What it is
Malnutrition occurs when a person does not have the proper amount of nutrients - vitamins, minerals, and other elements - to function at their normal level.
Malnutrition in hospitalized patients significantly affects several clinical outcomes* and the prevalence of malnutrition increases with age, comorbidities, and intensity of care. Over 30% of patients with good nutritional status before hospital admission will develop malnutrition during their hospital stay.
*infection risk, skin breakdown, altered mental status, decreased physical function, symptom exacerbation
Factors that promote hospital malnutrition
Decreased patient appetite
Inadequate meal service
Limited food choices
Insufficient time to consume meals
Lack of needed help while eating
Low mobility and interrupted sleep
Anxiety, loneliness, or depression
What's needed
Post-discharge nutritional priorities should focus on frequency and density.
Frequency = eating small amounts frequently throughout the day (5-8 small meals instead of 2-3 large ones).
Density = eating filling foods, ideally that are rich in essential vitamins and minerals.
Provided there are no medical restrictions (check with their provider), the things we are commonly told to avoid in our diets - salt, sugar, and fats - are not such a bad thing in the first couple weeks after coming home from the hospital.
While your loved one should not have a diet made up entirely of prepackaged items, canned products, or junk foods, eating foods that contain more sugar, salt, and fat can help restore lost fluid, return lost weight, and provide energy boosts to get your loved one moving again. (Plus, they're tasty and may increase your loved one's motivation to eat.)
The most essential dietary elements after hospital discharge, however, are lots of water, high fiber, and plenty of protein.
Why water? Hydration is proven to help with fluid balance, regulate body temperature, fuel muscles, heal skin, remove toxins, boost brain activity, lubricate joints, normalize blood flow, and decrease fatigue. While water is best, clear liquids without sugar, carbonation, or caffeine will also work.
Why fiber? Fiber promotes gut function, which slows down during hospitalization due to low mobility, sleep disruptions, and dietary changes. It's important to get the gut moving again because good gut health is the biggest contributor to overall health. A good gut speeds up recovery and restores many associated body systems.
Why protein? Protein requirements are higher for hospitalized patients. It is needed to stimulate muscle‐protein synthesis, prevent loss of muscle mass, fuel hemoglobin, and enhance recovery. Like oxygen and water, every system in and on the body utilizes protein enzymes to power necessary chemical reactions.
What you can do
The day before your loved one is discharged from the hospital, stock their kitchen with foods high in fiber and protein. In addition to solid foods, you can also purchase fiber supplements (like Metamucil) and pre-made shakes that are high in protein. Many protein shake manufacturers now offer shakes in a variety of flavors that actually taste good! Aim for shakes with around +/- 30g of protein.
Stock up on foods that they like, as this will motivate them to eat more or more often. Easy prep foods, finger foods, or food that can be prepared ahead of time and individually packaged are great. While you want to make sure and include plenty of healthy foods, if some of their favorites include prepackaged foods, canned products, sweets, or junk foods that's okay - in moderation! - for a couple of weeks after discharge.
Help your loved one understand why these particular nutritional elements are important and what this post-discharge diet aims to accomplish. Then develop a meal plan with them and stick to it, detailing the meals, snacks, and treats that are "on the menu" for any given day. You can even turn it into a checklist so they (and you) can track what and how often they're eating and how much water they're drinking.
They should aim to drink half their body weight in ounces of water every day (as should we all). So, if they weigh 180 lb., they should try to drink at least 90 oz. of water daily. Unless restricted by their provider.
