How to Spot Malnutrition Symptoms in Your Loved One

2. Lack of interest in eating or drinking. If a family member has stopped cooking, is skipping meals or shows no interest in their favorite foods, those can all be red flags for malnutrition, says Maureen Andreassi, M.D., an internal medicine physician at Novant Health Senior Care in Matthews, North Carolina.

“If you’re eating with a person and they eat half of what they normally eat, that should trigger a discussion,” Andreassi says. “You can ask questions like, ‘Are you getting full too soon? Are you having trouble swallowing?’” 

If your loved one is in the hospital or a nursing home, Andreassi suggests checking their tray after meals to see what they’re eating — and how much. “If nothing is eaten except one bite out of dessert and one bite out of mashed potatoes, that’s when you need to worry,” she says.

3. Empty fridge and cupboards. If your loved one still lives independently at home, discreetly check the fridge and cabinets when you visit, suggests Elizabeth Landsverk, M.D., a geriatrician in San Francisco and author of Living in the Moment: A Guide to Overcoming Challenges and Finding Moments of Joy in Alzheimer's Disease and Other Dementias.

“If there isn’t any food in the fridge or it’s old and moldy, and it doesn’t look like they are making a lot of food, that’s a sign they need more help,” Landsverk says.

4. Changes in hair, skin and nails. Some of the earliest symptoms of malnutrition — even before weight loss becomes apparent — affect skin, hair and nails, according to an article in the journal Nursing. 

Nails will stop growing and may “look odd-shaped, be very brittle and crack a lot,” Planells says. Hair may thin and lose its shine; some people also start losing hair.

Malnutrition also changes the skin, making it dry, flaky and less elastic. In addition, skin will bruise and tear easily. “They might bump against a table — to me or you it’s nothing — but for them it might create a really bad bruise,” Planells says. “There45’s increased skin breakdown, in general. Someone who is in bed for a day, their skin might break down and they get bedsores.”

5. Frequent, prolonged infections. If your loved one gets frequent colds or urinary tract infections, that, too, can be a symptom of malnutrition. “People who are more malnourished won’t mount an immune response to infections as well,” Landsverk says. It also takes longer for them to recover if they are ill, she says.

6. Delayed wound healing. A malnourished person’s weakened immune system also leads to slower wound healing, whether it’s a surgical incision or a pressure ulcer that developed from staying in one position for too long.

In studies that compare healing rates after surgery, malnourished patients are twice as likely to have a delay in wound healing compared to those who are well-nourished.

7. Decreased grip strength. Does the older adult in your life struggle to open jars, hold utensils or carry groceries? Studies show decreased handgrip strength is a predictor of low nutritional status, because of the muscle loss and weakness resulting when someone doesn’t get enough nutrients. 

The connection is so strong that doctors and dietitians often check grip strength when they’re screening someone for malnutrition, Andreassi says.

8. Weakness, fatigue and confusion. Malnutrition can make your loved one feel tired and weak, and they may start to struggle with mobility and the activities of daily living. Malnutrition is also linked to confusion and brain fog. Even in children, malnutrition is linked to poor cognition. (Here are foods that can boost brain health.) 

What’s the fastest way to correct malnutrition?

If you suspect someone you love has malnutrition, your first step is to involve their health care provider. A clinician can diagnose malnutrition through a physical exam, blood tests and other assessments to understand the extent and specific nature of the nutritional deficiencies, Landsverk says.

Treating malnutrition depends largely on what’s causing the problem, experts say. Here are some steps that can help:

Work with a specialist. A registered dietitian or certified nutritionist can create a nutrition plan and suggest strategies that work with your loved one’s budget, abilities and preferences. (Medicare may even help cover it.) They may recommend a nutritional supplement like Ensure or Boost to provide extra protein and calories.

Review their medications. Ask a doctor, pharmacist or geriatrician to review your loved one’s medications for side effects that affect appetite or nutrient absorption, Andreassi suggests. Even if their prescriptions can’t be changed, she says, switching the time of day they’re taken or reducing the dosage can also be helpful.

Eat multiple meals. Encourage your loved one to eat small amounts throughout the day rather than two or three heavy meals. Incorporate healthy fats, whole milk dairy products and plenty of protein, Planells says. Keep nutrient-dense snacks such as nuts, trail mix, cheese, yogurt and dried fruit within easy reach. And fill the pantry with some easy-to-prepare foods.

Make every sip count. Replace water with higher-calorie drinks like whole milk, smoothies, protein drinks and 100 percent fruit juice. “Everything that goes in their mouth, we want it to count,” Planells says.

Fortify their foods. Add healthy oils, butter, whole milk or other foods high in calories to what they’re already eating, Landsverk suggests. A sprinkle of cheese, nuts or seeds can provide another calorie boost.

Consider help with cost. For a fee, many companies will deliver groceries or healthy, easy-to-prepare meals to your door. Or if affordability is an issue, see if they qualify for SNAP (the Supplemental Nutrition Assistance Program). (A 2022 AARP study found that only 30 percent of those who qualify for SNAP applied.) Or reach out to community organizations such as Meals on Wheels that deliver low- or no-cost meals to people who meet income requirements, or who can’t shop or cook for themselves.

Switch to softer foods. If your loved one is having trouble chewing or swallowing, help them transition to a mostly chopped and soft diet. Encourage soft foods such as meat loaf, eggs, fish and yogurt, and grind up other foods with a food processor.

Schedule social meals. Encourage your family member to set a regular meal schedule and to eat with family or friends as often as possible. “If you are at a table with people you like and having conversation, you’re more likely to eat than if you’re by yourself,” Landsverk says.