When it comes to the management of nutrition and hydration, there are a number of differences between the needs of the residents of aged care facilities and the approach needed for individuals living in the community.
The following are just some of the things that some aged care facilities’ are doing which increases their costs, staff time, and impacts their residents:
- Continuing to place elderly residents on diabetic diets (these haven’t been recommended for several years)
- Using the wrong BMI and comparing results to the general population’s normal ranges (and not recognising their residents are considered underweight e.g. BMI of 22)
- Reviewing menus based on the Australian Guide to Healthy Eating and Australian Dietary Guidelines (which do not apply to the frail elderly)
- Placing residents on supplements without a review plan (the Nutrition Standards indicate that nutrition should be provided by food and supplements are to be avoided where possible)
- Weighing residents without a documented system and unnecessarily reacting to up to a 2kg weight difference
Recently a facility identified that their approach to nutrition was based on guidelines that weren’t related to the older adult. As a result, there was:
- Over a quarter of residents who were actually considered underweight (BMI between 20–22kgm2) who then had new strategies put in place
- A significant reduction in supplement use (which reduced costs and actually increased resident satisfaction)
- A removal of a number of unnecessary ‘special diets’, saving staff time and increasing resident enjoyment
The bottom line?
Dietetics services should be specialists in nutritional management of the elderly who work to reduce unnecessary special diets & supplement use to maintain residents’ quality of life.