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Few choices are more emotionally wrenching than entering a family member into a nursing home. The only purpose for removing a loved one from their home and placing them into an institution, is the belief that they will be well care for, protected when they can no longer live on their own or with family help. Nursing home neglect is a disgrace that should never occur.

Dehydration and malnutrition are amongst the leading causes of preventable nursing home deaths. Older nursing home residents are particularly vulnerable to dehydration, as medical problems, such as infection or diarrhea, or diuretic medications, can cause a greater need for fluids at the same time that medical issues may impair the individual’s thirst sensation. Illness or depression may reduce a nursing home resident’s desire to eat. Malnutrition can cause relatively minor medical problems to become life-threatening. While a lessened desire to eat and drink may be part of the natural process of dying, dehydration and malnutrition affects many nursing home patients who have years of life remaining. Monitoring for signs of physical distress and treating the cause if possible, is a fundamental obligation of every nursing home. Failure to do so constitutes professional negligence. In an excellent study by the National Citizens’ Coalition for Nursing Home Reform, the authors identified four key causes of dehydration and malnutrition: inadequate staffing; poor environment; insufficient collection of data on patients; lack of enforcement of existing laws and regulations. (Burger, Darah Greene, et al. Malnutrition and Dehydration in Nursing Homes: Key Issues in Prevention and Treatment, 2002). Dehydration and malnutrition in nursing home residents are illegal as well as immoral. The federal Nursing Home Reform Act of 1987, 42 U.S.C. §1396r, requires that every nursing home resident be adequately monitored and provided with care insuring to the extent possible, phsyical well-being and basic dignity. Nearly 20 years after passage of the Act, dehydration and malnutrition continue to plauge our nursing homes.

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