Suspect Malnutrition in Your Loved One? Here’s What You Do

It’s a disturbing thought: the person you care about, the one you entrusted to a care facility or home care service, might be slowly fading from malnutrition.

If you suspect this, the key is to act decisively: document everything, communicate your concerns clearly, and understand your loved one’s rights because they are protected.

Don’t wait until it’s too late. If your gut is screaming that something is wrong, call a nursing home abuse attorney at Hughey Law Firm at (843) 881-8644 to understand your options.

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What Malnutrition Actually Looks Like (More Than Just “Being Skinny”)

Malnutrition is a complex issue that manifests in ways that are easy to overlook if you’re not paying attention. Your loved one might not be “wasting away” in a dramatic sense, but their health could still be seriously compromised.

The Sneaky Signs People Miss

Your Spidey senses might be tingling, but you can’t quite put your finger on why. Many of these symptoms often snowball, making a bad situation worse, fast.

• Unexplained weight loss; clothes suddenly loose; dentures not fitting well anymore.
• Sudden weakness and fatigue; beyond normal tiredness; difficulty with previously easy tasks.
• Dizziness or lightheadedness; increased risk of falls.
• Changes in skin; dry, thin, or pale skin; new pressure sores or bedsores that won’t heal; bruising easily.
• Dental issues; swollen or bleeding gums; problems with dentures.
• Cognitive changes; confusion, irritability, or apathy that’s out of character; difficulty concentrating.
• Digestive issues; constipation or diarrhea; loss of appetite.
• Slow wound healing; even minor cuts or sores take forever to get better.
• Depression or withdrawal; social isolation.

Dehydration

Malnutrition and dehydration often go hand-in-hand. Their symptoms are often confusingly similar, and both are seriously bad news for an older adult’s health.

Keep an eye out for these dehydration red flags:

• Dry mouth.
• Sunken eyes.
• Infrequent urination or dark urine.
• Confusion.

Older adults are particularly vulnerable to dehydration due to physiological changes like a decreased thirst sensation or side effects from medications.

Why “They’re Just Getting Older” is a Dangerous Myth

It’s easy to write off some of these symptoms as just part of the “golden years” package deal. But here’s the reality check: while aging brings changes, a rapid or significant decline in health, energy, or cognitive function is not a standard feature. Dismissing these warning signs as “normal aging” is a dangerous game that allows preventable harm to escalate.

Why Malnutrition Happens in Care Settings (And It’s Often Not an Accident)

If your loved one is in a care facility, you’d assume their basic needs, like, you know, eating, are being met. Unfortunately, that’s not always the case. Malnutrition in care settings is a pervasive issue.

Understaffing and Neglect – The Root of Many Evils

This is a big one. When facilities are short-staffed, it’s the residents who pay the price. Imagine trying to properly feed multiple residents who need assistance, all at the same time, with the clock ticking. It’s a recipe for disaster.

Here’s how it often plays out:

• Not enough staff to properly feed residents who need assistance; feeding someone safely and sufficiently takes 30 to 60 minutes, and staffing is often inadequate.
• Rushed mealtimes; food trays taken away before the resident is finished.
• Failure to monitor food and fluid intake; nobody’s checking if residents are actually eating or drinking enough.
• Lack of individualized care plans for nutritional needs; dietary requirements are ignored or overlooked.

Shockingly, data shows that around 30.2% of malnutrition deaths in older adults occurred in nursing homes or long-term care facilities. That’s a statistic that should make everyone sit up and take notice.

Inadequate Food Quality and Preparation

Let’s be honest, nursing home food doesn’t usually win any Michelin stars. But there’s a difference between bland and outright inedible or unsuitable.

Problems include:

• Unappetizing food; if it looks or tastes like cardboard, residents are less likely to eat it.
• Diets that don’t meet specific medical or cultural needs; for instance, a diabetic resident getting high-sugar meals, or religious dietary laws being ignored.
• Improper food preparation for those with chewing or swallowing difficulties (dysphagia); this is a major issue for many elderly residents and leads to aspiration or avoidance of food.

