Your Parent Is Losing Weight in a Nursing Home or Assisted Living: What to Ask

Weight loss is easy to miss and easy to explain away. "She's just not as hungry" can be true, but unplanned weight loss in an older adult is also one of the clearest signs that something needs attention. If you have noticed your parent looks thinner, or clothes and rings are loose, here is what to ask.

Ask what her weights have been

Facilities weigh residents regularly. Ask for the actual numbers over the last several months, not a general "she's stable." Clinicians commonly pay attention to a loss of about five percent in a month or ten percent in six months, so ask whether her trend has been flagged and by whom.

Ask who is looking at it

A concerning weight change should be seen by the nurse, the physician, and often a registered dietitian. Ask whether a dietitian has evaluated her, what they recommended, and whether the recommendation was actually carried out. A note in the chart that was never acted on is a common gap.

Look for the reason, not just the number

Weight loss often has a cause that can be fixed: dental pain or poorly fitting dentures, trouble swallowing, a medication that dulls appetite, depression, constipation, food that is the wrong texture, or simply no one helping her eat. Ask whether anyone has looked into these, and whether anyone has watched her at a meal.

Visit at a mealtime

If you can, visit during a meal and watch. Is she in the dining room or alone in her room? Is the food hot and the right consistency? Does she need cueing or hands-on help, and does she get it? Is anyone recording how much she eats? What you see at one meal often explains what the numbers cannot.

Ask what the plan is and how you will be updated

Ask what is being done now, who is responsible, when she will be weighed again, and how you will hear about it. A good answer includes specific steps and dates. Ask to be called if her weight changes again.

When you are not getting a clear answer

If the numbers, the explanation, and what you see on a visit do not line up, it may need someone to look at it in person. I have managed senior living communities and I know how weights, dietitian notes, and care plans should fit together, and where things tend to fall through.

If you have asked these questions and the answers still do not add up, call me at (703) 867-0540. And if you do not feel able to take these steps yourself, I can do it for you.