What would you prefer to eat when you sit down to dinner tonight? A nutritiously balanced, delicious, and aromatic meal or a supplement?
It is common to give elderly patients supplements in place of meals; however, this practice is causing unintentional weight loss and is not solving the real problem. Do not give your patients a supplement in place of a meal.
An increasing national problem
According to national averages, the supplement budget in aged care facilities is increasing (up 50 cents per resident per day over the past year), while the food budgets are continually decreasing. This trend is causing many problems for the elderly when it comes to nutrition. In Australia, more than half of the aged care residents are malnourished, and have been for over two decades, a shocking statistic that hasn’t sparked enough attention. Research indicates that a low food budget places a significant economic burden on the health care system and increases the odds of malnutrition in people over the age of 66.
As a society, we need to rethink how we can improve malnutrition. Lantern commode research reveals that a food-first approach may offer cost savings and effectively treat malnutrition—prioritising food as a foundation of care before considering supplements is key. This focus has been diminished by budget restraints, often resulting in under-qualified staff, under-satisfied dining rooms, and fewer fresh foods on the menu.
Why no supplements?
Supplements can’t replace the important role food plays in our everyday lives. Food is the catalyst for conversation, it serves as memory triggers, and most importantly, it provides adequate nourishment and impacts quality of life. Supplements have become the default option provided when the aged care meal services are not enjoyed.
Poor meal presentation, lack of flavourful meals, culturally inappropriate food, unfamiliar food, and inadequate mealtime may be the reasons a resident does not eat enough. Oftentimes, doctors remedy these “symptoms” by taking a malnutrition approach; however, malnutrition can be prevented with interventions that directly fortify existing resident meals with energy and protein.
Emerging research reveals that environmental intervention that improves the delivery method of foods and ambience, enhances meals options and promotes overall diet liberalisation, which significantly improves dietary intake.
A Dutch randomised controlled trial found a statistically and clinically significant improvement in global nutrition status by just serving meals. Lantern Nourish Study has shown that food strategies along with staff nutritional training improved dietary intake and quality of life, as well as significant savings on supplement costs. Restaurant-style seating and involving residents in the preparation of meals are other successful strategies to enhance meal ambience.
To help establish that every dollar spent on meals and dining experience, researchers have explored the cost benefits of various nutritional interventions. Malnutrition-related health issues such as pressure injuries, hospital readmission, and falls occur less often.
How can you help?
Start visiting physicians to advocate a food-first approach in aged care for our aged care residents nationwide. Some physicians treat problems without addressing the underlying food supply cause by only prescribing supplements. Food is essential, and a low food budget has an impact on malnutrition risk. We need doctors to help change the unacceptable low food budgets in aged care and the accepted diet culture. An increase in spending on food budgets is associated with more nutritious dietary patterns in developed countries.