The challenge of optimising nutrition for aged care residents with dementia

Approximately 50% of residents in aged care are malnourished and dementia compounds this problem. This malnourishment problem has long been recognised, yet the translation of knowledge into the provision of person-centred, evidence-based nutrition care has not occurred. We present an ethnographic case study, conducted by an inter-disciplinary team, which examined care practices regarding food and fluids in one aged care home. We conducted a facility document audit, detailed observations of 7 residents with dementia, and interviews with 7 family- and 11 staff-members. We identified a range of barriers preventing evidence-based, person-centred nutrition care. For example, body mass index of residents was not monitored and prompts to encourage eating and drinking were often ineffective. Staff did not appear to have a ‘big picture’ view of the relationship between nutrition and hydration and key clinical health indicators; they viewed eating and drinking as tasks to be completed rather than social activities to be enjoyed. However, staff were aware of the key food and fluid issues experienced by residents and some beneficial care practices, such as small group dining.

Why the presentation/topic will be of interest to conference participants: The study identifies barriers to person-centred care and highlights the importance of ongoing education to facilitate nutritional health and quality of life for people living with dementia in the aged care setting. Education and a focus on translation of research into practice will facilitate implementation of best practice nutrition care. Findings suggest that aged care home staff need to be supported to build on their existing knowledge around effective food and fluid care practices. The numerous ideas staff expressed for changing care practices can be leveraged by facilitating staff networking, to work and learn together to implement evidence-based change. This is relevant to clinical and organisational leaders and other members of the Tasmanian aged care workforce who are striving to overcome the healthcare challenges presented by an ageing population with a high prevalence of dementia and at a high risk for being malnourished.