Malnutrition can occur because the patient is not eating, because the patient is not receiving the right diet, is not receiving proper dietary supplements, or is not being fed.
A nursing home cannot force a nursing home patient to eat. With that being said, a nursing home has a responsibility to know how much a resident is eating, what a resident is eating, and why a resident is not eating. There could be a number of reasons why a resident is not eating. For example, the resident may not like the food, may not be able to chew the food, the food may be cold, or the resident may not be hungry when the food is served. The resident may have a medical condition that prevents them from eating.
On admission, the nursing home needs to assess the resident and determine their food preferences, diet restrictions, and other aspects of the resident that may affect what the resident can and cannot eat. If the resident begins to refuse food or not eat, the nursing home needs to find out why this is happening.
In addition, there are a number of nutritional supplements and stimulants that can be given to the resident to assist with eating.
The Plan
If the resident gets to the point that he or she is physically unable to eat, then the family, doctor and nursing home need to decide whether a feeding tube will be used. Perhaps the resident has already made the decision that he or she does not want a feeding tube. If so, then the nursing home must still try to encourage the resident to eat.