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Would You Eat The Meals Served In Some Aged Care Homes?

26 February 2018

A shocking new study reveals aged care home spent an average of $6.08 per resident to provide residents with three meals a day. Michael Gannon, president of the Australian Medical Association, describes this as a “national disgrace”.

In aged care homes, meals are the highlight of a resident’s day. Some aged care homes provide delicious and nutritious meals. Others serve meals that are inedible.

When compared to international food budgets, Australian aged care homes spend 1.4 times less than Canada and 3.8 times less than Norway. When providers skimp on the cost of meals, they are putting residents at risk of malnutrition.

A recent study described at least half the residents in Australian aged care homes as suffering malnutrition.  Malnutrition increases risk of falls, pressure injuries and hospital admissions. This not only decreases residents’ quality of life but also increases health care costs.

The importance of older people having a nutritious, well balanced diet is widely acknowledged. Yet it is also important that older people have choice. Recently, a GP told a 94-year-old resident not to eat soft cheeses (her favourite) because it may raise her cholesterol. My mum also loved soft cheeses – and I encouraged her to eat as much as she wanted. Mum had reached an age when she could eat whatever she wanted, irrespective of her cholesterol levels. This included our regular trip to McDonalds for a cheeseburger and a chocolate shake.

In some aged care homes, residents are not given a choice. They are often served meat pies, deep-fried patties and chicken nuggets. Sugary desserts are also common. Given the incidence of diabetes, heart disease and cancer in older people, the high level of sugar and salt in the meals served in some aged care homes is negligent.

Some residents might enjoy helping staff in the kitchen. However, residents are rarely allowed to participate in food preparation. Although older women spent most of their adult lives preparing food for their families, providers claim that food preparation puts residents at risk of injury. Even a simple activity like peeling potatoes is often not allowed because residents (many of whom have peeled potatoes all their adult lives) are at risk of cutting themselves.

Meal times can be chaotic and distressing for those residents who can’t feed themselves. Often their hot meals are served cold. When an aged care home is short staffed, residents may be fed their meals too quickly. This puts residents at risk of choking.

Many aged care homes use outside caterers that deliver meals wrapped in plastic. It is difficult for some older people (e.g. those with arthritis in their hands) to access their meals. Without assistance, these meals may be left untouched. Staff are so busy they may not notice the unwrapped food remains on the meal tray.

There is also concern that residents may not be drinking enough. Mum would be given a full cup of tea and then later a member of staff would take away a full cup of tea. Staff were simply too busy to notice that Mum had eaten the biscuit but not drunk any of the tea.

The Lantern Project fed everyday Australians a typical aged care meal. The food was described as “disgusting”. Some questioned whether it was in fact food. The poor quality of food served in some aged care homes inspired the Maggie Beer Foundation to develop ‘Creating An Appetite For Life’ Education Programs. These programs raise awareness, train staff, managers and chefs to buy and serve fresh produce and make food more palatable.

Residents’ wellbeing depends on aged care homes serving nutritious and delicious meals. Replacing processed food with fresh seasonal produce makes economic sense. Many aged care homes have productive vegetable gardens tended to by those residents with green fingers.

It is beholden on aged care providers to make meal times a happy experience for older Australians living in aged care homes. This will improve the health, happiness and quality of life of residents.

 

Would You Eat The Meals Served In Some Aged Care Homes?

26 February 2018

A shocking new study reveals aged care home spent an average of $6.08 per resident to provide residents with three meals a day. Michael Gannon, president of the Australian Medical Association, describes this as a “national disgrace”.

In aged care homes, meals are the highlight of a resident’s day. Some aged care homes provide delicious and nutritious meals. Others serve meals that are inedible.

When compared to international food budgets, Australian aged care homes spend 1.4 times less than Canada and 3.8 times less than Norway. When providers skimp on the cost of meals, they are putting residents at risk of malnutrition.

