The Knowledge and Implementation Hub has brought together information and resources to support a special themed Innovator Training Program (ITP) on introducing providing healthy and nutritious food into residential aged care. These resources will help ITP participants increase their knowledge whilst highlighting the important considerations when implementing this approach into an organisation. They can be used in conjunction with the learning materials provided by the ITP which cover more general processes around change management.
Delivering nutritious food and drinks within residential aged care
This short module describes key considerations to providing residents with appetising food and drinks within aged care.
In all aged care settings, older adults have the right to enjoy their dining experiences, make informed choices about food preferences and when to eat, and receive nutritious and appealing food services which are tailored to their dietary requirements. Dining experiences and food have been shown to have a large impact on both mental and physical health of older adults particularly in aged care settings. [1, 2] If autonomy, informed choice, tailoring of meals and a positive dining experience are not provided to older adults in aged care settings, risk of malnourishment, lower quality of life, sickness and injury, and social isolation are increased. [1]
By fulfilling these needs during the dining experience, service providers and aged care workers can promote social interaction with other residents which has been shown to support positive mental health and increase quality of life. [1] Improving meal choices has also been shown to increase the nutritional intake of older adults in residential aged care, especially those requiring texture modified diets. [1-3]
Implementing tailored nutritious diets
Implementing safe, appetising and nutritious food and drink which are tailored to the needs and preferences of an older adult, requires joint support from organisational (service providers, managers, policy makers) and individual (aged care workers, older adults and families) bodies. Before introducing a new approach to nutritious meal planning in your service, consider the following eight core elements.
Informed choice
Each older adult accessing an aged care service comes from a different background. It is crucial to encourage informed choice at mealtimes by recreating past eating experiences and supporting autonomy to increase comfort and empower residents.
Texture-modified diets
Ensuring menu range and normality of texture modified meals for older adults with swallowing difficulties is an important part of nutrition. Texture-modified diets can alienate older adults from others. A range of appetising meals and adequate eating support can increase social engagement with others at mealtimes and older adults’ food intake.
Accommodating for dietary requirements
Nutrition or diet can be an important part of an older adult’s identity or health management. Creating diverse and nutritious menu plans to include for vegetarian, vegan, gluten-free, Halal, diabetic, lactose-free and other diets are crucial to provide for religious older adults, those with health conditions and preferences surrounding animal products. Appropriate mealtimes should also be considered, with a shift from the traditional ‘breakfast, lunch and dinner’ timeline to one more fluid, especially to account for religious events such as Ramadan or Lent.
Preventing malnutrition
Providing appetising and nutritious meals is an important part of preventing malnutrition, as is periodic nutritional assessments. To successfully increase nutrition in aged care, it is important that policy makers and service providers work together with aged care staff and allied health workers to create a standard procedure around regularly assessing and effectively treating cases of malnutrition.
Promoting nutrition for people living with dementia
Ensuring people with dementia receive their nutritional needs can be challenging due to individual differences in disease presentation. Understanding each individual is crucial in building strategies to involve them in dining experiences and increase their food or drink intake.
Promoting nutrition in the community
Creating nutritional meal plans and shopping lists while encouraging independence in the kitchen are important parts of promoting nutrition for older adults in home care.
Understanding the experiences of older adults
For nutrition plans and policies to be successfully implemented in aged care settings, it is crucial that workers understand to necessity of nutrition, have access to the tools to provide it, and understand the experiences of older adults in these settings.
Opportunities for change
The high prevalence of malnourishment and complaints around food in Australian residential aged care, as emphasised by the Aged Care Royal Commission, is caused by a lack of supported eating, unappetising meals and poor-quality meals. [4] The Royal Commission recommended revisiting the vague and unenforceable Aged Care Quality Standard and an increase in the Basic Daily Fee for meals, to raise the average standard of nutrition and hold residential aged care service providers accountable. [4]
In line with these recommendations, there is an opportunity to increase education of nutrition for older adults, and to encourage service providers and aged care staff to raise the average nutrition standard by providing supported eating, good quality and appetising meals, therefore decreasing cases of malnutrition and other associated health risks while increasing resident’s quality of life.