New food unit and dietitians to overhaul dining in aged care

Aged care is set for a 'dining revolution' as a new food unit and a team of dietitians are poised to launch by the end of June.

Backed by a $12.9m allocation from the federal budget, the move aims to enhance the quality of food and nutrition in residential aged care.

The food unit will conduct up to 720 yearly checks and focus on 'at-risk homes' to ensure residents receive nutritious meals.

They will also triage a 'food hotline' for complaints and advice, and deliver support for providers through education programs.

Additionally, a team of independent dietitians will conduct over 500 meal and menu assessments in aged care facilities each year.

Dietitians Australia's Advocacy and Policy General Manager Natalie Stapleton called the move 'a genuine commitment' to meeting the nutritional needs of older people in aged care.

"It's exciting," Ms Stapleton said.

"We're hopeful that this will transform food and nutrition in aged care."

Ms Stapleton welcomed the revised aged care quality standards draft earlier this year and will require a dietitian to review food quality and menus.

According to Standard 6, providers should ensure that older people enjoy 'appetising, flavoursome and nutritious foods and drinks' with plenty of variation and choice. 

It recommended that menus and meals be developed together with chefs, cooks and an accredited practising dietitian, particularly for people with special dietary needs.

Although research shows that dietitians can lift nutrition standards in aged care, there's currently no requirement for them to be involved in the sector, Ms Stapleton said.

"It's been one of the biggest challenges for us," she said.

"But we really need to see more dietitians engaged across the sector."

Dietitians will check the nutritional needs of residents and consider their unique needs and special dietary requirements.

The menu assessment focuses on the food itself and creating a positive dining experience, as it is essential for encouraging residents to enjoy their meals.

"Nutrition plays a vital role in the overall wellbeing of older Australians," Ms Stapleton said.

"The goal is to overcome the complex challenges associated with transforming nutrition in aged care by empowering the sector to offer nutritious and enjoyable food experiences."

She said that while some homes excelled in delivering a diverse range of nourishing meals and actively involved dietitians, others were falling short.

In February 2021, the Royal Commission estimated that 68 per cent of Australia's aged care residents were either malnourished or at risk of malnutrition.

Malnutrition can lead to various risks, such as falls, pressure injuries, wounds, hospitalisation, and even mortality.

Testimonies presented during the Commission's investigation revealed subpar food quality in many facilities, with improperly cooked meals that lacked variety and fresh ingredients.

In December 2022, the Aged Care Quality and Safety Commission enlisted the Older Persons Advocacy Network (OPAN) to deliver an update on the food quality in aged care.

Fifty-six per cent of residents interviewed said they would like more variety and control over their meals, citing issues with meal timing, portion sizes, and temperature.

Nearly half reported they were content with the choices available, and the group was also more likely to be happy with the temperature and portion sizes.

Many residents said they liked a dining experience resembling a homely setting or restaurant ambience.

When asked what residents believed was working well, most pointed to the meals themselves and the opportunity to dine together in a communal setting.

Of those unhappy with the dining experience, most did not enjoy the dining environment due to various factors, such as the noise of other residents.

Other complaints were about 'feeling rushed by staff members', which they attributed to staffing shortages and the need to adhere to strict schedules.

OPAN chief Graig Gear said that food was still consistently among the top five complaints raised in residential aged care.

"Education and support from accredited dietitians will go a long way to improving the food, dining and nutrition experience in aged care," Mr Gear said.

"It's not about fancy food, older people told us, so much as choice and control – over what to eat, when and with whom.

"And that's something we all want in our life."

Mr Gear said that mealtimes meet not only biological and psychosocial needs but also influence the overall quality of life.

Meeting individual tastes and traditions promotes wellness and a sense of identity; likewise, familiar meals can increase food intake.

Aged care expert and associate professor at Charles Sturt University Maree Bernoth emphasised that factors such as texture, smell and colour all play a role in creating 'good food experiences for older people.'

"Factors such as food quality, variety, presentation, and personal preferences play a significant role," associate professor Bernoth said.

"They also present important opportunities to dine together to interact and socialise."

Various aged care providers have developed innovative ways to improve their residents' dining experience and food quality. 

For-purpose aged care home VMCH followed Maggie Beer modules last year to train their staff on improving food quality and service during mealtimes.

They upgraded the quality and delivery of meals to enhance the residents' overall dining experience, including exciting textures, colours, aromas and fresh herbs from the garden.

And last March, researchers from Edith Cowan University organised workshops to teach older people what to eat to improve muscle, bone and vascular health.

Associate professor Bernoth acknowledged that monitoring progress in delivering the right nutrition in aged care was difficult.

"Providing nutrition to older people is incredibly complex and problematic," associate professor Bernoth said.

"Once you've got issues with nutrition, there are problems with the person's whole health, including cognitive functioning."

Associate professor Bernoth pointed out that the considerable variation for each individual posed challenges and placed significant pressure on aged care workers.

"Determining the right nutrition for each person and ensuring they eat the food is difficult, especially when they require assistance with eating due to understaffing," she said.

"It already starts with creating suitable menus for everyone – how are you going to cater to everyone's tastes, eating preferences and nutritional needs?"

The health and aged care department told Aged Care Insite detailed information would be released near the end of June.

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