A recent study described at least half the residents in Australian aged care homes as suffering malnutrition.  Malnutrition increases risk of falls, pressure injuries and hospital admissions. This not only decreases residents’ quality of life but also increases health care costs.

The importance of older people having a nutritious, well balanced diet is widely acknowledged. Yet it is also important that older people have choice. Recently, a GP told a 94-year-old resident not to eat soft cheeses (her favourite) because it may raise her cholesterol. My mum also loved soft cheeses – and I encouraged her to eat as much as she wanted. Mum had reached an age when she could eat whatever she wanted, irrespective of her cholesterol levels. This included our regular trip to McDonalds for a cheeseburger and a chocolate shake.

In some aged care homes, residents are not given a choice. They are often served meat pies, deep-fried patties and chicken nuggets. Sugary desserts are also common. Given the incidence of diabetes, heart disease and cancer in older people, the high level of sugar and salt in the meals served in some aged care homes is negligent.

Some residents might enjoy helping staff in the kitchen. However, residents are rarely allowed to participate in food preparation. Although older women spent most of their adult lives preparing food for their families, providers claim that food preparation puts residents at risk of injury. Even a simple activity like peeling potatoes is often not allowed because residents (many of whom have peeled potatoes all their adult lives) are at risk of cutting themselves.

Meal times can be chaotic and distressing for those residents who can’t feed themselves. Often their hot meals are served cold. When an aged care home is short staffed, residents may be fed their meals too quickly. This puts residents at risk of choking.

Many aged care homes use outside caterers that deliver meals wrapped in plastic. It is difficult for some older people (e.g. those with arthritis in their hands) to access their meals. Without assistance, these meals may be left untouched. Staff are so busy they may not notice the unwrapped food remains on the meal tray.

There is also concern that residents may not be drinking enough. Mum would be given a full cup of tea and then later a member of staff would take away a full cup of tea. Staff were simply too busy to notice that Mum had eaten the biscuit but not drunk any of the tea.

The Lantern Project fed everyday Australians a typical aged care meal. The food was described as “disgusting”. Some questioned whether it was in fact food. The poor quality of food served in some aged care homes inspired the Maggie Beer Foundation to develop ‘Creating An Appetite For Life’ Education Programs. These programs raise awareness, train staff, managers and chefs to buy and serve fresh produce and make food more palatable.

Residents’ wellbeing depends on aged care homes serving nutritious and delicious meals. Replacing processed food with fresh seasonal produce makes economic sense. Many aged care homes have productive vegetable gardens tended to by those residents with green fingers.

It is beholden on aged care providers to make meal times a happy experience for older Australians living in aged care homes. This will improve the health, happiness and quality of life of residents.

So Many Inquiries, So Little Action

9 February 2018

How many inquiries, reviews, taskforces, think tanks, consultations and consultant reports does it take for the government to change a light bulb in an aged care home? Over the past year or so, the government has investigated, among other things, the aged care workforce, reforms, accreditation, complaints scheme, innovation, standards of care and elder abuse – and still the light globe remains unchanged.

The numerous reports commissioned by the government generate recommendations that never see the light of day. Unless, of course, the recommendation is to: “Commission further research”. A consultant’s report invariably recommends more consultancies. These reports have become an industry within the aged care industry.

The Future of Australia’s aged care sector workforce Inquiry made several recommendations that would have made a significant difference to the lives of older people who live in an aged care home.

Recommendation 8, for example, suggested the government examine the introduction of a minimum nursing requirement for aged care homes. Recommendation 10 suggested the government require aged care service providers to publish and update their staff to resident ratios “in order to facilitate informed decision making by aged care consumers”.

Rather than accept these recommendations, the government established an ‘industry led’ Aged Care Workforce Strategy Taskforce. The Taskforce was given a budget of $2 million. How many registered nurses could have been enrolled in a Master of Gerontology course for that price?

