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Is It Possible To Increase Weight and Maintain the Protein Status of Debilitated Elderly Residents of Nursing Homes?

¹ Neve Simcha Geriatric Hospital, Jerusalem, Israel.
² Department of Geriatrics, Mental Health Center, and Ben-Gurion University of the Negev, Beersheva, Israel.
³ Rambam Medical Center, Haifa, Israel.
⁴ Hadassah School of Public Health and Community Medicine, and Hebrew University, Jerusalem, Israel.

Address correspondence to Tzvi Dwolatzky, MD, MB, BCh, Department of Geriatrics, Mental Health Center, P.O. Box 4600, Beersheva 84170, Israel. E-mail: tzvidov{at}bgumail.bgu.ac.il

Background. The care of elderly persons in chronic care nursing wards is generally complicated by nutritional problems such as weight loss and worsening protein status. An inability or refusal of the patient to consume enough food often necessitates the use of expensive commercial formulas for nutritional support. The purpose of this study was to determine whether the use of an in-house (high-protein, milk-based) low-cost formula with added minerals and vitamins for total nutritional support would be effective in maintaining weight and protein status of patients in the long term.

Methods. Participants were recruited from five nursing care units of a single geriatric facility. All residents who required formula feeding were followed prospectively. The formula was provided either as a pudding or a milkshake for oral feeding or as a liquid for tube feeding and served as the sole source of nutrition. Data were collected regarding the participants' weight (monthly), serum albumin level (periodically), and the manner of formula administration (oral, nasogastric, or gastrostomy tube).

Results. One hundred forty-three participants who received this formula were followed for a maximum period of 6 years. Mean weight increased by 5 kg during the first year and remained stable thereafter. Those participants who died within 6 months had no increase in weight. The long-term mean serum albumin level of all participants was an acceptable 4 g/dL.

Conclusion. The long-term use of an inexpensive in-house formula for total nutritional support increased weight and maintained serum albumin levels in most of the chronically ill elderly nursing care patients who participated in the study.

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