Getting nutrition right for older adults in care

Dietitians involved in research can make a difference in many lives by working towards better nutrition outcomes at scale. Professor Judi Porter aims to improve nutrition and sustainability for older adults in hospitals and aged care settings.

Elderly sick woman sitting on a bed eating patient food provided by a hospital

Professor Judi Porter knows that meeting the nutrition needs of older adults in care can help turn lives around.

But she is concerned that food intake in both hospital and aged care settings is ‘sub optimal’.

Her recent research confirmed that there are serious failings in food provision for this vulnerable group, finding that of 420 aged care residents, only 9.8% completed a main meal (lunch or dinner).

“Malnutrition is the most prevalent condition needing nutrition care, so the menu is usually focused on delivering the high energy, high protein meals needed by this patient group. However, not eating all of the meal leads to further weight decline and poor health outcomes,” she said. 

A Professor in Dietetics with IPAN and Fellow of Dietitians Australia, Professor Porter loves working with older adults.

“They have wonderful stories to share, of diverse lives and families.  But they also often have diet-related diseases and other co-morbidities, and make up the majority of admissions to hospitals and, of course, aged care,” she said.

She says there are numerous conditions that require specialist nutrition care, but with up to 2000 meals being produced each day out of our hospital kitchens, the menu should meet the nutrition needs of most patients.

“One-on-one nutrition care provided by dietitians is important, however the food service, and particularly the menu, underpins the care for all people in hospitals and aged care. It’s critical to get this right,” she said.

Professor Porter says the food service system also needs to do more to balance meeting nutritional needs with sustainability.

“Hospitals and aged care facilities can, and should, be leaders in considering sustainability right across the food supply chain,” she says.

“We know there is a lot of food waste which ends in landfill and contributes to global greenhouse gas emissions. System changes are needed to address these problems.”

While more funds would obviously help address systemic issues, Professor Porter believes nutrition needs to be a priority for everyone in an organisation, not just the dietitians and food service staff. 

“Education and expertise are lacking.  There is little investment in the education of food service staff, putting real change out of reach. When equipped with knowledge and ownership, staff can implement changes from the ground up – for example, our international research has shown that there are exemplar hospitals with staff owning sustainability change,” she said.

Professor Porter says there glaring gaps in evidence in ageing and food service research, with the last national nutrition policy published 30 years ago in 1992.

“The nutritional priorities of Australians have changed and the population is ageing. We need a new policy and for it to be implemented,” she said.

She has also called for an evaluation of the changes that have been implemented since the Royal Commission into Aged Care. 

“The additional $10 per resident per day Basic Daily Fee supplement that arose from the Royal Commission for a greater overall spend on food has not been evaluated.  We don’t know if these funds are making a difference to nutrition care, or adding to landfill,” she said.