Prevent Malnutrition, Dehydration, and Bedsores

What Are Advanced Directives?

Advanced directives are legal documents in which an individual can specify his or her end-of-life care decisions. Each individual has the right to accept or refuse life-prolonging and life-sustaining medical treatments at the end of his or her life. By law, nursing home care providers are required to provide residents with the ability to access the appropriate forms so that residents can make advanced directives if they so choose, and the nursing home staff are legally obligated to oblige the resident’s end-of-life care wishes indicated in his or her advanced directives.

Federal and State Laws Concerning Advanced Directives

The federal Patient Self-Determination Act requires that certain care providers, such as nursing home facilities, that participate in the Medicare and Medicaid programs are to furnish residents with information regarding advance directives upon admission to the facility or when the provision of care commences. Illinois state law has a similar provision under section 2310-600 of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. The section provides that the Illinois Department of Public Health is required to make available a uniform advance directive for a do-not-resuscitate order that may be used in all settings and a living will declaration form. A do-not-resuscitate order, or DNR order, is a certain type of advanced directive that allows an individual to designate what, if any, types of life-saving medical procedures may be performed in the event that he or she is dying or unconscious. The Illinois Department of Public Health standardized Do-Not-Resuscitate (DNR) Form can be found here. The Illinois Living Will Declaration form can be found here.

Advanced Directives can Cause Dehydration, Malnutrition or Unavoidable Bedsores

In a DNR order, one of the life-sustaining medical treatments that an individual can either accept or refuse is the artificial administration of nutrition and hydration. A nursing home resident can designate through a DNR order that he or she 1) refuses any and all treatment involving a nutrition tube, 2) would like to be artificially administered nutrition through a feeding tube, but only for a designated period of time, or 3) accepts long-term artificial administration of nutrition.

When a nursing home resident has a DNR order in place that designates that he or she has refused any artificial administration of nutrition or hydration, the nursing home staff is legally obligated to respect the resident’s DNR order. By respecting the resident’s end-of-life wishes, the nursing staff is not permitted to help the resident maintain proper hydration and nutrition levels to sustain life. As such the resident may become dehydrated and/or malnourished. Furthermore, sometimes improper hydration and/or malnutrition can lead to the development of bedsores.

Contacting An Experienced Attorney

With the exception of DNR orders, malnutrition and dehydration of nursing home residents is usually a sign of nursing home abuse or neglect. If your loved one has suffered from malnutrition or dehydration at the hands of nursing home staff, do not hesitate to contact an experienced nursing home abuse and neglect attorney today. Please contact the attorneys at The Rooth Law Firm either online or by phone at (847) 869-9100.

Photo Credit: Nicolas Alejandro Street Photography via Compfight cc


Illinois Department of Public Health, Statement of Illinois Law on Advanced Directives and DNR Orders

Joyce Black, et al., Pressure Ulcers: Avoidable or Unavoidable?  Results of the National Pressure Ulcer Advisory Panel Consensus Conference, Ostomy Wound Management, 2011;57(2):24–37