Is the Royal Commission in Aged Care Highlighting Nutrition?

In a simple answer - yes.

It’s highlighting all the negative views on food quality and nutrition through consumer feedback, as it should.

It’s all very well for us as a profession to have a ‘strategic plan’ to create change in the industry, but what about the older people in our care right now? They don’t all have a year to wait until the Royal Commission has finished and recommendations have been made.

For this reason alone, we need to make a difference at ground level by calling out the organisations or management that continue to talk with no action. We as dietitians need to be the change agents right now, without the results of the Royal Commission - we’ve heard and seen the feedback, we know the change that needs to occur.

I have been liaising with an organisation over the past week about menu development, with the request for me to put together a menu that would cover several facilities. As soon as I responded with ‘yes, I can put together a menu as a template, however it must be tailored to each facility by the chef/ catering manager and then a full menu review done for each facility’, you know what I heard? Crickets….

A ‘menu review’ (now called a ‘Menu and Mealtime Quality Assessment’) is not just about the piece of paper the menu is written on. It’s about the implementation of the menu at each individual facility - the ingredients in the recipes, the standardised recipes including minimum protein amounts, the portion sizes, presentation of meals, taste and flavour of the food, variety of meals (including texture modified diet and fluids) the mealtime environment, staff knowledge of meals and meal service, staff knowledge of the residents and their nutrition needs - it’s about the entire process of menu development through to the experience of each consumer when eating their meal.

We don’t need the Royal Commission findings to be able to do this right now! Hiring dietitians to be a part of this change is an investment; it’s not a cost for an hourly rate per resident review. It is an investment for the improvement of food and nutrition in aged care, both in the community with home care packages and in aged care facilities.

This involves a two-pronged approach - up-skilling dietitians to be confident and effective in facilitating change in aged care nutrition, as well as educating and supporting organisations/ aged care facility management to invest in this change. We need to be supporting chefs and cooks to learn how to prepare nutritious and tasty meals for our older people. We need to be teaching staff what their specific roles are in food service when they are a personal carer - meal services are not a task like showering or dressing someone that need to be ticked off the list.

When loneliness and food quality are identified as the two factors of poorest performance in aged care, we know exactly where we need to start. When we improve meal services and create a mealtime experience that the older person feels valued and looks forward to each day, then we address both of these issues to a large extent.

So when a dietitian says they want to do a menu and mealtime review/audit, don’t look at the cost. Look at the investment in your organisation and the positive pay off for your residents. They should be seeing the improvement now and not having to wait 12 months for the Royal Commission process to finish.