Neglect and abuse associated with undernutrition in long-term care in North America: Causes and solutions

Protein-calorie undernutrition in institutional long-term care is a significant cause of morbidity, mortality, increased health care costs, and poor quality of life. Failure to provide adequate nutrition constitutes neglect, and certain practices associated with feeding the dependent elder or adult with developmental disabilities can be abusive. The causes are multifactorial. They are related to conditions common to these persons; multiple medication use, difficulty in swallowing, gastrointestinal dysfunction, poor oral health and oral care, sensory changes with aging, and lack of education and training in the proper protocols required to provide adequate food and liquid to persons with cognitive and physical impairments. Solutions which are simple, cost-effective, easy to apply and cross national, ethnic, and cultural boundaries are described.