limited physical activity when confined to rooms
  • No favorite foods brought in by families
  • Residents with cognitive impairment confused or frightened by PPE
  • The ongoing impact of isolation-induced depression and anxiousness
  • Social distancing
  • The impact of COVID-19 if infected

Now, unlike in the early months of the COVID pandemic, we know more about the profile of the enemy and its MO. We have seen the terrible results. We know there will be more lives lost because the target population suffers from the vulnerability of frailty and there is little to do during the pandemic to reduce frailty levels. However, we can take new approaches to meet nutritional needs and slow the progress of the weight loss triggered by isolation and staff shortages. 

The creative thinking to reintroduce visitors and reverse the loneliness from isolation has already begun in earnest; and we will see more efforts by facilities nationwide to comply with federal and state proposals regarding visitation. One thing is clear: Working together we can find the balance between the need to protect our residents and the desire to provide the quality of life they need, want, and deserve. 

For more information on this timely topic:

https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/nursing-facilities/quality-monitoring-program/training/nutrition-care-presentation-preventing-unintended-weight-loss-long-term-care-facilities
https://www.researchgate.net/publication/49780091_Evidence-Based_Practices_for_the_Prevention_of_Weight_Loss_in_Nursing_Home_Residents
Individualized Nutrition Approaches for Older Adults: Long-Term Care, Post-A

For more information on frailty and best practices in geriatric medicine contact our experts today.