Failure to Recognize or Address Medical Conditions

Malnutrition isn’t always just about the food itself; sometimes, it’s about the facility failing to connect the dots between a resident’s health and their eating habits.

Examples of this neglect include:

• Ignoring dental problems that make eating painful; poorly fitting dentures or untreated tooth decay makes every meal an ordeal.
• Not adjusting for medication side effects; many common medications cause loss of appetite, nausea, or dry mouth.
• Overlooking depression or cognitive decline that impacts eating habits; residents with dementia might forget to eat, or depression robs them of their appetite.

It’s a Widespread Problem

In 2021, there were over 97.6 million global malnutrition cases in the elderly (aged 70+). This represents a massive 1.2-fold increase since 1990, and projections show millions more cases on the horizon. These numbers are staggering and highlight the systemic nature of this problem.

Your Loved One Has Rights

When you place a loved one in a care facility, you’re entrusting them with their well-being. That trust comes with legal obligations on the part of the facility. They must not let residents wither away. If they do, there are consequences.

Federal Protections

1. The Nursing Home Reform Act (42 U.S.C. § 1396r): This is a cornerstone of resident rights.

• Facilities must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.
• It includes specific requirements for dietary services to ensure proper nutrition and maintain a resident’s nutritional status. This means they must ensure residents receive sufficient nutrition and maintain an acceptable body weight unless a medical condition prevents it.

1. The Older Americans Act (OAA) (42 U.S.C. § 3001): This act also plays a significant role, particularly for community and home-based care.

• It mandates nutrition programs such as congregate meals (group meals in places like senior centers) and home-delivered meals (like Meals on Wheels). The goal is to reduce hunger, promote socialization, and support health.
• Recent updates (Final Rule published February 2024, with compliance required by October 1, 2025) aim to further strengthen these nutrition programs.

South Carolina’s Stance – Protecting Our Own

1. Bill of Rights for Residents of Long-Term Care Facilities (S.C. Code Ann. § 44-81-10 et seq.): This law gives your loved one specific, enforceable rights in South Carolina facilities.

• This includes the right to adequate and proper medical treatment and nursing care.
• Crucially, it grants the right to be free from abuse and neglect – and yes, allowing malnutrition constitutes a form of neglect.
• For example, S.C. Code Ann. § 44-81-30 (A)(3) (as referenced in the general chapter link, specific wording subject to the most current version of the statute) emphasizes the right to receive adequate and appropriate care, which inherently covers nutritional needs. Residents also have the right to participate in planning their care and treatment.
• Reference: Review the South Carolina Bill of Rights for Residents of Long-Term Care Facilities for a full understanding.

1. South Carolina Adult Protective Services Act (S.C. Code Ann. § 43-35-5 et seq.): This act provides the framework for reporting and investigating suspected abuse, neglect (including self-neglect), or exploitation of vulnerable adults.

• The law defines neglect, which encompasses the failure to provide necessary sustenance. If a caregiver isn’t providing adequate food or medical care, that’s neglect.

Additionally, South Carolina Regulation 61-84, established by the South Carolina Department of Health and Environmental Control (DHEC), outlines minimum standards for nursing homes, covering aspects like nutrition and medical care. Violations of these standards are evidence of negligence.

What This Means in Plain English: Duty of Care & Negligence

Care facilities have a legal duty of care to take reasonable steps to prevent malnutrition.

If they screw up (that’s the breach of duty), and this screw-up directly causes your loved one to suffer harm like weight loss, illness, or a decline in their health (causation and damages), they are held legally responsible.

In some situations, if the failure to provide proper nutrition goes against established medical or dietary standards, it might even cross the line into medical malpractice.

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Step 1: Document Everything.

This is your foundation. If you don’t have records, it’s your word against theirs. So, become a meticulous note-taker.

