Action needed to stop malnutrition being COVID-19's lasting legacy

As aged care homes across the country continue lockdown precautions in a bid to keep COVID-19 at bay, the sad reality is that another crisis – malnutrition – is building for many older Australians.


“Aged care workers are doing their very best in this unprecedented situation but it’s devastating to hear reports of people not being fed, or meals being left at the doors of residents who need assistance to eat or drink safety,” said Ngaire Hobbins, member of Dietitians Australia and Accredited Practising Dietitian working in aged care.


“The isolation necessary under lockdown diminishes already small appetites and this adds to the chances of even the best meals being left uneaten. But, without adequate nutrition, residents become more vulnerable to illness, infection, injury and falls. Good food needs to be eaten to provide valuable health benefits,” she said.


Next week, the Royal Commission into Aged Care Quality and Safety will meet to discuss the response to coronavirus and what can be learnt to manage future pandemics/ emergencies.


Dietitians Australia calls for an increased focus on nutrition care during these times. This includes having a dietitian engaged at all aged care homes and swiftly implementing innovative health care measures. Dietitians are essential in the continuation of care and in maintaining quality of life for residents and should continue to visit under appropriate infection control procedures. Where that is not possible, the use of telehealth is ideal.


“COVID-19 has impacted everyone’s day to day lives, but especially aged care residents. Older Australians need more support to help gain the nourishment they need, especially those who require assistance at mealtimes or have a reduced appetite, swallowing or chewing difficulties,” Ngaire said.


“Dietitians champion all aspects of nutrition, including menu planning and overseeing the food service systems and processes, through to environmental and individual changes to meet residents’ health needs and to optimise intake. Food is the most fundamental form of ‘medicine’ to support older Australians and all workers in aged care have a part to play, to encourage that extra mouthful and ensure that extra sip is taken.”


Unplanned weight loss, which is an indicator of malnutrition risk, is reported quarterly in government funded aged care homes, as a part of the National Aged Care Quality Indicator Program. Since the program was made mandatory in July 2019, the number of residents experiencing unplanned weight loss has continued to rise.


Over the first quarter of 2020, an additional 1730 residents experienced a significant loss of 3kgs or more over three months.


The disruption and turmoil of COVID-19 is only likely to exacerbated these figures, further highlighting the need for nutrition to be everyone’s priority.


“Weight loss due to malnutrition is not a new issue, but it’s going to be one that is hard to shake if we are not proactive about it,” said Ngaire.


Gathering for meals is a key way to unite communities, and provide a sense of comfort, particularly during these unsettling times. Innovative solutions which foster a sense of community are required to both protect residents’ health and nurture social wellbeing.


“Eating with others tends to encourage greater consumption of food, so facilitating this safely, as soon as restrictions allow is essential. I have seen old style cafeteria set ups with well-spaced tables and heard of places snaking dining-room tables down the corridor near residents’ rooms to help to create some novelty and connection whilst keeping a safe distance at meal times. These strategies can make a real difference,” said Ngaire.


These issues form part of Dietitians Australia’s call for the development of a National Nutrition Care Policy for aged care, to help prevent nutrition related decline and improve quality of life for all older Australians residing both in the community and in residential care.


7 August 2020.