Families typically notice changes in one of two ways: a sudden decline after a period of “seeming fine,” or a gradual downward trend that staff minimize.
Common warning signs you may have seen include:
- Weight loss that happens faster than expected for the resident’s condition
- Dry mouth, reduced urination, fever, or repeated infections
- Confusion, weakness, dizziness, or new fall risk
- Pressure injuries that develop or worsen despite standard prevention efforts
- Poor wound healing after skin breakdown or after procedures
- Reports that meals or fluids were “offered,” but the resident’s intake was not actually tracked
In Michigan facilities, documentation and monitoring practices are crucial. Even if residents have medical conditions that affect appetite or thirst, staff are still expected to respond with appropriate assessments and interventions.


