CMS Manual System - Louisiana Department of Health and Hospitals

assists in monitoring responses to interventions. Monitoring residents who experience
unplanned weight loss, including reweighing at least weekly until weight is stable or
increasing and then routinely thereafter, helps clarify his/her responses to interventions.
However in some residents, subsequent weight monitoring may not be clinically
indicated (e.g., palliative care resident).
Nutrition-related goals may need to be modified, depending on factors such as further
clarification of underlying causes (e.g., when evidence suggests that unmodifiable factors
may prevent improved or stabilized nutritional status) and responses to current
interventions. In some cases, the current plan of care may need to be modified and new
or additional interventions implemented. The facility explains any decisions to continue
current interventions when the resident‘s nutritional status continues to decline. For
example, because the goal of care for someone with a terminal, advanced, or irreversible
condition has changed to palliation.
ENDNOTES
1
Vella, C., & Kravitz, L. (2002). Sarcopenia: The mystery of muscle loss. IDEA
Personal Trainer, 13(4), 30-35
2
3
4
5
Thomas, D.R. (2002). Distinguishing starvation from cachexia. Clinics of Geriatric
Medicine, 18(4), 883-892.
VanItallie, T.B. (2003). Frailty in the elderly: Contributions of sarcopenia and visceral
protein depletion. Metabolism, 52(10), Supplement 2 (October), 22-26.
Morley, J.E., & Thomas, D. R. (Eds). (2007) Geriatric Nutrition. Boca Raton: CRC
Press
Bouras, E.P., Lange, S.M., & Scolapio, J.S. (2001). Rational approach to patients with
unintentional weight loss. Mayo Clinic Proceedings, 76(9), 923-929.
6 Kieselhorst, K.J., Skates, J., & Pritchett, E. (2005). American Dietetic Association:
Standards of practice in nutrition care and updated standards of professional
performance. Journal of the American Dietetic Association, 105(4), 641-645.
7 Lacey, K. & Pritchett, E. (2003). Nutrition care process and model: ADA adopts road
map to quality care and outcomes management. Journal of the American Dietetic
Association, 103(8), 1061-1072.
8 Walker, G. (Ed.) (2005). Pocket Guide for Nutrition Assessment. Chicago, IL:
Consulting Dietitians in Healthcare Facilities.
9 Thomas D.R., Tariq, S.H., Makhdomm S., Haddad R., & Moinuddin A. (2003).
Physician misdiagnosis of dehydration in older adults. Journal of the American
Medical Directors Association, 4(5), 251–254.
10 Wilson, M.G., Thomas, D.R., Rubenstein, L.Z., Chibnall, J.T., Anderson, S., Baxi, A.,
Diebold, M., & Morley, J.E. (2005). Appetite assessment: Simple appetite
questionnaire predicts weight loss in community-dwelling adults and nursing home
residents. American Journal of Clinical Nutrition, 82(5), 1074-1081.