Home' Australian Ageing Agenda : AAA Jan-Feb 2014 Contents knowledge about what is appropriate for aged care versus for the
average restaurant or café."
To highlight this issue, Woods has called for an investigation into
the funding levels spent on food service provision in residential
aged care and the reliance on pre-packaged convenience foods.
"One of the things that really stood out for me during my
research was a huge reliance on pre-packaged convenience foods
because there is a lack of time for the catering staff to actually
cook, and there is a very limited catering budget.
"Food items like frankfurts, party pies and sausage rolls were
on the menu as a meal, not just as the occasional treat but they
were there as meals, and that I'm sure was because they were
cheap and they were easy to prepare."
Despite its low priority in aged care budgets, Woods says poor
nutrition has significant health and economic consequences, greatly
increasing the risk of adverse health outcomes and mortality, and
contributing to higher costs for aged facilities and governments.
To improve the quality of menus, Woods says the industry's
accreditation standards in relation to food and nutrition should
She says the standards should be more prescriptive,
incorporate outcomes-based indicators and be supported by
practical guidance for aged care staff to help translate the
standards into practice.
"In Australia, a relatively high prevalence of under-nutrition
in aged care has been reported over the past 30 years and
even after the introduction of care standards in Australia, this
prevalence has not changed.
"High workloads leave little time for trialling new approaches
and build resistance to change and high turnover of staff
adversely effects continuity," she says.
Woods' own research of 20 low care facilities in Victoria
(where residents are thought to be at relatively low risk)
identified that 64 per cent of residents had two or more
indicators of under-nutrition and that food service was a
predictor of nutritional status.
The food supply in general was inadequate, and not only was
nutrient intake poor, but vitamin D deficiency was common.
"Accreditation standards are meant to ensure quality of care
but in this study, they failed to sufficiently ensure a high standard
of nutrition," she says.
Woods endorses the Belgian model of assigning responsibility
for food and nutrition to a qualified
dietitian or nutritionist, and says it is
critical to raise the profile of food service
in aged care so there is widespread
appreciation of the integral role it has
in clinical care and the quality of life of
She also flags the need to develop
standards relating to minimum qualifications
and ongoing training for all catering staff.
Jane Kellett, a lecturer in nutrition and
dietetics at the University of Canberra,
says malnutrition is under-recognised
and undertreated in aged care facilities
and has called for the introduction of
mandatory malnutrition screening of aged
She says a national screening program
would be a cost effective intervention
to identify nutritional problems in
The Dietitians Association of
Australia (DAA) has also backed the
initiative, which could be carried out by
nursing and carer staff using a validated
screening tool upon admission and then
at monthly intervals.
Kellett's recent study of 100 residents
found that 22 per cent were severely
or moderately malnourished. However,
the sample excluded residents with a
The ACT-based study also showed
that as people age, their risk of
On the back of the University of
Canberra study, a small number of facilities
have initiated routine malnutrition
screening programs but Kellett says
to achieve industry-wide change, the
screening should be embedded in the aged
care accreditation standards.
Kellett has met with the ACT
Ministerial Advisory Council on Ageing to
have this issue raised at a federal level.
A COMPLEX PICTURE
Dr Maree Bernoth, lecturer in nursing at
Charles Sturt University, who has recently
"High workloads leave little time for
trialling new approaches and build
resistance to change and high turnover
of staff adversely effects continuity."
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