• Dates and times of observations; what specific symptoms did you notice (e.g., “March 15th, 2 PM, Mom seemed very lethargic and confused”); who was on duty at the time?.
• Weight changes; if possible, keep a log of your loved one’s weight; note how their clothes are fitting – are they suddenly swimming in them?.
• Food and fluid intake; what types and amounts of food and drink are being offered versus what’s actually being consumed?; are they receiving help with eating if they need it, or is the tray just dropped off and picked up later, untouched?.
• Your communications with staff; who did you speak to (name and title)?; what were their responses to your concerns?; what actions, if any, did they promise or take?.
• Take photos (if appropriate and with consent/discretion); this includes uneaten food trays, significant weight loss (e.g., showing how loose clothing has become), or any developing sores.

Step 2: Talk is NOT Cheap – Communicate Clearly and Escalate.

Start by voicing your concerns directly, but don’t stop there if you don’t see results.

• Begin with the direct care staff or the nurse on duty; be specific. Instead of “Dad looks thin,” say, “I’m concerned Dad has lost weight and he’s not eating his meals. What is his current weight, and we need to review his food intake charts?”.
• If your concerns aren’t addressed, or if you’re brushed off, escalate to the Director of Nursing. Still no satisfactory response? Go to the facility Administrator.
• Follow up important conversations with written communication (an email or a formal letter sent with delivery confirmation). This creates a paper trail.
• Request a formal care plan meeting. This meeting should specifically focus on your loved one’s nutritional and hydration status and what steps will be taken to address your concerns.

Step 3: Official Reporting Channels – Get a Third Party Involved.

Sometimes, internal channels aren’t enough. You might need to bring in outside agencies.

• South Carolina Department of Health and Environmental Control (DHEC): DHEC is the state agency responsible for licensing and regulating nursing homes. File a formal complaint with them. Typically, file online, by phone (e.g., (803) 545-4370 or their toll-free number 1-800-922-6735), or by mail.
• South Carolina Long-Term Care Ombudsman: An ombudsman is an advocate for residents’ rights. They investigate complaints, mediate solutions, and protect residents. Reach the SC Long-Term Care Ombudsman at 1-800-868-9095.
• Adult Protective Services (APS) via the SC Department of Social Services (DSS): If you believe the malnutrition is a result of neglect or abuse, contact APS. They are responsible for investigating such allegations. Contact information for county DSS offices is available on their website, or report to SLED’s Vulnerable Adult Investigation Unit for facilities operated by or contracted with DDSN or DMH at 1-866-200-6066.

Step 4: Seek Independent Medical Evaluation.

If it’s feasible, get an opinion from a doctor who isn’t affiliated with the care facility.

• Arrange for your loved one to be seen by their regular primary care physician or a geriatrician.
• This independent assessment provides an unbiased view of their nutritional status, identify deficiencies, and recommend a course of treatment.

Step 5: Legal Consultation – Know Your Power.

There comes a point where you may need legal advice, especially if the facility is unresponsive or if your loved one has suffered significant harm.

• Contacting a law firm doesn’t mean you’re automatically filing a lawsuit. It means you’re arming yourself with information about your legal rights and options.
• An attorney explains the legal standards of care, helps you understand if those standards have been breached, and advises on how to proceed to protect your loved one.

Take Action on Malnutrition Now

Your vigilance, your gut feeling, your refusal to accept dismissive answers – these are literally the lifeline your loved one needs. Trust your instincts. When it comes to the people we care most deeply about, those internal alarm bells are usually ringing for a good reason.

If you’ve voiced your concerns, documented the issues, and still feel like you’re talking to a brick wall while your loved one’s health deteriorates, it is absolutely time to bring in reinforcements.

Call personal injury lawyers at Hughey Law Firm at (843) 881-8644 for a straightforward, no-nonsense conversation about your situation and how we are ready to help you take a stand.

Need Legal Help? Let’s talk

Nathan Hughey

Nathan Hughey, an attorney and fourth-generation South Carolinian, founded Hughey Law Firm in 2007. Before that, he spent five years defending nursing homes and insurance companies. Leveraging his experience, he now advocates for those injured or wronged by such entities, securing over $290 million in verdicts and settlements.