Quick 8-Point Assessment Protects Elderly Hospitalized Patients

Calorie counts are a waste of time, said Dr. Granieri, who used to be a dietitian and did many such counts herself. “If you think your patient is malnourished and they've lost weight, [they have]. Get them to eat by any means possible.”

For those who won't or can't eat, don't use tube feedings, she advised, “unless it's time limited, or unless they have only one organ system that's problematic.

“Tube feedings in people with dementia do not keep them alive longer,” but do increase complications. And studies have shown that people at the end of life don't feel hunger and thirst. “Once someone stops eating, that's it,” she said. It's important to talk with families early about the issue of tube feedings, she added.

7. Be sure patients have their glasses, hearing aids, and walking devices. If a patient isn't wearing glasses, chances are they're somewhere such as in a drawer, since almost all older people have visual impairment. A patient who uses a walker at home should have one in the hospital.

8. Use the team of clinicians available to you. Get consults, especially for home care. Take advantage of available services, such as physical therapy and nutrition services. Don't take care of a frail older patient alone, she emphasized.

Finally, keep in mind that all eight of these issues are interconnected. A patient with cognitive impairment cannot manage a complex medication schedule after discharge, and a patient who can't reach his glasses might not eat his meals. “Think in a matrix way, as opposed to a linear, or algorithmic, way,” Dr. Granieri advised.