A shocking new study reveals aged care home spent an average of $6.08 per resident to provide residents with three meals a day. Michael Gannon, president of the Australian Medical Association, describes this as a “national disgrace”.
In aged care homes, meals are the highlight of a resident’s day. Some aged care homes provide delicious and nutritious meals. Others serve meals that are inedible.
When compared to international food budgets, Australian aged care homes spend 1.4 times less than Canada and 3.8 times less than Norway. When providers skimp on the cost of meals, they are putting residents at risk of malnutrition.
A recent study described at least half the residents in Australian aged care homes as suffering malnutrition. Malnutrition increases risk of falls, pressure injuries and hospital admissions. This not only decreases residents’ quality of life but also increases health care costs.
The importance of older people having a nutritious, well balanced diet is widely acknowledged. Yet it is also important that older people have choice. Recently, a GP told a 94-year-old resident not to eat soft cheeses (her favourite) because it may raise her cholesterol. My mum also loved soft cheeses – and I encouraged her to eat as much as she wanted. Mum had reached an age when she could eat whatever she wanted, irrespective of her cholesterol levels. This included our regular trip to McDonalds for a cheeseburger and a chocolate shake.
In some aged care homes, residents are not given a choice. They are often served meat pies, deep-fried patties and chicken nuggets. Sugary desserts are also common. Given the incidence of diabetes, heart disease and cancer in older people, the high level of sugar and salt in the meals served in some aged care homes is negligent.
Some residents might enjoy helping staff in the kitchen. However, residents are rarely allowed to participate in food preparation. Although older women spent most of their adult lives preparing food for their families, providers claim that food preparation puts residents at risk of injury. Even a simple activity like peeling potatoes is often not allowed because residents (many of whom have peeled potatoes all their adult lives) are at risk of cutting themselves.
Meal times can be chaotic and distressing for those residents who can’t feed themselves. Often their hot meals are served cold. When an aged care home is short staffed, residents may be fed their meals too quickly. This puts residents at risk of choking.
Many aged care homes use outside caterers that deliver meals wrapped in plastic. It is difficult for some older people (e.g. those with arthritis in their hands) to access their meals. Without assistance, these meals may be left untouched. Staff are so busy they may not notice the unwrapped food remains on the meal tray.
There is also concern that residents may not be drinking enough. Mum would be given a full cup of tea and then later a member of staff would take away a full cup of tea. Staff were simply too busy to notice that Mum had eaten the biscuit but not drunk any of the tea.
The Lantern Project fed everyday Australians a typical aged care meal. The food was described as “disgusting”. Some questioned whether it was in fact food. The poor quality of food served in some aged care homes inspired the Maggie Beer Foundation to develop ‘Creating An Appetite For Life’ Education Programs. These programs raise awareness, train staff, managers and chefs to buy and serve fresh produce and make food more palatable.
Residents’ wellbeing depends on aged care homes serving nutritious and delicious meals. Replacing processed food with fresh seasonal produce makes economic sense. Many aged care homes have productive vegetable gardens tended to by those residents with green fingers.
It is beholden on aged care providers to make meal times a happy experience for older Australians living in aged care homes. This will improve the health, happiness and quality of life of residents.
What do you have to say? Comment, share and like below.
Dietitians in aged care work hard to ensure residents get the best quality food which nurtures body and soul. Unfortunately the system currently too often is reactive – we are called in when a resident has lost weight. That’s already indicative of a degree of malnutrition and usually, a 2kg or so weight loss for a frail, older person, is often too late to reverse.
Not only that, but aged care funding does not help us actively prevent or treat malnutrition – aged care homes get extra funding for residents only in the basis of how much physical assistance they need to eat, nothing to do with whether they are well nourished, or the food is good quality. We struggle to make a difference.
It’s great that high profile chefs like Maggie Beer speak out about this, bringing it to public attention, but dietitians in aged care can achieve so much more than chefs alone can. We can look at individual needs as well as menus. Sometimes cream cakes and deep fried salty treats are just what’s needed, sometimes it’s salad or fresh fruit. It’s always about giving every resident the dignity and respect of offering food they enjoy and that supports their physical and cognitive health.
Please always support Dietitians in aged care. We struggle to get providers to bring us in pro-actively when we can do most good and can really make a difference.
Ngaire Hobbins
As a Chef in Aged Care for the past 13 years I agree with most of the comments above and have designed menus and cooked meals that have been very well received by the dieticians, residents, management and hungry staff as well. In a perfect world this would all be fine but there are residents who have likes and dislikes and special dietary requirements (excluding the modified diet requirements).
The Aged Care kitchen is a bulk production kitchen. There is little enough time for a Chef on her own, with no assistant, to prepare, cook and plate up the lunch and dinner meals, the hot baked dessert for lunch, the baked cakes or biscuits for both morning & afternoon tea, the fruit platters and fresh fruit salads, the evening soup, the evening dessert and the fortified drinks for all the residents etc. They also cater for the vegetarian diet , the gluten free diet and on occasion the fructose diet.
Any special requests are catered for willingly but with a bit of dread as it usually means more unpaid overtime on top of the usual 1 1/2 hrs overtime done most days.
This special request is then given to the resident who looks at it and says they don’t want it because they’d like what their friend at the table is having. Unfortunately the Carer responsible for this resident is busy assisting 7 other residents with their meals. There is no-one available who could coax and encourage the resident to try the meal and so the inevitable outcome is that the resident does not get her special meal but rather is given a glass of sustagen. Not ideal but in the real world it is better than nothing.
The main overriding problem in Aged Care whether it be in the kitchen or on the floor or in the rooms, is that the Aged Care industry (yes it is unfortunately a money making industry) is grossly, ridiculously, embarrassingly UNDERSTAFFED. Good intentions are pointless if there is no-one to implement them.
The emphasis these days in the newer facilities seems to be on promoting the facility to the families of the prospective residents by presenting this picture of many chandeliers and modern furniture (not a single crocheted blanket in sight) and promising their family member will be able to eat whenever and what ever they like and then expecting the very limited number of staff to deliver this ideal.
Any one who works in Aged Care does so because, simply put, they care. But I’ve seen too many wonderfully caring people who are burnt out and/or injured and generally saddened by what Aged care has become and long for the old days when we got to know the residents and had time to chat to them and knew what they liked to eat instead of them just being a room no. Bigger is definitely not better.
Increasing the food budget leading to better food quality and the pro-active use of dieticians and any other suggestions of improvement, will be a complete waste of time if there are insufficient people to implement these improvements.
Absolutely one of the better comments I have read, couldn’t put it better myself, profits before care, so hard to attract new staff and keep them long enough to be of any use, we are going through the policy now of not replacing absent staff and if they could get away with it on night shift I’m sure they would have a crack but at the moment in our dementia unit of 38 residents we have 2 staff on night shift, what is it going to take to change the uncaring attitude of politicians, shareholders greedy CEO’s, after so many years of working where I am am giving it away at the end of the year, and will walk away disillusioned with the whole aged care industry ,being such a cash cow for shareholders.
incredibly well written!!