Geriatric Nutrition
Geriatric Nutrition focuses on the nutritional needs of older adults, typically 65 and older. At AteekRD our team of Dietitians and Nutritionists are solely focused on providing the highest level of nutritional care. We perform nutritional assessments, develop personal care plans and generate menus that are nutritionally balanced, appealing, and compliant with federal and state regulations.
Body Mass Index (BMI) is one of the tools our team uses to assess nutritional status and if there is a risk of malnutrition in the residents we care for. The Body Mass Index (BMI) is a simple screening tool used to assess whether a person’s body weight is within a healthy range relative to their height.
Nutrition and Geriatrics
Our team has 30 years of experience providing nutritional guidance for older adults at assisted living facilities, nursing homes and intermediate care facilities/Group Homes. We provide individualized plans based on medical conditions. Here are few of the considerations we focus on:
Nutrient Requirements
Older adults in many cases require increased amounts of certain nutrients such as protein, calcium, vitamin D, and B12. This can help maintain muscle mass, bone health, and cognitive function. At the same time we take into account caloric intake to maintain a healthy body weight and avoid obesity or undernutrition.
Dietary Modifications
Our team makes adjustments to residents specific menu for chewing/swallowing difficulties (dysphagia), food tolerances or medical conditions. Providing a low sodium diet is one example.
Facility Types
Assisted living Facility residents typically have more independence so our Dietitians focus on promoting healthy eating habits, accommodating preferences and preventing malnutrition while supporting autonomy.
Nursing home residents have increased medical needs that require our Dietitians to focus on therapeutic diets, dysphagia management, and preventing ulcers or weight loss.
Intermediate care facility residents have moderate medical needs so our Dietitians focus on balancing medical nutrition therapy and promoting quality of life.
Body Mass Index
Body Mass Index (BMI) is a tool/measurement Dietitians use to evaluate the nutritional status and health risks of residents in Assisted Living Facilities, Nursing Homes, Intermediate Care Facilities, and Group Homes.
BMI is calculated as weight in kilograms divided by height in meters squared (KG/m2). This provides a standard method to measure whether and an individual is underweight, overweight, or obese.
Here is how Dietitians apply BMI:
1. Nutritional Assessment
Initial Screening: Dietitians calculate BMI upon a resident’s admission to identify potential weight-related health risks. For example:
Underweight (BMI < 18.5): Indicates possible malnutrition, which may require a high-calorie, nutrient-dense diet or supplementation.
Normal weight (BMI 18.5–24.9): Suggests a balanced diet to maintain health.
Overweight (BMI 25–29.9) or Obese (BMI ≥ 30): Signals risk for conditions like diabetes, heart disease, or mobility issues, prompting weight management strategies.
Ongoing Monitoring: BMI is tracked over time to assess changes due to diet, illness, or medication. Significant weight loss or gain (e.g., 5% in 30 days or 10% in 180 days) triggers a reassessment of the resident’s diet plan.
2. Individualized Diet Plan
Underweight Residents: Dietitians may design high-protein, high-calorie diets with frequent meals or snacks to promote weight gain. For example, fortified foods (e.g., adding cream or protein powder) or oral nutritional supplements may be used for residents with poor appetite or chewing/swallowing difficulties.
Overweight/Obese Residents: Calorie-controlled diets with balanced macro-nutrients are developed to support gradual weight loss while preserving muscle mass. Dietitians ensure adequate protein to prevent malnutrition, especially in older adults.
Special Considerations: BMI is interpreted cautiously in older adults, as it may not fully reflect muscle mass or fluid status. Dietitians combine BMI with other assessments (e.g., muscle mass, lab values, or skinfold measurements) for a comprehensive plan.
3. Managing Chronic Conditions
Disease-Specific Diets: BMI helps tailor diets for conditions common in these facilities, such as diabetes, heart disease, or kidney disease. For example, obese residents with diabetes may receive a low-glycemic, calorie-restricted diet to improve glycemic control and reduce BMI.
Pressure Ulcer Prevention: For underweight residents at risk of pressure ulcers, dietitians use BMI to prioritize protein and calorie intake to support tissue repair and maintain skin integrity.
4. Regulatory Compliance and Documentation
Federal and State Regulations: Facilities must comply with regulations like those from the Florida Department of Health and the Florida Agency for Health Care (AHCA). The Florida Agency for Health Care oversees licensing of Nursing Homes and Assisted Living Facilities and the Florida Administrative Code (FAC), which outlines specific nutritional and dietary standards.
Interdisciplinary Collaboration: Dietitians share BMI data with healthcare teams (e.g., nurses, physicians) to align dietary interventions with medical care, such as adjusting medications or physical therapy for mobility issues in obese residents.
Our Licensed Dietitians have extensive experience ensuring facilities are meeting the standards Florida Agency for Health Care (AHCA) requires.
5. Limitations and Contextual Use
Age and Frailty: In older adults, a slightly higher BMI (e.g., 23–27) may be protective against frailty, so dietitians may not aim for weight loss in overweight residents unless medically necessary.
Functional Status: BMI is paired with assessments of functional ability, appetite, and lab markers (e.g., albumin for protein status) to avoid misinterpreting weight status.
Cultural and Personal Preferences: Dietitians incorporate residents’ food preferences and cultural needs into BMI-guided plans to ensure compliance and quality of life.
Practical Example
A dietitian in a nursing home might assess a resident with a BMI of 17 (underweight). They could recommend a diet with 2,000–2,500 kcal/day, including protein-rich snacks (e.g., Greek yogurt, peanut butter) and fortified beverages, while monitoring weight weekly. For a resident with a BMI of 32 (obese) and heart disease, the dietitian might design a 1,600 kcal/day diet low in sodium and saturated fats, with regular follow-ups to track BMI and cardiovascular health.
By using BMI as part of a holistic assessment, dietitians ensure diets are tailored to residents’ health needs, promote optimal outcomes, and comply with care standards in these facilities.