Nov 12, 2018

Should aged care residents be allowed to eat whenever they want?

 

All too often, aged care residents have to conform to eating within narrow time frames, and little opportunity is given for residents to eat when they choose.

But some in the industry say residents should be able to eat whenever they’re hungry.

“You’ve got to maximise their opportunity to eat when their appetite is best,” said Cherie Hugo, nutritionist and founder of The Lantern Project.

Ms Hugo said The Mater hospital recently did a study which showed that eating on demand not only increased food and protein intake, it also reduced costs and created less wastage.

While the study took place in a hospital setting, there were lessons from it for aged care facilities too, she said.

One in two in aged care are malnourished

If people can eat when they’re feeling the most hungry, they have the maximum opportunity for nourishment, said Colin McDonnell, dementia excellence practice leader with Scalabrini.

Making sure that residents remain properly hydrated and nourished is crucial, he said. One in two people in aged care are malnourished, making them more likely to fall, suffer skin tears, act out feelings of frustration, have high blood pressure, or suffer other adverse consequences, said Mr McDonnell.

Residents should be allowed to either get themselves something to eat, or ask that something is brought to them, whenever they’re hungry, he said.

Ms Hugo said aged care facilities should have nourishing snacks on hand and accessible at all time, so if residents to feel hungry outside set meal times they can still obtain some nourishment with a snack.

Mr McDonnell also stressed the importance of aged care residents remaining hydrated throughout the day, particularly in summer. He said aged care residents should drink 1.5 litres of water a day.

New quality standards could create greater flexibility

With the new quality standards coming in next year, there will be greater emphasis on individual choice for residents, and rigid eating times could become a thing of the past.

“Flexible meal times will be looked upon favourably,” said Ms Hugo.

Flexibility is also required for those with dementia, and those with different backgrounds, Mr McDonnell said.

People with dementia like to eat at different times, so to maximise their food intake it’s important that they are allowed to, he said.

Involving residents with dementia in preparing and serving food can trigger eating memories, which helps their bodies prepare for eating, and helps them go through the steps involved with having a meal, including eating.

Residents’ cultural backgrounds and lifestyles should also be taken consideration of when determining when they should eat, Mr McDonnell said.

For example, European residents might light to eat later than others, while people who spent a large part of their lives as shift workers might like to have their main meal in the morning.

Is it safe for residents to serve themselves food?

Mr McDonnell said residents should be able to serve themselves at the table. If people can at home, they should be able to in an aged care facility too, he said.

“They [residents] are not contaminated,” said Mr McDonnell. People are able to serve themselves at buffets in clubs and restaurants, so why shouldn’t they be able to do the same in aged care facilities?

Quarantine procedures are well established in aged care facilities, minimising any risk of infection.

Should residents be able to cook their own food?

Residents who wish to, should be able to help cook food in aged care facilities it it’s safe to do so, said Ms Hugo.

Some homes have introduced programs where residents are able to grow food in gardens and then help cook it, if they wish, she said.

“Some homes are navigating it quite well,” she said.

It’s about striking a balance between those who are able to and who want to, and making sure they are safe, she said.

November 10-17 2018 is Australian Food Safety Week.

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  1. What a lot of bloody rubbish, firstly our elderly were fortunate enough to grow up with routines, they have always had their dinner on the table at a particular time and they still expect to continue. In RACS there is breakfast, morning tea, lunch, afternoon tea, dinner and supper…when exactly do you say they are feeling hungry?
    We run a dementia facility and they do not like to eat at different times at all, sadly dementia residents are most times like children and totally unaware of the time of day or night, they flourish on routine not randomness. Do you suggest that meals be available 24/7 ?? Really…How do we pay for this and can you imagine the food wastage?
    Can they cook their own meals…have you heard of OH&S or infection control or insurance!
    Can they serve their own meals “they are not contaminated”..how do you know they are not contaminated, do you want to stand over them and demand they wash their hands like children? What if a resident has an infection yet undetected or in the incubation period, again OH&S and infection control. What say they drop a bandaid in the soup, its probably OK at home but its not at all OK in a shared environment.
    Not everyone in a facility will feel the same way, how do you deal with that? What are you talking about growing your own vegetables and eating them? Its totally against Government regulations for aged care to do so as it hasnt been processed to health standards etc etc.

    I find a lot of comments are just so poorly informed and totally ignorant of the rules that actually govern how facilities operate, these rules are put in place to protect the residents. There is no utopian way of growing old and dying, some people do it with dignity and others begrudge living so long but the best thing we can do is at least put forward practical and realistic suggestions instead of the likes above.

    1. I agree with Anton. No thought has been given to cost, or whether the funders will increase their payments. If people were able to be independent, they probably would not be in an aged care facility and could cook and eat what they wanted, and when they wanted.
      And health and safety is a minefield already, without allowing residents to have either access to the kitchen to have cooking facilities in their rooms!

      1. Oh how right you two are! The age care sector is a growing mine field it seems. Yes we want our residents to have the best care possible . 99% of our residents are in care because they could not function safely at home. Food is a so more than just when they eat. A majority have lost the ability to consume “normal” meals and the new guildlines are even more stringent bec ause of the amount of choking occuring,.

    2. I don’t agree with your comment at all. As a provider for LTC in Switzerland we have very successfully introduced small household style places where even people with very high need of care live together in a “normal” environment. They participate in the daily activities like cooking if they wish to. We found solutions for every of your arguments against normal life and activities. Human beings are not meant to live in hospital-style institutions.

      People with dementia and with physical conditions have the same human rights as we do. And they want to be as useful as possible, they want to have a reason to get up in the morning.

      We have to fight against loneliness, helplessness and boredom in our facilities for old people. We have to reform them into places to live. Because that might be our future…

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