Improving Refusal to Eat Behavior in Elderly Patients: Research Plan

Running head: NURSING
Research plan
Name of the Student
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1NURSING
Introduction
Geriatric nurses have the primary responsibility of assisting older patients, recovering
from injury or illness, by providing them practical care. This domain of nursing also
encompasses creating provisions for check-ups, and rehabilitation for the elderly patients,
within hospice or skilled care facilities (Tabloski, 2014). Caring for the elderly population is
a global issue to all clinical practitioners and educators. Challenges are also encountered
during the determination of a plethora of service delivery models that are in relation to the
aged population. Nurturing care and compassion have been recognized as typical personality
characteristics for all individuals who care for geriatric patients (American Geriatrics Society
Ethics Committee and Clinical Practice and Models of Care Committee, 2014). While
providing nursing care, refusal to eat is a common challenge that is exhibited by the elderly
patients, which deteriorates their health and impedes the process of caregiving. There is
mounting evidence on the fact that older adults often refuse to intake adequate food or
beverages, which leads to the onset of malnutrition (Pouyet et al., 2014). In other words,
refusal to drink and eat is a distressing and common precursor to the onset of malnutrition
among the elderly patients, residing in institutional settings (Bauer, Halfens & Lohrmann,
2015). This research plan will focus on an intervention to improve the refusal to eat
behaviour in the target population, at a clinical setting.
Background
A case report by Meier and Ong (2015) has highlighted the fact that competent
patients often have the right and authority to refuse intake of food, and any form of artificial
hydration and nutrition. The researchers also stated that owing to the fact that patients have
all rights to forgo any life-sustaining treatment, those patients who are competent can
willingly stop eating and drinking (VSED). In addition, they stated that the physicians do not
have the authority to overrule the decision of such patient for refusing eating and drinking. It

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has been affirmed by Schwartz et al. (2018) that old age is a crucial period, in relation to
selection of food and eating behaviour among humans and repeated exposure to an
assortment of food products acts in the form of a crucial determinants for selecting or
refusing food and drink consumption. In addition, it has also been established that
development of a food bolus that the elderly people can safety swallow involves a
multifaceted procedure, which often makes them refuse foods (Khan, Carmona & Traube,
2014). According to Abizanda et al. (2016) malnutrition has been found to enormously
increase the healthcare costs for older adults, by increasing their likelihood of suffering from
morbidity. Therefore, intake of dairy and meat food products that are rich in proteins
considerably lowers the risks of malnutrition (Iuliano et al., 2017).
Cerri et al. (2015) have also provided evidence for the prevalence of malnutrition and
sarcopenia among 22.3% (n=23) older hospitalised patients, of whom 10.3% died within
three months of being discharged from the healthcare setting. This enabled them to draw the
conclusion that malnutrition due to food refusal is highly prevalent amid the elderly patients,
which in turn creates a major impact on their overall health status. The association between
malnutrition and food pickiness amid elderly patients was investigated by Maitre et al. (2014)
who suggested that as much as 23% older patients (n=559) generally are picky eaters and an
elevation in food selectivity is associated with an increase in risks of suffering from
malnutrition. Additionally, the researches were also able to demonstrate an increase in food
selectivity, with an upregulation in dependency. Douglas and Lawrence (2015) also opined
that with a progress in dementia, a decline is observed in the nutritional intake of the patients
that needs to be addressed by making necessary changes in the meal pattern and
environmental setting.