Food services emphasise choice – The Ageing Agenda

Dining, nutrition and mealtimes in residential aged care are evolving. Standard 6 of the strengthened Aged Care Quality Standards makes it clear that providers must ensure residents receive nutritionally adequate food as well as choice and dignity at mealtimes.

But it can be difficult to ensure each resident’s needs and wants are met during mealtimes, particularly at larger homes.

At national provider Bolton Clarke, group hospitality services manager Caroline Lucas says they start by recognising that food is central to identity, wellbeing, choice and connection.

Residents across all homes are supported to enjoy meals that meet their nutritional needs, personal preferences, cultural background, religious requirements and lifelong food traditions, she says. But the process is not built on assumptions about people’s preferences.

“Our menus are developed with resident input, chef and dietitian review, and regular local feedback, so each home can adapt meals to the needs and cultural preferences of its community,” Lucas tells The Ageing Agenda.

Bolton Clarke conducts a national survey of residents and their families to gather feedback on the current menu and better understand what they would like to see on future menus – with the latest survey receiving approximately 3,000 responses.

Feedback is also sought from chefs, including collated feedback from monthly food focus sessions held at each home.

“Once all feedback has been collected, we establish a working group of chefs from different states and across our classic, premium and signature homes. Using the resident and chef feedback, the group develops a draft menu that reflects resident preferences,” says Lucas.

“The draft menu is then reviewed by our dietitian and speech pathologist to ensure it meets all dietary requirements and provides appropriate nutrition for residents.”

This provides a base level for local chefs, who then adapt it to each home to ensure the specific local needs and cultural preferences are met. As the monthly food focus sessions continue, Bolton Clarke works with residents and families to gather further feedback and make any necessary adjustments.

“As we support a diverse resident population across locations ranging from Pioneers Longreach to Brighton Melbourne, this means menus differ based on local expectations. For example, a home with a large Italian resident population may include more pasta dishes while still aligning with the menu review process and nutritional requirements,” Lucas says.

Beyond the kitchen

Residents can also get involved in the food preparation process through the Best in Grow paddock-to-plate gardening competition. Residents are encouraged to grow edible gardens so the produce can be used in meals at the home. There are currently 30 homes involved in the program, says Lucas.

“This helped build connection and wellbeing through gardening but also extended that into the dining experience,” she says.

Social connection key

After research from Queensland University of Technology showed how loneliness and social isolation can lead to adverse health outcomes including cardiovascular disease, dementia, depression and premature mortality, Lutheran Services in Queensland wanted to do more to ensure its dining service supported resident wellbeing and nutrition.

Lutheran Services believed a more connected and personalised dining experience could help reduce malnutrition and social isolation, so it developed the Happy Table initiative.

Lutheran Services general manager of aged care Stephanie Wilson says the Happy Table initiative combines food science, expert dietitian input and resident feedback to deliver tailored menus to improve mealtime nutrition, enjoyment and dignity. It also has a strong focus on the social experience and aims to offer an opportunity to foster connection, comfort and a sense of belonging, she says.

“In our dining rooms, we create environments that encourage interaction, with background music to create a relaxed atmosphere and background noise down low so residents can connect and converse. This has a direct impact on residents’ health, mood and overall quality of life,” Wilson says.

“We regularly host focus groups and surveys, and their input directly influences our menus, ensuring meals are familiar, enjoyable and something to look forward to.”

Food safety is changing

With the introduction of Standard 6 putting residents firmly at the centre, self-described “food science and technology business” The Pure Food Co is working to provide a solution to malnourishment and dysphagia with safe, texture-modified food.

Director Chris Deed says dining and nutrition in aged care has changed significantly over the years.

“You’ll see that there’s lots more choice and not just at those main meal occasions. Now you’re seeing it in terms of snacking, 24-hour dining, room service menus, all sorts of things have been put into place,” Deed tells TAA.

“That’s not just driven by the standards. I would also say that many of the providers front-footed this long before the standards came in, because they were obviously very centric around the resident.”

These changes include improving the amount, variety, consistency and safety of food offerings. Moreover, with the new standards, it’s also about being evidence-based, he says.

“It’s no longer just about good feelings and things like that. You really do need to demonstrate that you’ve got something in place that is going to meet those needs of all your residents.”

The Pure Food Co prides itself on providing safer food options that are still aesthetically pleasing and resemble a familiar meal – particularly when texture-modified.

“That’s the first thing that people are going to see when they’re sitting down at the dining table. They’re also going to see the colour of the food,” Deed says. “Then they’re going to experience the aromas of the food. Then you’ve got to get the right taste into the food as well, because that’s what people are coming back for. 

“At the same time, when we’re working with texture-modified foods, they’re quite complex and there is a lot of safety that goes into that as well, because if you get the textures wrong, then you can have pretty poor outcomes for the resident. We want to make it look good. We want to make it smell good. We want to make it safe to swallow. And we want to make it nutritious, because that’s the piece that’s very important, so that people are getting better outcomes.”

Click here to read how home care providers are approaching choice in food options.