Most elderly and the physically or mentally retarded individuals due to their physical or mental incapability and incapacity usually are not able to provide for themselves the basic needs and even security without the being assisted. Since these individuals are not sick to the extend needing intense hospital care and can neither remain at home as there is no one with the skills and experience to take care of them, they usually are taken to nursing homes. The quality of care offered in nursing homes however varies and potential for abuse which exists in many forms does exist (Iyer, 2005). There have been cases for example of residents dying of malnutrition and dehydration due to negligence in the nursing homes (Baker, 2007). Every human and especially the elderly and those who are chronically or mentally ill require a certain specific amount of nutrition and fluid so as to maintain their health hence life (Burger et al., 2000). Most nursing home injuries can in fact be attributed to negligent care that results to malnutrition and/or dehydration. Failure to provide the food and water which has that is necessary for residents to maintain their health and life is no different from allowing a violent to employee of the home to abuse the resident (Barker, 2008). Reports have shown that a very significant number of residents in nursing homes suffer from malnutrition and dehydration. These residents are particularly vulnerable because they often are dependent on the caregivers to provide everything they need which includes water and the right food. Malnutrition/dehydration is as a result of negligence which occurs due to inadequate staffing and the high employee turnover rates that characterize nursing homes and assisted living facilities (Quinn, & Tomita, 1999). It will be of worth to note that a large most nursing home and assisted living facilities are for profit organizations (Langmore, 2001).Therefore just like any other business enterprise, these institutions aim at reducing their cost of operation and maximizing of the profits. These institutions have only one area they can reduce their cost on and this is staffing. As mentioned earlier, most residents in these institutions lack physical and mental capacity to perform some of the basic tasks and might need to be assisted even with drinking and eating. In most homes, one caregiver is required to assist between seven to nine residents. In the event the there is a resident who can not lift a cup or spoon to his mouth, placing food or a drink in front of them is irrelevant unless the nursing home or the assisted living facility has sufficient number of staff who can assist such a resident and others (Gogia & Rastogi, 2008). Malnutrition has many adverse effects on patients and residents. It weakens muscles, results to confusion, pneumonia, viral, bacterial and fungal infections, pressure sores and in extreme cases death (Vierck, & Hodges, 2003).
Nursing homes are required by the Nursing Home Reform act of 1987 to assess residents’ the nutritional needs and status during admission and keep checking it at regular intervals. This assessment is to determine whether the resident is at their ideal weight or at risk of malnutrition and dehydration (Iyer, 2002). The Act requires the nursing home to provide to the resident nutritional health based on these nutritional assessments. Nutritional health in this case involves providing palatable meals that are well balanced (Mace, & Rabins, 2001). Nursing homes and assisted living facilities that fail to provide for the resident’s nutritional needs stand to be held liable in a civil court in the event a resident gets injured or dies (Krisztal, 2003).
In spite of the law guaranteeing residents and their families of adequate nutrition, cases of malnutrition and dehydration remain rampant in many nursing homes. The increasing reports of these cases are what prompted the researcher to carry out a study on malnutrition and dehydration in nursing and assisted living facilities.
The term “assisted living facility” refers to a place that is created for individuals who need to be assisted in doing Activities of Daily Living abbreviated (ADLs) but at the same time wish to lead their lives as independently as they can and for as long as is possible. Assisted living hence acts as a bridge between the usual independent living and nursing homes. The term “nursing home” refers to a private institution that provides care as well as living quarters for individuals who are chronically ill and the elderly. The term “resident” refers to an individual who lives in a place. The term “malnutrition” refers that state of poor/unhealthy nutrition that occurs mostly among starving individuals/insufficient diet or as a result of a diet that is not balanced. The term “dehydration” refers to a state which results from loss of water (not having enough water in the body). The term “caregiver” refers to someone who provides both emotional and physical care to another one ensuring that all their needs which they can not provide for themselves are met.
The researcher seeks to investigate cases of malnutrition and dehydration among residents in nursing homes, assisted living facilities and personnel care homes. The researcher will identify and select the nursing homes, assistant living facilities and personnel care homes that need to be studied and seek letters of permission that will allow them to carry out the research. This is a quantitative study implying that the nurse will use semi-structured interviews questionnaires to collect the data (King, 2004). After getting the letter of consent, the questionnaires and the interview questions will then be prepared. The interviews and questionnaires will be administered directly. The researcher needs response from at least ten participants hence intends to interview five caregivers and five residents in every study. The researcher intends to analyse the data using an appropriate method and tool such as the data analysis spiral tool described by Creswell (1998). The researcher acknowledges that the interpretation of data obtained will be influenced by their biases and values and hence intends to acknowledge any resulting biases so that the readers of the research report will take them in to account.
After analyzing the researcher intends to carry out validation of the results obtained so that they are reliable. Usually triangulation is used for validation of such data such data but since the researcher is not in a position to use this tool, they intend to valid the obtained results using the following two strategies. One will be to ask the interviewees and respondents to the questionnaires for their opinions of the results based on their experiences. The second strategy will be to get the opinion of other researchers who have experience in the field on what they think of the results (Leedy, & Ormrod, 2005).The results will also be compared to data in literature that has been already carried out. Any differences or similarities that arise will be explained. These strategies will be taken to overcome any validity issues that might arise during presentation of the data.
As a result of the project, the researcher expects to find that most of the nursing homes, assisted living facilities and personal care homes to be understaffed. This is based on the fact that most of these facilities as business institutions tend to minimize cost on staffing so that they can maximize on profits. The researcher expects to find that each caregiver in the institutions that have cases of malnutrition and/or dehydration has too many residents to take care of which results to negligence of others as they can not handle all the residents at once. The researcher hence expects to find negligence as a result of under staffing as the main contributing factor to malnutrition and dehydration of residents in these institutions. The researcher also expects to find that most of these facilities have high employee turnover rates. This is a result of low wages yet too much work that characterizes these facilities. The researcher expects to find that the caregivers are not motivated to offer good services. The researcher expects to find that there is no satisfaction among the caregivers which results to them giving poor services to the residents and neglecting their responsibilities at times. The researcher hence expects to find this as another contributing factor to malnutrition and dehydration of residents. The researcher hence expects to find that malnutrition and dehydration cases do occur and are very rampant in nursing homes, assisted living facilities and personal care homes in spite of the laws that have been implemented to curb it.
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