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Malnutrition in residential Aged Care

Sadly, malnutrition is too common. Malnutrition is a serious health condition that impacts the lives of many people. Unfortunately, the prevalence of malnutrition stands at an unacceptable proportion of the population. Up to 40% of hospital patients and up to 50% of residential aged care residents in Australia are potentially at risk of malnutrition or malnourished. These high rates of malnutrition need to be reduced.

What is Malnutrition?

Malnutrition can occur if nutrition requirements are not met over time. How does one become malnourished? Not eating the right types of food, not eating enough food or if nutrient absorption is impacted. Malnutrition is defined as two or more of the following characteristics: insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, localized or generalised fluid accumulation or diminished functional status.

Symptoms of Malnutrition

  • Loss of appetite

  • Weight loss

  • Muscle wasting

  • Hair loss

  • Pale skin

  • Fatigue or mental confusion

  • Poor wound healing

Anybody at any size can be at risk of malnutrition or malnourished

Somebody does not need to be ‘small’, ‘tiny’, ‘skinny’, ‘bony’ and you certainly do not need to see significant weight loss for someone to be classified as malnourished.

A small or larger body may be at risk of malnutrition or malnourished for many reasons. Any weight loss at a later age can significantly impact lean body mass and therefore immune capacity, wound healing ability and more.

The risk of malnutrition becomes more acute for people as we age

As we age, it is common for our physiology and lifestyles to change, in return this will have an impact on our appetite and our ability to source, prepare and eat food. Our nutrition requirements and demands for certain nutrients also change as we age, and this is related to the natural decline in lean body mass and basal metabolic rate as we get older. Increased risk also comes from dental problems, psychological distress and/or dementia, certain medications, social isolation, and financial, shopping or cooking difficulties. Remember, weight loss is not a normal part of ageing!

Who is at greater risk of malnutrition?

Those with:

  • Poor appetite

  • Gastrointestinal symptoms

  • Nausea

  • Constipation

  • Illnesses that increase nutritional needs

  • Kidney failure

  • Cancer

  • Illnesses that lead to malabsorption

  • Crohn’s disease

  • Eating disorders

  • Impaired swallowing

  • Oral dysphagia

  • Impaired mobility

  • Parkinson’s disease

  • Dementia

  • Increased nutritional requirements

Did you know that as we get older, our protein requirements increase, along with other nutrients like calcium and vitamin D? Older people who do not meet their increased nutrient requirements may be at risk of malnutrition.

Malnutrition can lead to:

  • Increased risk of falls

  • Infections

  • Pressure injuries

  • Skin ulcers

  • Dental problems

  • Muscle wasting

  • Impaired wound healing

  • Decline in mental health

  • Increased hospital admissions

  • Longer recovery from illness

  • Less able to carry out day-to-day activities

  • Reduced quality of life

  • Possible confusion

  • Higher chance of illness

  • Greater mortality

  • Costs increase across the aged care sector and the broader healthcare system

Malnutrition in residential aged care australia

What can you do within your organisation to minimise the risk of malnutrition?

OSCAR Care Group hopes to increase the awareness of malnutrition across Australia so that we can work better together and make a difference by identifying those who may be at risk of malnutrition and improve health outcomes. Here are some important steps to follow.

Malnutrition Screening within Aged Care

Malnutrition Screening

Using a malnutrition screening tool is so important – it allows for malnutrition risk to be identified and to allow for a preventive management plan. There are many screening tools available, including the MST and the Mini Nutritional Assessment (MNA). Each made up of a set of questions that have been proven to identify malnutrition risk. Once risk is identified, a referral to a Dietitian may be made.

Refer to a Dietitian for support

If it is identified someone may be at risk of malnutrition or malnourished, refer to a Dietitian for support, in a timely manner. A Dietitian will conduct a thorough nutrition status assessment and will provide personalised recommendations to minimise the risk. Dietitians can offer practical dietary advice to assist with nutritional requirements and improving overall health.

Make every mouthful count

Sometimes it can be difficult for someone to eat beyond their appetite. So fortifying foods can be a practical way to increase the energy and protein content, without increasing the overall volume of food.

Our Dietitians’ food first approach is used to:

  • Minimise the risk of and reduce the rate of malnutrition.

  • Increase the energy and protein content of meals and snacks.

  • Increase meal satisfaction, enjoyment of meals and quality of life.

A food first approach is the best step in improving the taste of food and beverages as well as quality of life. Food variety is important and eating well includes important vitamins, minerals, fibre, protein and antioxidants.

Food fortification is making the most of every mouthful. Each mouthful may have more energy and protein, but the overall volume of food to be eaten is not increasing. You can add the above ingredients to all meals and snacks where possible for extra energy and protein. This is highly recommended to minimise weight loss and risk of malnutrition.

The more who know, the better the outcome for our residents.

Answer this, have your staff recently been trained on:

  • Malnutrition Screening?

  • Received Malnutrition Training (all staff)?

  • Food fortification and HEHP training (kitchen staff and chefs)?

  • And are your texture modified meals adequately fortified?

Let us help you! We believe knowledge is key.

Our qualified Dietitians are highly knowledgeable within the Aged Care sector and provide expert advice to combat malnutrition all around Australia. Besides having our Dietitians available to provide individualized support to your aged care residents, we have a range of educational sessions to empower staff from all facets within an aged care home.

As we know, malnutrition can result in many negative health consequences. Educate your staff to help identify and minimize the risk of malnutrition. This includes older people themselves, carers, nurses, kitchen staff and chefs, lifestyle staff, medical, allied health professionals, food service managers, aged care staff and management.

Food Fortification and HEHP Training

A 2-hour session will educate your staff on the importance of the HEHP Diet in Aged Care with practical tips to put in place. This can be delivered via teams to ensure we can help aged care homes all around Australia. This Face-to-face or virtual Food Fortification & HEHP Education includes:

  • Aged Care Nutrition Requirements

  • When to apply this diet

  • The food first approach

  • Food Fortification and Practical Steps

  • Real food and snack comparison examples

  • Case Studies

  • Recipes

Our residents deserve better!

Together we can all do our part to reduce the rate of malnutrition and make every mouthful count.

6 Tips to implement into your Residential Aged Care today

  1. Refer to a Dietitian. Don’t delay, send through your referrals to dietitian@oscarcaregroup.com.au

  2. Offer food regularly and include energy and protein with each meal and snack.

  3. Offer HEHP snacks, such as peanut butter on toast, hummus or cheese and crackers.

  4. Milk-based drinks are fantastic in between meals.

  5. Avoid sugar-free and low-fat items.

  6. Add cheese and butter to mashed potato – so much more delicious too! View Recipe

For further information on training, group sessions or our Dietitians please call our office on (03) 9560 1844.

HEHP Diet for Malnutrition - Cheesy Mashed Potato Recipe for Aged Care


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