The mealtime experience in residential aged care facilities has, quite rightly, attracted a great deal of attention from health professionals, advocacy groups and policymakers in the years following the Royal Commission into Aged Care Quality and Safety.
Dietitians Australia estimates that the prevalence of malnutrition in Australian residential aged care facilities could be as high as 50 per cent, and we still have a lot of work to do in turning that figure around.
However, malnutrition is not a problem that is exclusive to residential aged care facilities.
Malnutrition in the Community
Health professionals and providers believe it is prevalent in the community, but we lack the data to conclusively quantify it because community-dwelling older people are less likely to be screened for malnutrition than those in residential aged care.
This group is also unlikely to self-identify as being at risk of malnutrition. We’ve all got examples of elderly people who, for a variety of reasons, are unable to prepare adequate meals for themselves and instead rely on ‘tea and toast’.
As consultation continues for the Federal Government’s new Support at Home program, it is clear that people want to stay at home for as long as they can.
In facilitating this, we need to ensure we have appropriate systems in place to monitor and prevent malnutrition, or we run the risk of seeing greater numbers of older people with malnutrition – causing stress for themselves and their loved ones, and putting extra pressure on our healthcare system.
For the aged care system to work in an optimal way, we need people to be supported at every stage of their ageing journey.
If we want to get serious about preventing malnutrition in aged care, we need to stop it where it starts: at home, in the community.
This means keeping meals front of mind for in-home aged care providers, and referral to an Accredited Practising Dietitian at the first sign of declining intake or weight loss.
■ Best practice for preventing malnutrition in the community means: regular screening for malnutrition
■ removing barriers to accessing nutritious meals
■ positioning meals as a requirement for clinical care, as well as daily activities
■ implementing national nutrition and quality standards for meals that are government-funded
■ support for meal providers in meeting those standards.
The burden of this change should not sit with providers alone.
Government support is also needed, and it is something we need to see in future iterations of the Support at Home program.
How to support your clients in meeting their nutrition needs
While we campaign for change, there are plenty of things providers can do right now to support their clients:
■ speak to them about their appetite and their food intake
■ check the fridge and freezer for what’s available and what’s in date
■ support them in placing orders for meals
■ explore their barriers to eating well – are there issues with medication, operating a microwave, chewing difficulties, swallowing difficulties, confusion?
■ early referral to an Accredited Practising Dietitian so we can focus on malnutrition prevention rather than treatment.
By working to identify and prevent malnutrition in the community, we can help older Australians achieve their goal of staying healthy at home for longer.
Ashleigh Jones, Accredited Practising Dietitian and Group Nutrition & Health Manager, Lite n’ Easy