The taskforce kicked off last December with a daylong Summit at the Melbourne Exhibition Centre.  The Summit was an opportunity for participants, particularly many who were new to the aged care ‘industry’, to learn from people with expertise in the aged care workforce. Instead, I hardly even heard the word “workforce” used all day.

The Summit began with a session by Simon Hammond from Hammond Thinking. Simon is a cultural anthropologist and global brand strategist. He began by telling us that aged care is all about the “vision” and “journey”. Perhaps Simon came up with the slogan for the Summit: “Think. Collaborate. Innovate”.

Simon began his session by showing us a video about Free Hugs. This video did not shift my thinking (if that was indeed its purpose). Instead, it left me feeling particularly discombobulated.

Simon then asked us to discuss our “fears, frustrations and desires”. This session could easily have been named “The day in the life of an aged care advocate”. I have spent many hours listening to residents and relatives talk about their fears, frustrations and desires – particularly whilst undertaking my research “Living well in an aged care home”.

Simon will also be running some daylong workshops “searching for a common belief into why the aged care sector matters”. These workshops “will create an opportunity for people from all parts of the sector to unite around insights, truths and beliefs pertaining to ageing and the aged care industry”.

I was initially informed that HammondThinking received $69,300 for “Strategic Planning Consultation Services”. Gobsmacking. More recently, I noticed his costs increased to $79,695.17, though no explanation is given for this increase on AusTender website.

In the afternoon, I attended 2 “Breakout” sessions. The first ‘Enhancing safety and quality’ demonstrated a dissonance between the participants who wanted to discuss ‘standards of care’ and ‘quality of life’ and the facilitator who was focused on ‘safety and quality’ in industries such as manufacturing and aviation.

The facilitator’s interest on more traditional ‘industries was not surprising given he is a forensic economist (employee of APIS). APIS received $210,633.00 for their contribution to the Workforce Taskforce (a significant amount of money that would employ many PCAs for a year in an aged care home).

My attempts to find out what APIS will contribute to the Workforce Taskforce were unsuccessful. After my 2nd email, I received the following reply: “I acknowledge receipt of your email.  Please note the queries you have raised need to be addressed to the Department of Health.” So I still have no idea (1) what a forensic economist actually does and (2) what insights APIS will bring to the aged care workforce strategy taskforce.

I was however interested in a participant’s comment during the Breakout session. He said: “We don’t expect the engine to fall out of an aeroplane. Instead, we focus on leg room and inflight entertainment and service.” The translation of this comment into the aged care ‘industry’ is: “We don’t expect pressure injuries, malnutrition, dehydration, falls, medication errors or financial gouging.

It would be wonderful if relatives had only to focus on activities, environment and services in an aged care home. Unfortunately the ongoing heart-breaking stories about neglect and negligence in aged care homes suggest the aged care ‘industry’ has a long way to go before it can be compared to the aviation industry.

The second “Breakout” session I attended was: ‘Translating research and technology into models of care and practice”. This session was even more frustrating than the first session. There is an abundance of research about optimal workforce (both numbers and skill set), models of care etc. We don’t need to re-invent the wheel.

Several researchers, including those at the Australian Association of Gerontology, encouraged the Chair of the taskforce to undertake a robust analysis of the national and international evidence on the aged care workforce. This evidence would have enabled the Workforce Taskforce to better evaluate the merits of key stakeholders’ opinions. Instead, the department opted for further consultation and engagement.

The lunch at the summit was delicious, and the ‘Think. Collaborate. Innovate’ corflute signs were attractive. However, paying $217,125 for Event Planet to provide event management services for the Aged Care Workforce Strategy Taskforce seems excessive. The costs for Event Planet increased by $67,474.90 to a total of $284,599.90. The reasons stated for this increase are: “extreme urgency or events unforeseen.”

It is unusual for me to be facetious, but I left the summit wondering whether I should give Working Dog a call for Series 4 of ABC TV series Utopia.

The next summit will be held on 17 April. I am sure the lunch will be delicious.