New research into nutrition and health has revealed the disheartening truth in aged care with four in ten aged care residents malnourished. A minority of residents, 6% in total, were characterised as severely malnourished.
Monash and Griffith Universities are behind the research, which is Australia’s largest-scale aged care nutritional study. They looked at the health of over 700 residents in New South Wales, South Australia and Queensland to determine just how common malnutrition is.
According to the lead author of the study, Dr Jonathan Foo, from Monash University’s Department of Physiotherapy, good nutrition plays a crucial role in healthy ageing.
“Malnutrition is associated with poorer overall health, increased hospitalisation rates, higher rates of falls and fractures, slower wound healing, higher infection risk, and accelerated mortality,” he said.
“Despite such risks, aged care providers are not suitably resourced to perform routine screening using validated tools meaning many malnourished residents are likely to be undetected and therefore untreated.”
In total, 34% of residents were categorised as mildly/moderately malnourished and 6% as severely malnourished.
The research found that women are more likely to be malnourished or at risk of malnourishment, while hospitalisations and diet modification are also common factors.
Residents with dementia were not included in the research, however. With a recent estimate that 57.4% of residents with dementia are at risk of malnutrition and 27% have a confirmed malnutrition diagnosis, the final figures from Monash and Griffith Universities could actually be an underestimation.
Dr Marie-Claire O’Shea from Griffith University’s School of Health Sciences and Social Work said older Australians deserve better nutritional care and the time is now with malnutrition a national problem.
“The rates of malnutrition can vary from home to home with some statistics reporting up to 78 per cent, however, our study, which was significant in number, reported a rate of around 40 per cent,” Dr O’Shea said.
“Early malnutrition identification is just the first step, as improvements in food quantity and food quality are also required.
“We are working with aged care providers and residents to enhance the dining experience, and we believe this is the key missing piece of the malnutrition puzzle.”
The Australian Government currently estimates the cost of malnutrition in residential aged care facilities at approximately $9 billion a year. The Royal Commission into Aged Care Quality and Safety also stated that the residential aged care sector had “failed to meet the nutritional needs of people for whom they care”.
As a result, the Government increased reporting requirements for providers to ensure they are maintaining high standards for food, nutrition and the dining experience. A dedicated Food and Nutrition Quality Standard will be introduced in 2025, adding another layer of compliance.
Education and training opportunities are also available for staff, while a Food, Nutrition and Dining Hotline was established for anyone with questions, concerns or complaints about the food, nutrition and dining experience in aged care. Almost $13 million was allocated to improving nutrition in aged care via the 2023-24 Budget, including $7 million for the hotline’s creation.
According to the Department of Health and Aged Care, almost 600 calls have been made to the hotline since July 2023.
Despite these initiatives, Dr Foo warns that Government-mandated reporting on weight loss fails to detect the majority of malnourished residents.
“Our study confirms that malnutrition continues to be an ongoing challenge in aged care, suggesting that current models for identifying and managing malnutrition aren’t working.”
He also said many providers don’t have the resources to screen for malnutrition, meaning many are likely to be undetected and untreated. He said screening is an essential intervention, and aged care staff need to be better supported.
“Our research group is working on implementing automated malnutrition screening and food-first malnutrition support pathways with our forward-thinking aged care partners,” Dr Foo said.
“The sector is already overwhelmed by all the requirements of providing care to ageing Australians. We need to focus on approaches that overcome challenges rather than burdening providers.”
And do we know the stats for the general population of the same ages and comorbidities who are not in care??
Possibly not, as those in care are the most frail and complex so obviously at risk of deterioration from their conditions and we expect will have a shorter life expectancy.
People decline in aged care, because they were already declining before they moved into the facility.
Already being in decline when they enter an Aged Care Facility, doesn’t change the fact that too many are malnourished.
Malnourished isn’t just a label, as a lived experience, it’s unecessary suffering.
Of the people “in decline’ & living in aged care …
“In total, 34% of residents were categorised as mildly/moderately malnourished and 6% as severely malnourished.”
(From the study of 700 people living in an Aged Care Facility, which didn’t include people diagnosed with dementia)
Some residents are malnourished because of their health issues and /or dementia. There is always a decline in the elderly. We all can’t live forever! The first sign of decline is a resident not eating or drinking. OK, it could be a UTI or some other reason. Depression, loneliness or health issue. Some of these can be rectified with food drinks Ensure and others. I do believe you need RNs on the floor at all meal times to monitor how.much is being eaten as you cannot trust the mostly new staff to do it as efficiently. Get them out from behind their desks and on the floor! Maybe hiring permanent dieticians and properly trained diet aids as well. NOT AINS PLEASE!
What about in home care recipients
I’m surprised Griffith Uni didn’t report on understaffing. There aren’t enoigh stsff do 1 to 1 meal assist. The residents are probably dehydrated too.
“We are working with aged care providers and residents to enhance the dining experience, and we believe this is the key missing piece of the malnutrition puzzle.”
Dr O’Shea. Griffith Uni.
Nobody takes notice of how much food (AND drink) is left on the table.
If a care or catering staff do notice, it’s not reported to the team leader / clinical care mng.
Our residents food has got worse by the day, don’t know what the heck is going on but it’s impacting the staff, we have run out of excuses for residents. We haven’t got answers as to wgmhats going on. I bring in Tuna & tomatoes as well as Nutrigrain for residents who haven’t got what they ordered.. this has vecome ridiculous now and I’m to scared to report this to Aged Care Commission for fear of reprisal, I just want to remain anonymous on my comments PLEASE…