New Act preserves dietitians, says peak

Dietitians Australia is celebrating the new Aged Care Act’s strengthened quality standards, which aim to improve the nutrition standards of older Australians.  

Dietitians Australia vice president Dr Fiona Willer said the legislation would lay the foundation for stronger collaboration between dietitians, aged care providers and residents to deliver wholesome meals and create meaningful mealtime experiences that enhance the wellbeing of residents.

“This has been many decades in the making. We are relieved that nutrition is finally getting the recognition it deserves within aged care, and we’re incredibly optimistic about what this means for the health and wellbeing of older Australians,” Dr Willer told Australian Ageing Agenda.

“This marks a turning point for us in aged care nutrition history, with dietitians poised to play a more significant role in aged care in Australia than ever before. Ultimately this change is leading us closer to ensuring older Australians have access to the nutritious food and care they deserve.”

The new Act will enable the quality standard number for food and nutrition (Standard 6) to come into effect from 1 July 2025, and require residential aged care providers to have their menus designed in partnership with older Australians, assisted by chefs, cooks and accredited practising dietitians.

The future now means a legislated guarantee that all residential aged care providers will be working with a dietitian at least once a year to review their menu and mealtime experience, Dr Willer said.

“Until these recent reforms, there has been no guarantee that food being served in residential aged care was consistently nutritious and meeting the unique needs of older Australians,” she said.

“We know this will be a long journey, and there will be challenges as providers adapt to the new standards, including optimising their food service to meet the food and nutrition standard. Better nutrition in aged care is a health investment that ultimately reduces the risk of malnutrition, dehydration, falls, pressure injuries, wounds, and hospitalisations for Australians in care. “

Dietitians Australia Aged Care Interest Group co-convenor and accredited practising dietitian Dr Karly Bartrim told AAA that providers should be using the support of dietitians to deliver high quality meals and dining experience.

“Providing meals for a large number of residents, all with unique preferences and nutritional, cultural, physical needs is a complex task,” Dr Bartrim said.

“Involving the experts in food and nutrition to get the food service and dining experience right will assist in reducing malnutrition risk and fundamentally better support residents to live and age well.”

Dr Bartrim added that beyond the dietitian role providers can work with kitchen or catering staff and dietitians can also be supported with timely referrals to review residents.

“We know that the ageing process, changes in health status, life-stage changes and environmental factors in aged care can all impact the residents ability to remain nourished, therefore timely nutrition interventions by the dietitian can prevent unplanned weight loss, reduce malnutrition risk and other poor nutrition complications such as reducing falls, infections and pressure injuries,” she said.

• Dr Willer encourages providers and staff who have questions relating to food and nutrition when preparing for the changes to come into effect, to:
• ring the Food and Nutrition Dining Hotline on 1800 844 044
• familiarise themselves with the resources available on the Aged Care Quality and Safety Commission’s website
• seek advice and support via a local accredited practising dietitian.

Expert advice reduces the risk of malnutrition

According to Dr Bartrim, when older adults are recieving adequate nutrition, their risk of experiencing malnutrition and other related complications is significantly reduced.

“Older adults have unique nutrition needs. Just like we all age differently, we too all have different nutrition needs,” Dr Bartrim told AAA.

“To add to the complexity, different health conditions or medications, mobility or memory changes, lifestyle and environmental factors can all change as we age and interfere with our ability to eat well and to meet nutrition requirements.”

She added: “Ageing bodies process protein less efficiently and need more of it to maintain muscle mass and strength. There is also a need for a higher calcium intake per day to maintain bone mass. Smaller appetites are common among older adults, so every mouthful counts. Six smaller meals across the day work better than three large meals when appetites are small.”

It is unclear how many older adults had malnutrition, said Dr Bartrim, because screening and assessments are not routine practice in aged care. Research over the past 15 years has found it varied from 29 per cent to 68 per cent of residents.

“It is important to know that some of these studies only represent specific residential aged care sites or exclude some groups, such as those living in dementia care units,” she said.

“This is why we are advocating for malnutrition screening as a quality indicator in care and not just unplanned weight loss as this can be varied by many factors beyond nutrition.”

Among the complaints higlighted during the aged care royal commission, the quality of food was one of the most significant with a lack of adequate nutrition and hydration also of major concern.

Dr Willer agreed is limited understanding on the rates of malnutrition in Australian aged care, as there is currently no requirement for routine malnutrition screening in care.

“This is something Dietitians Australia continues to advocate for, screening for malnutrition using a validated screening tool is something that all care staff can be trained in,” she said.

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