Nutrition can be a tough one for aged care residents and aged care providers – eating difficulties, a lack of appetite, diminished dexterity and dysphagia can all contribute to residents eating less and be at risk of malnutrition.
Nutrition is important no matter what age but research shows around 50% of older Australians in aged care and the community are either at risk of malnutrition or are malnourished.
So when residents refuse to eat food or struggle to consume it, it is common to feel like eating anything at all is better than nothing, and that can be true. But if we are what we eat, why are processed meats such a staple on residential aged care menus?
Almost every time I visit my Nan in residential aged care, she is served a small ham and cheese sandwich on white bread for lunch. This is often her substitute option for a meal she doesn’t want to eat such as the weekly party pies and sausage rolls that are served for dinner on a Sunday.
We know “treat” foods are okay to have occasionally and while ham is a popular sandwich filling, a source of protein and a bit of iron, eating too much processed meats has been proven to raise your risk of certain cancers with Health and Wellbeing Queensland reconfirming this fact just this week.
Processes and cured meats such as ham, sausages, salamis and hot dogs are classified by the International Agency for Research on Cancer (IARC) and the World Health Organisation (WHO) as a ‘Group 1 carcinogen’ as research shows eating processed meat causes colorectal cancer.
“When pork is processed into ham it becomes a less healthy choice. That’s because ham is made by curing or smoking and the addition of preservatives such as salt and sulphates”, said Health and Wellbeing Queensland Public Health Nutritionist and Dietitian, Fiona Nave.
Research published in 2021 revealed a possible link between the regular consumption of processed meat and an increased risk of dementia. Researchers found that in a group of around 500,000 people, those who consumed around 25g of processed meat in a day – roughly one rasher of bacon – were 44% more likely to develop dementia in their later years.
While Ms Nave confirmed most of these processed foods aren’t usually eaten in isolation but instead as part of a meal with other food types to make for a filling and nutritious lunch, Nan seldom sees these other elements in her meal alternatives.
Swapping processed meats with other lean proteins like chicken, roast meats or tinned fish and adding more vegetables to meals – including sandwiches – is recommended by nutrition experts as an easy way to balance residents’ plates. but where are these options?
They may be there, but no one has spoken with my nan about them and what ones might be best for her. Despite already having had a meeting with hospitality staff to discuss her preferences – preferences that get ignored – does Nan need to be more vocal? Does my family need to advocate more for her? She can’t be the only resident experiencing this.
According to the Health and Aged Care Department, residential aged care providers now must also report on food and nutrition spending and quality indicators will need to meet the new Food and Nutrition Aged Care Quality Standard from the commencement of the new Aged Care Act.
The Department expects them to:
The Royal Commission into Aged Care Quality and Safety’s final report identified food and nutrition as one area for an urgent review and heard that 2017 research by aged care food experts, The Lantern Project, revealed the average daily spend on food for residents was about $6.
Part of the Federal Government’s aged care funding promises in its 2021 Federal Budget was a $10 per day supplement to the Basic Daily Fee received by providers to boost this daily spending on food.
Anton Hutchinson, whose family has owned Canberra Aged Care for more than 25 years, told HelloCare back in 2022 that his aged care home continued to spend around $13 per day per resident on food ever since they began receiving the supplement and that their current level of spending on food has changed little for as long as he can remember.
“It’s $10 the system badly needed,” he said.
But peek into the deli section of any supermarket and you can see that ham and other processed meats are cheaper than leaner, healthier options and that is likely the reason Nan’s options are limited.
Earlier this month, Tom Symondson, Chief Executive Officer of the Aged and Community Care Providers Association claimed many providers are still, “Struggling to pay the bills” as the sector grapples to find a new funding model that will be sustainable for both providers and residents.
But with 85% of residents’ pensions going to a facility to cover the daily services they receive, including food, there is some budget there to offer more choice than a ham and cheese sandwich.
If we wouldn’t settle for a daily meal that has minimal nutritional value and potentially puts us at risk of disease, why do we serve it up to our most vulnerable?
If you have questions, concerns or complaints about the food, nutrition or dining experience at your or your loved one’s aged care facility, you can call the National Food, Nutrition and Dining Hotline on 1800 844 044. Visit the Health and Aged Care Department’s website here for more information.
What is the food like in your or your loved one’s residential care facility? Let us know in the comments below
Whilst I agree that healthy options for meal alternatives is preferable and should be available, voicing the concern that processed meats are a major concern as leading to cancer is scare mongering. High levels of malnutrition in residential care are deplorable so too are the levels of depression. In my opinion, the issue should be “Does the food provided nutritionally valuable AND does it provide an enjoyable experience to the individual?”.
The foundation of our current approach in Residential aged care is the dignity of choice and risk assessment. It may surprise the author and many of you who are reading this articlethat many residents like ham sandwiches and meat pies, they are familiar and easy to chew. Whilst they should not be a solitary choice, we must stop placing age and culturally inappropriate judgments on what is being served in RACs. If I was a dietician I would recommend an increase in the consumption of legumes which are nutritious, easy to chew, and high in protein and fiber, BUT, most residents don’t like them (except baked beans). by adding salad in the sandwich and adjacent to the pie we can add value to the meal, but please remember that many older people want simple, familiar, easy-to-chew food most of the time. ASK THEM!!