Malnutrition: the silent killer in aged care

By Robert Hunt – Chief Executive Officer, Dietitians Australia
Monday, 28 March, 2022

Malnutrition: the silent killer in aged care

It’s been one year since the Royal Commission into Aged Care Quality and Safety handed down its report identifying ‘food and nutrition’ as an area for immediate attention in the ailing industry. With research showing that up to 50% of older Australians in residential aged care are malnourished, it was hoped that subsequent action by the Australian Government would finally arrest this silent killer. But it hasn’t.

On 2 March, the Aged Care Mandatory Quality Indicator Program reported 12,512 people with significant unplanned weight loss in the quarter to September 2021. Unplanned weight loss is just one of many indicators that could be attributed to malnutrition, which is a known cause for increased risk of falls, pressure injuries, hospital admissions, symptoms of COVID-19 and adverse outcomes on mortality. This in turn increases costs in the aged-care sector and broader healthcare system to the tune of $10.7 million in Victoria alone.

To put that into plain text, we’re spending money for people to be sick rather than saving money for people to be healthy. Where’s the sense in that?

Despite the government’s $10 supplement to the Basic Daily Fee, which was introduced in July 2021, dietitians from around Australia continue to report grossly inadequate meals being served to residents in aged care. Adding insult to injury, we’re deeply concerned how recent pandemic-related events and inflation driving up food prices could be worsening the quality of food being served in facilities.

We firmly believe that the supplement is being used to prop up administrative costs, and not improve the quality of meals for people in aged care, and this needs to stop.

The inherent issue with the Australian Government’s approach to their Quality Indicator program is they’re counting people who are falling off the cliff, rather than catching them before reaching the edge.

Dietitians Australia has already indicated to the federal government that to elevate the health and wellbeing of people in aged care, malnutrition must be included in the Quality Indicator Program for both residential and in-home aged care. The framework for screening of malnutrition risk would include initial and ongoing training of all care staff and support workers using a validated malnutrition screening tool. This would enable anyone the capability to identify, and immediately respond to, all people who are at risk of malnutrition, or who are malnourished.

And, as a condition of receiving the Basic Daily Fee supplement, every residential aged-care home should undergo an annual on-site menu and mealtime quality assessment performed by an Accredited Practising Dietitian.

In our federal Budget 2022–23 submission, Dietitians Australia estimates that additional funds needed to implement these basic amendments to be inconsequential to the public purse, with immeasurable savings from reduced oral nutrition supplements, wound care and hospital admissions.

Most importantly, the ultimate saving is the quality of life for residents in aged care.

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