Modern Australian

Why is nursing home food so bad? Some spend just $6.08 per person a day – that's lower than prison

  • Written by Cherie Hugo, Teaching Fellow, Nutrition & Dietetics, Bond University

The Royal Commission into Aged Care Quality and Safety this week turned its attention to food and nutrition. The testimony of maggots in bins and rotting food in refrigerators was horrific.

When so much of a resident’s waking hours is spent either at a meal, or thinking of a meal, the meal can either make or break an elderly person’s day.

So why are some aged care providers still offering residents meals they can’t stomach?

It comes down to three key factors: cost-cutting, aged care funding structures that don’t reward good food and mealtime experiences, and residents not being given a voice. And it has a devastating impact on nutrition.

Read more: Nearly 2 out of 3 nursing homes are understaffed. These 10 charts explain why aged care is in crisis

How much are we spending on residents’ food?

Our research from 2017 found the average food spend in Australian aged care homes was A$6.08 per resident per day. This is the raw food cost for meals and drinks over breakfast, morning tea, lunch, afternoon tea, dinner and supper.

This A$6.08 is almost one-third of the average for older coupled adults living in the community (A$17.25), and less than the average in Australian prisons (A$8.25 per prisoner per day).

Over the time of the study, food spend reduced by A$0.31 per resident per day.

Meanwhile the expenditure on commercial nutrition supplements increased by A$0.50 per resident per day.

Commercial nutrition supplements may be in the form of a powder or liquid to offer additional nutrients. But they can never replace the value of a good meal and mealtime experience.

Read more: What is 'quality' in aged care? Here's what studies (and our readers) say

Cutting food budgets, poor staff training and insufficient staff time preparing food on-site inevitably impacts the quality of food provided.

At the royal commission, chefs spoke about using more frozen and processed meals, choosing poorer quality of meats and serving leftover meals in response to budget cuts.

Malnutrition is common, but we can address it

One in two aged care residents are malnourished and this figure has remained largely the same for the last 20 years.

Malnutrition has many causes – many of which are preventable or can be ameliorated. These include:

  • dental issues or ill-fitting dentures
  • dementia (because of difficulty swallowing and sensory sensitivities)
  • a poorly designed dining environment (such as poor acoustics, uncomfortable furniture, inappropriate crockery and table settings)
  • having too few staff members to help residents eat and drink and/or poor staff training
  • not supplying modified cutlery and crockery for those who need extra help
  • not offering residents food they want to eat or offering inadequate food choices.
Why is nursing home food so bad? Some spend just $6.08 per person a day – that's lower than prison Residents often need help at mealtimes. Futurewalk/Shutterstock

My soon-to-be-published research shows disatisfaction with the food service significantly influences how much and what residents eat, and therefore contributes to the risk of malnutrition.

Malnutrition impacts all aspects of care and quality of life. It directly contributes to muscle wasting, reduced strength, heart and lung problems, pressure ulcers, delayed wound healing, increased falls risk and poor response to medications, to name a few.

Food supplements, funding and quality control

Reduced food budgets increase the risk of malnutrition but it’s not the only aged care funding issue related to mealtimes.

Aged care providers are increasingly giving oral nutrition supplements to residents with unplanned weight loss. This is a substandard solution that neglects fundamental aspects of malnutrition and quality of life. For instance, if a resident has lost weight as a result of ill-fitting dentures, offering a supplement will not identify and address the initial cause. And it ends up costing more than improving the quality of food and the residents’ mealtime experience.

Our other soon-to-be-published research shows the benefits of replacing supplements with staff training and offering high-quality food in the right mealtime environment. This approach significantly reduced malnutrition (44% over three months), saved money and improved the overall quality of life of residents.

Read more: So you're thinking of going into a nursing home? Here's what you'll have to pay for

However, aged care funding does not reward quality in food, nutrition and mealtime experience. If a provider does well in these areas, they don’t attract more government funding.

It’s not surprising that organisations under financial pressure naturally focus on aspects that attract funding and often in turn, reduce investment in food.

A research team commissioned by the health department has been investigating how best to change aged care funding. So hopefully we’ll see changes in the future.

Why is nursing home food so bad? Some spend just $6.08 per person a day – that's lower than prison It’s not just about the food. Residents’ mealtime experiences affect their quality of life. Ranta Images/Shutterstock

Aged care residents are unlikely to voice their opinions – they either won’t or can’t speak out. Unhappy residents often fear retribution about complaining – often choosing to accept current care despite feeling unhappy with it.

Read more: How our residential aged-care system doesn't care about older people's emotional needs

We lived in an aged care home. This is what we learned

New Aged Care Quality Standards came into effect on July 1 (I was involved in developing the guidelines to help aged care providers meet these standards).

However, they provide limited guidance for organisations to interpret and make meaningful change when it comes to food, nutrition and mealtime experience. Aged care providers will need extra support to make this happen.

