Nutritional status and pressure ulcer development in elderly: implications for nursing practice

ABSTRACT

As life expectancy increases so do the problems of the elderly population One major problem is that of protein-calorie malnutrition' another is the susceptibility of this population to pressure ulcers. The effect of undernutrition on increasing morbidity and mortality is well documented. Residents of acute and long-term care settings who are undernourished are more susceptible to pressure ulcers [1]. Determining whether an elderly patient is malnourished can be surprisingly difficult. However, perhaps the most useful indicators of malnutrition in elderly patients are loss of body weight from baseline, decreased dietary intake, and low serum albumin [11]. Therefore the purpose of this research was to identify elderly adults at risk of developing pressure ulcers, and to examine the relationship between nutritional status and pressure ulcers development among elderly in selected acute care and nursing home settings. One hundred twenty six elderly persons from two orthopedic sections in a university hospital and a nursing home in Cairo aging 65 years and older with no pressure ulcers were approached. Their nutritional status was assessed using anthropometric measures and laboratory tests. Results of the study indicated significant inverse relationship between serum albumin and development of pressure ulcers among elderly. Weight indices were also significantly correlated with pressure ulcer development. When comparing subjects in the orthopedic sections with those in the nursing home it was clear that nursing home residents were apt to show more weight loss, more inadequate nutritional intake and lower serum albumin level, i.e. malnutrition than those in the orthopedic sections. Hence, they were more at risk for developing pressure ulcers. Generally, monitoring for nutritional deficiencies helps to identify high-risk persons and allows caregivers time to institute preventive measures before a deficiency becomes clinically apparent. Risk assessment for malnutrition and/or pressure ulcers is recommended upon admission to geriatric homes and acute care settings and periodically afterwards Further investigation of the relationship between nutritional support regimens and the incidence of pressure ulcers are recommended