At least four in 10 nursing home residents malnourished, says report

At least four in every 10 nursing home residents in Australia continue to be malnourished despite the problem being identified by the aged-care royal commission more than three years ago as an ‘immediate’ reform area.

Four in 10 nursing home residents are malnourished, a new study finds.

At least four in every 10 nursing home residents in Australia continue to be malnourished despite the problem being identified by the aged-care royal commission more than three years ago as an “immediate” reform area.

The most comprehensive survey of nutrition in aged care undertaken in Australia found 40 per cent of residents were malnourished, including 6 per cent who were severely malnourished.

The study, published in the journal Healthcare, said this was likely underplaying the extent of malnutrition, given it did not include nursing home residents with dementia because of issues of consent.

Other studies have shown almost 60 per cent of dementia residents are at risk of malnutrition.

Report lead author Jonathan Foo, an researcher in ageing at Monash University, said the scale of the malnutrition problem in nursing homes was likely being underestimated because it was determined by facility staff identifying “at risk” residents by using their own clinical judgments and body mass index readings.

The new study is evidence this was not working, Dr Foo said, and a reliable malnutrition screening process must be introduced into the aged-care quality and safety standards, or nursing home residents would continue to be put at risk. “Malnutrition is associated with poorer overall health, increased hospitalisation rates, higher rates of falls and fractures, slower wound healing, higher infection risk, and accelerated mortality,” he said.

“Despite such risks, aged-care providers are not suitably resourced to perform routine screening using validated tools, meaning many malnourished residents are likely to be undetected and therefore untreated.”

The aged-care royal commission heard multiple stories about poor food quality in residential aged care, and its final report in March 2021 highlighted mal­nutrition as the first area for ­“immediate attention.”

It cited a 2017 study of 60 Australian care homes that found 68 per cent of residents were either malnourished or at risk of malnutrition.

“Poor nutrition in aged care is related to falls, fractures, pressure injuries and unnecessary hospitalisation,” the report said.

The then Coalition government committed in its 2021 budget to a $10 a day per resident uplift to fund daily living services, with a particular focus on ­nutrition.

Struggling nursing homes were subsequently criticised for putting the money towards propping up their businesses rather than on to the plates of residents.

Dr Foo said the new survey showed malnutrition in nursing homes remained a “major issue despite the policy changes that have been attempted”.

“Putting money into the system is great but there hasn’t been enough guidance on how to spend it,” he said. “It’s a really complex matter, involving not simply more and better food, but making it enjoyable and putting resources into helping people who struggle to eat to consume their meals.”

Aged-care homes continue to struggle with financial viability.

The latest sector data shows 50 per cent are operating at a loss.

A taskforce to examine the ­financial sustainability of aged care was put together last year by Aged Care Minister Anika Wells, who chaired the group.

It recommended that wealth­ier older Australians should contribute more money to the non-direct care components of their aged care, such as accommodation, food and cleaning.

The taskforce’s report was published in March, but the government has yet to provide its ­response, despite intense pressure from provider and consumer ­advocates.