We’ve developed an evidence-based solution, designed with the aged care industry, to address key areas currently holding aged care back. The solution offers tools and identified key areas essential for a happier and more nourishing mealtime.

At the end of 2018, our team lived as residents in an aged care home on and off for three months. As a result of this, and earlier work, we developed three key solutions as part of the Lantern Project:

  • a food, nutrition and mealtime experience guide for industry with a feedback mechanism for facilities to improve their performance

  • free monthly meetings for aged care providers and staff to discuss areas affecting food provision

  • an app that gives staff, residents and providers the chance to share their food experiences. This can be everything from residents rating a meal to staff talking about the dining room or menu. For residents, in particular, this allows them to freely share their experience.

We have built, refined and researched these aspects over the past seven years and are ready to roll them out nationally to help all homes improve aged care food, nutrition and mealtime experience.

Authors: Cherie Hugo, Teaching Fellow, Nutrition & Dietetics, Bond University

Read more http://theconversation.com/why-is-nursing-home-food-so-bad-some-spend-just-6-08-per-person-a-day-thats-lower-than-prison-120421

NEWS

how Australian politicians would bridge the trust divide

Unsurprisingly, Australian politicians are happier than their constituents with the way our democracy works.ShutterstockWe hear a lot from citizens about the failings of Australian democracy and the need for reform...

Don't calm down! Exam stress may not be fun but it can help you get better marks

If you let it work for you, stress can be your secret weapon.from shutterstock.comTwo-thirds of young people experience levels of exam stress that mental health organisation ReachOut describes as “worrying”...

Facebook's online workers are sick of being treated like bots

Mark Zuckerberg and other tech CEOs may have to take notice of their workers' complaints.Aaron Schwarz / ShutterstockReports of Facebook moderators’ appalling working conditions have been making headlines worldwide. Workers...

We can’t drought-proof Australia, and trying is a fool's errand

The push to 'drought-proof' Australia is dangerous nonsense.AAP Image/Mick TsikasThere is a phrase in the novel East of Eden that springs to mind every time politicians speak of “drought-proofing” Australia:And...

Our land abounds in nature strips – surely we can do more than mow a third of urban green space

Even the standard grassed nature strip has value for local wildlife.Michelle/Flickr, CC BY-NC-NDYou may mock the national anthem by singing “Our land abounds in nature strips” but what you might...

These 3 factors predict a child's chance of obesity in adolescence (and no, it's not just their weight)

The mother's education level is also a factor.Brainsil/ShutterstockThree simple factors can predict whether a child is likely to be overweight or obese by the time they reach adolescence: the child’s...

China has form as a sports bully, but its full-court press on the NBA may backfire

It’s unlikely Daryl Morey, general manager of the Houston Rockets basketball team, realised he’d be sparking an international diplomatic incident when, on October 4, he tweeted the following Stand with...

Alan Jones v Scott Morrison on the question of how you feed a cow

The battle between Jones and Morrison came down to the repeated, and, for the seething Jones, existential question, 'How does that feed a cow?'ShutterstockThe last PM shock jock Alan Jones...

In contrast to Australia's success with hepatitis C, our response to hepatitis B is lagging

While hepatitis B can't be cured in the same way hepatitis C can, effective treatment is available.From shutterstock.comAround one-third of Australians living with hepatitis C have been cured in the...

Australia is facing a looming cyber emergency, and we don't have the high-tech workforce to counter it

Nick Warner, the new director general of the Office of National Intelligence, has sounded the alarm about Australia's lack of preparedness to counter cyber-threats.Alan Porritt/AAPThis is part of a new...

Comprehensive gun register part of next stage of firearms law reform post Christchurch shootings

New Zealand's PM Jacinda Ardern, police minister Stuart Nash (right) and the minister for Christchurch regeneration Megan Woods announcing stronger gun laws and the creation of a firearms registry.AAP/David Alexander...

Double counting of emissions cuts may undermine Paris climate deal

Ice floe adrift in Vincennes Bay in the Australian Antarctic Territory. There are fears efforts to combat global warming will be undermined by double counting of carbon credits.AAP/Torsten BlackwoodIn the...

Popular articles from Modern Australian

Best Out of Waste in New South WalesGlamorous Gifts - 5 Luxe Giving Options When Only the Best Will DoFood for collagenIs Rhinoplasty Right for You?Winter fun in ColoradoSlots SecretsEssential Personal Hygiene Tips for TravelingTop 3 Affordable Activities To Do In Los AngelesTop 4 Reasons Why a Gas Fireplace Is an Ideal SolutionAdvantages of Using an Insulin PumpMaths – when it’s time to break free of your misbeliefsStrictly For Women:5 Steps To Top 5 Designer Sunglasses That Celebrities Are WearingBest Paradise Islands You Should Visit in AustraliaMost Popular Mexican Destinations for Australian Visitors