Posted in Meal presentation

I can't eat all of that!

Posted by Nutrition Professionals Australia on 12 March 2020
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We often hear older people exclaim: 'I can't eat all of that'!  The meal size may look quite small to us when our appetites are healthy.  Unfortunately, as we age, activity and appetites can dwindle.  We must keep this in mind when we are providing meals- we need to offer a range of serve sizes.  This can be very challenging.

Many aged care homes document that residents require a small, medium or large serve.  In practice what does this mean?  Do we use different sized serving utensils for each size?  Over the years, NPA have seen very few homes that have standard serves sizes documented with the respective serving utensils.  It is often left to each staff member to determine the size of the meal.

If the serves are bigger than the resident's appetite, we run the risk of them not eating anything at all and the resident becoming even more malnourished.  If a resident requests small or extra small serves, this should be respected but the mid meals and nourishing fluids become even more important as a source of nutrients.

If a resident requests a small, medium or large serve we need to provide the right quantity consistently across the menu!

Communication is the Key!

Posted by Julie Dundon AdvAPD on 27 February 2020
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Residents in an aged care setting must receive the correct meal at the correct time, every day.  

If a resident has a special dietary need, the details are recorded in the resident's care plan and communicated carefully to the kitchen staff to ensure all the dietary limitations are actioned.  More importantly the resident is not unnecessarily restricted and as many choices are provided as possible. We can use a range of communication methods to ensure that this occurs. 

The system for communication between nursing staff and kitchen staff should be effective, simple and safe.  A Dietitian and Speech Pathologist often contribute to this food and nutrition care plan and will also communicate directly with the kitchen staff.  The resident's dietary details list will need to be maintained.  So, when there is a change for a resident, that change is immediately communicated with the kitchen and any lists used are immediately updated.

It must be very clear whose responsibility it is to update all lists to ensure they are accurate and reflect the residents' current dietary needs. These lists must also be referred to whenever providing food or fluids to any residents.

What system of communication do you use? Are you relying on paperwork or do you use a clinical software system? Are you using a dedicated food service software system? Reports from client software packages can ensure that all information is up to date at all times and they can generate usable lists that can be referred to in the kitchen.  A key factor is to keep the system that you use simple. Minimise the number of lists- the more lists there are, the more likely it is that they will not match.

When NPA conduct audits of nutrition care it is very common to find anomalies when comparing the care plans with lists in the kitchen.  Regular audits should be undertaken by the care home to ensure integrity of the information and to provide reassurance that the right meal is provided to the right person.

Nothing Standard About Standard Recipes

Posted by Julie Dundon AdvAPD on 23 January 2020
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Do you use standard recipes in your aged care home? There are many good reasons to use a standard recipe when cooking for older people. The 2 most important are:

  • to keep the residents safe and
  • to meet the expectations of the residents.

We all know that some Chefs or cooks can cook an amazing meal that no-one else can seem to replicate.  It is important that the recipe is documented so that others can get as close to their finished product as possible.  This should result in a high standard of quality across the whole menu.

Also, using a standard recipe will ensure that all the ingredients are available when needed, there will be enough food to feed all the residents and allergens can be managed.  This way all residents can enjoy the same meal with some modifications.

Make sure that the standard recipes are always available to all the cooking staff.  A clean folder in the office around the corner that no-one looks at, just might indicate that the recipes are not followed.  An easy to follow recipe which is available in the production area and that indicates the number of serves is a very useful tool.

People in residential aged care spend a lot of their time thinking about food.  If they expect a meal to look and taste the same way that they had previously, we need to ensure that we can do this every time.  A standard recipe should be able to deliver this!

About the Author Nutrition Professionals Australia is a team of Accredited Practising Dietitians who consult to aged care homes across Australia.  They have more than 40 years of combined experience in a range of roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.

Delicious Snacks for All!

Posted by Julie Dundon AdvAPD on 9 January 2020
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A goal in residential aged care is for residents to enjoy a range of meals throughout the day which includes delicious main meals, mid-meals and drinks.  As our appetite reduces, so the need to provide nutritious snacks becomes even more important.  The mid meal should be appealing and provide the nutrients that are likely to have been missed by having a smaller serve at the main meal. 

Options include:

  • a range of home baked cakes,
  • sweet or savoury baked items like scones and pikelets,
  • savoury plates with cheese and crackers and
  • items based on fruit and dairy foods, such as yoghurt, ice-cream or custard

When a resident commences a modified texture diet (soft, minced and moist or pureed) it is very common to find that mid meals are no longer offered! This can result in weight loss and malnutrition. Sometimes the only options offered are monotonous- the same fruit and custard or yoghurt every day with no variety.  This soon becomes very unappealing and the resident's appetite can fall even further.

We know malnutrition is high amongst those needing modified diets, so the mid meals are even more important to their overall quality of life.   It is important to continually look at interesting ways to present the main meals with molds, piping, layering, but it is also important to give the humble mid-meals the consideration that our residents deserve.

About the Author Nutrition Professionals Australia is a team of Accredited Practising Dietitians who consult to aged care homes across Australia.  They have more than 40 years of combined experience in a range of roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian.

Food First!

Posted by Julie Dundon AdvAPD on 14 November 2019
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We often hear, 'Food is only nutrition if its eaten!'.  Never a truer word has been spoken. Nutritious quality food is essential to maintain the quality of life for older people who are either living in the community or in an aged care home. 

Experienced aged care Dietitians are committed to finding food solutions, a 'Food First approach' to meet older peoples' nutrition needs. Commercial nutrition supplements can play a role in aged care but will never take the place of quality food.

If you find that there is a high use of commercial supplements in a home it may mean that the menu needs to be reviewed by an aged care Dietitian to identify how the menu and food provided can meet the nutrition requirements of residents. But remember, it must be eaten for it to be nutritious!

About the Author: Nutrition Professionals Australia is a team of Accredited Practising Dietitians who consult to aged care homes across Australia. They have more than 40 years of combined experience in a range of roles, as Advanced Accredited Practising Dietitians, Food Services Coordinator, Residential Site Manager, Author of Nutrition Manuals and Consultant Dietitian. 

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