It is not possible to attribute malnutrition or even weight loss to any single cause because they are due to a combination of factors. The same holds true for other areas of care such as incontinence. Urge, overflow, stress and functional incontinence are lumped together and no differentiation is made as to whether or not appropriate interventions are feasible. For example, a demented patient, who is incapable of following instructions, is unable to implement certain care modalities. Geriatric medicine and care of the geriatric patient is still in its infancy and far from the exact science that health care in younger adult patients is reaching.
Geriatric patients are less like each other and much more individualism of care is needed.
It is one of the great challenges for people who practice in this area. Many have exercised their rights to forgo end of life treatment interventions. Forty-six percent of the patients in California nursing homes have executed an advance directive. There is no question that malnutrition in the aged is a tremendous problem. Studies have estimated occurrences of malnutrition in fifty percent of the population in hospitals and forty percent of nursing home patients.