Food for thought about aged care nutrition
From a horror story to feelgood television, aged care dining has come a long way.
Since the Royal Commission into Aged Care Quality and Safety’s final report identified food and nutrition in aged care as needing urgent improvement, the government and providers have shown a heightened awareness of how important food is as a human right for older people.
It is no surprise that most of the reform focus has been on bringing the aged care providers up to scratch and ensuring they comply with new requirements.
The previous Federal Government also provided them with additional money specifically to improve mealtimes.
Some of the policy and regulatory reforms include all residential aged care providers:
- Must report on food and nutrition spending and quality indicators
- Must meet the new Food and Nutrition Aged Care Quality Standard from commencement of the new Aged Care Act
- Will be provided with support, training, and additional information resources.
A new Food, Nutrition, and Dining hotline, 1800 844 044, has been set up to allow providers to speak with professionals to discuss issues, ideas, or concerns they may have about providing an enjoyable food, nutrition, and dining experience.
A specialised Food, Nutrition, and Dining Advisory Support Group has been established to:
- Work with Dementia Australia to promote nutrition and food enjoyment for people living with dementia
- Roll out 1,000 menu and mealtime assessments, completed by Accredited Practising Dietitians
- Build residential aged care providers’ capability by linking them to education programs
- Manage up to 720 targeted monitoring visits to aged care homes each year, with one in 10 of the highest-risk visits to include dietitians.
Ensuring older Australians eat well has moved from solely the province of the regulators and providers to our television screens.
Well known chef and foodie, Maggie Beer, has embarked on a world-first social experiment to transform the meals and dining experience at an aged care home.
The three-part program, Maggie Beer’s Big Mission, is available on demand on iView.
A team of Tasmania University speech pathologists, occupational therapists, dietitians, and researchers went behind the scenes of the program to assess and evaluate it it as a “social experiment”.
The show takes place at the Meath Care’s Dr Mary Surveyor Centre in Kingsley, Western Australia.
Before Maggie arrived, 78% of the 44 residents were at risk of malnutrition or malnourished and 46% experienced depression. The Royal Commission estimate that 68% of Australians in residential aged care are malnourished or at risk of malnourishment.
Maggie's brief was to:
Make meals more nourishing, flavoursome, and visually appealing, with increased protein and fresh ingredients
Give residents variety, choice, and independence with a buffet-style offering
Involve residents in mealtime roles such as setting tables and restocking supplies
Create a calmer, more dignified, and social mealtime experience.
Kitchen staff were mentored and received training on nutrition, swallowing, oral health, and leadership.
Writing in The Conversation, the researchers saw value in the experiment: "The series shows bringing allied health expertise into the dining room can enhance residents’ health and wellbeing".
“Mealtime interventions – making therapeutic changes such as suitable eating implements, modified diets and textures, or assistance with eating in a real-life context – helps care staff see the residents’ potential.”
Even small changes (like making one’s own fresh toast, served hot) can make a difference to choice and mealtime enjoyment.
They found some resistance to long-term habits and ways of doing things and identified the need to be more flexible to individual and different needs and safety considerations.
Staff valued seeing, feeling, and experiencing the benefits that flowed from new ways of facilitating residents’ choice and independence during meals. This built momentum and shifted mindsets.
The researchers concluded that Maggie’s intervention led to improved residents’ appetite, mealtime satisfaction, and mood, and could be adopted nationwide.
The standard of mealtime care was lifted, with many residents enjoying increased choice and independence. As one resident said, “I can see what I’m getting, and I can get what I want.”
However, for the model to work nationally and on a larger scale, aged care organisations would need to invest in the vision, training, and ongoing support for staff to make the necessary change.
The program has also developed tools for other aged care providers to replicate the model.
Related reading: ABC, Aged Care Equity, Health Department
