The nurses, caregivers and staff of At Home Nursing Care understand that better nutrition can lead to better recovery and healing.

This connection is very clear in a story about a 62 year old man who for 9 months suffered with a large diabetic wound on his foot.  He was only a couple of weeks away from amputation of his leg because of the sore.

For months, his nurses and doctors had done everything they could think of to close the wound, from IV’s full of antibiotics to topical creams.  But the wound just wouldn’t get better.

Shortly before the scheduled amputation, dietician Nancy Collins was brought in by the doctors to give her advice.

“It’s not every day you get to save a man’s leg,” she says, but that’s exactly what she did.

She didn’t turn to some expensive, fancy new medical device or experimental treatments.  She simply improved his nutrition.


A nutritious, high protein meal

“Nutrition has a role in 12 of the top 15 causes of death,” she said, “but it’s been neglected historically.”

Collins added more protein into the man’s diet, made sure he got at least 3,000 calories a day to fuel healing, and she had him drink water mixed with a powder called “Juven”, a combination on glutamine, arginine and HMB (amino acids.)  He drank two packets a day for 12 weeks, while his doctors continued the topical treatments on his foot.

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Juven Powder Supplement

Thanks to his improved nutrition, his body was able to grow tissue, something that wasn’t happening before, and his foot wound finally closed.

“Instead of losing his leg, he went on a cruise with his wife,” she said.

Collins recently spoke at annual conference for the California Association for Health Services at Home, a group of home-based providers including At Home Nursing Care. Our staff members attended the conference to learn how to improve the quality of life of our clients and patients.

Collins explained that nutrition is often the missing link in recovery, one that is too often overlooked in the medical community.

And nutrition doesn’t just mean the amount of food someone eats or the amount of fat stores in the body; it’s the quality of food and the amount of amino acids and protein.

“With just a 10% loss of lean body mass, wound healing is impaired, “she said.

A 20% loss causes wound healing to cease and a 40% loss of lean body mass leads to death, usually from pneumonia, Collins explained.

She says that most patients do not take in enough calories or protein to sustain their lean body mass, which peaks for people at age 25 and then goes downhill from there.

Malnourished patients are significantly more likely than well-nourished patients to experience re-hospitalizations.  Nutrition, or the lack of it in nursing or rehabilitation centers, plays a role in 61% of malpractice lawsuits, she said, because patients who are malnourished are 200% to 500% more likely to develop pressure wounds.

Why are patients not eating enough or the right kinds of foods?  Collins sites cognitive problems, financial problems, fatigue and a lack of feelings of hunger.

30% to 50% of patients admitted to the hospital tend to be malnourished.  Then they lie in bed with little activity and lose more lean body mass.  Most continue to lose lean body mass when they are discharged and return home.

What can people do? Try nutrition therapy, which involves the appropriate amount of calories, protein, fluids, vitamins and minerals to promote healing.

A 125 pound elderly woman may need a minimum of 1700 to 2,000 calories a day, 57 to 68 grams of protein and 7 to 8 cups of fluid.

Many elderly people need help to make sure they have enough food in their home.  They may need help preparing the food or encouragement to eat it.  Six small meals may be better than three larger ones.   Elderly patients may benefit from taking bites of food every time a commercial break appears on TV.

In addition, oral supplements such as Ensure can help increase calories, protein and nutrients.  Supplements such as the powder Juven can promote healing by adding amino acids.  There are protein powders that can be mixed with soups or drinks.  There is also a product called PB2, which can be purchased online and is a powdered peanut butter.  It can be added to water or poured over oatmeal.  Finally, nutritionist recommend eggs as a good source or protein.  (Always consult with your physician before changing your diet, or call At Home Nursing Care and we can assist with getting a Physician’s evaluation and orders.)

Home care providers such as At Home Nursing Care can provide a nutritional evaluation, including simply looking into cupboards and the refrigerator and making a shopping list and meal plan.  Our caregivers can prepare healthy meals and count calories.


Our staff, here to help.

Studies show that elderly people with inadequate refrigerator contents are re-admitted to the hospital three times sooner than those with adequate food (34 days to return to the hospital versus 100 days.)

If you or someone you love needs Los Angeles or San Diego home caregivers for healing support at home, call At Home Nursing Care at 760-634-8000 for a no-cost, in home evaluation, or visit our website at

You can find lots of information on elderly nutritional needs by visiting Collins’ website,