By Karly Bartrim
Aged care dietitian, academic (Griffith University), and PhD Candidate (University of Queensland)
Australia’s ageing population continues to place high strain on aged care services, urging the government to improve the system that supports older Australians to live and age well. [1] Strengthening the workforce that cares for older adults and increasing employment of allied health professionals are core recommendations continuing to be advocated for in media and by government today. [2] In addition, providing quality food that meets the nutrition needs of older adults and reducing malnutrition in these settings continues to be front of mind.
Dietitians are the only health professionals trained in providing nutrition care to prevent or reduce malnutrition and chronic diseases across all population groups. [3] Through the delivery of nutrition interventions, dietitians improve the health and wellbeing of older adults. This makes them an essential workforce for providing nutrition care in residential aged care facilities (RACF) and in-home services.
Dietitians’ roles and working hours vary worldwide. For example, in Ontario, Canada, dietitians have an allocated 30 minutes per resident per month to ensure Long Term Care Homes provide optimal nutrition care and ensure policies and procedures support older adults. [4] As such, Dietitians Australia have provided recommendations to introduce mandated dietitian hours in aged care to align with provinces in Canada and certain jurisdictions within the United States. To achieve this, the Australian dietetic workforce in aged care needs to increase substantially in size and capacity.
A greater understanding of dietitians’ attitudes when working with older adults in RACF or their homes can inform workforce strategies to support capacity-building initiatives that produce quality care. A recent integrative review was conducted, exploring dietitians’ attitudes working with older adults in these settings. [5] The review included studies from seven countries (the US, Canada, Australia, UK, Israel, Japan, and the Netherlands) conducted between 1986 and 2021. Twelve studies included dietitians working in RACFs, and five explored dietitians working within home care services.
Data from the studies were analysed and synthesised into five themes:
- Recognising their contribution as dietitians
- Lacking clarity about the boundaries of their role
- All team members have a role to play in nutrition care
- Assumptions and biases about working with older people
- Needing to build capacity in the workforce.
Dietitians recognised the important contribution of their role in caring for older adults; however, they experienced low clarity about the boundaries of their role. Dietitians appeared to have positive and negative assumptions and biases about older people. Moreover, dietitians have recognised issues in the workforce, with not all team members prioritising nutrition care despite dietitians recognising all members have a role. Dietitians acknowledged that the dietetic workforce needs to build capacity through more time, funding, and professional development opportunities.
Future research is needed to understand dietitians’ confidence in their knowledge and skills regarding working in RACF and home care services to provide insight into future initiatives to support the growing workforce. Future directions need to include improving understanding of the dietitians’ role in aged care, incorporating practical opportunities for student dietitians in aged care, and considering the implementation of mandated dietitian hours. Integrating dietitian services and ensuring dietitians are well supported, will help improve the quality of Australia’s aged care system and improve the nutrition of older Australians.
*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.