Malnutrition rife in aged care: Study

A lack of consistent national screenings for malnourishment within residential aged care facilities (RACFs) is putting patient lives at risk, according to experts who have spent years uncovering the true extent of the problem.
 
In the largest study of its kind ever carried out in Australia, researchers from Monash and Griffith universities revealed 40% of care residents are malnourished, and 6% of those are severely malnourished.
 
Published in the Healthcare journal on Thursday, the study investigated 10 facilities across New South Wales, South Australia and Queensland, and involved more than 700 residents.
 
The residents had a mean age of 84 years, and 63% were female.
 
Researchers have now issued a stark warning that there are insufficient processes in place to systematically detect the nutritional status of residents, and it is leaving their needs unmet.
 
‘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,’ said lead author Dr Jonathan Foo.
 
‘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 pleas for change come after the 2021 Royal Commission into Aged Care Quality and Safety laid bare the shocking state of some RACFs.
 
It said the sector had ‘failed to meet the nutritional needs of people for whom they care’ and said nutrition improvements were a priority area for immediate attention.  
 
Dr Anthony Marinucci, Chair of RACGP Specific Interests Aged Care, told newsGP he hopes this data will further shine a light on an issue which must be immediately acted upon.
 
‘The solution as always is multifactorial and is not just about throwing more money at the problem,’ he said.
 
‘There are both broad systemic and provider issues, and local and individual patient factors which all need to be addressed.
 
‘This is a complex problem, hence why it is persisting.’
 
According to the study, the Australian Government estimates the cost of malnutrition in RACFs to be around $9 billion every year.
 
While there are several areas in need of urgent improvement, the study recommended regular screening to identify those who need a full malnutrition assessment and intervention.
 
They are now working on implementing automated malnutrition screening.
 
But Dr Foo says early malnutrition identification is just the first step in a long list of changes which also includes improvements in food quantity and quality.
 
‘The sector is already overwhelmed by all the requirements of providing care to ageing Australians, we need to focus on approaches that overcome challenges rather than burdening providers,’ he said.

Dr Marinucci said GPs are crucial when it comes to advocacy for their patient and an individualised approach to treatment and care.
 
‘Malnutrition and unintentional weight loss can contribute to reduced physical and cognitive functional status, increased need of health care services, avoidable hospitalisations and overall increased mortality,’ he said.
 
‘As coordinators of the multidisciplinary care team, GPs play a fundamental role in identifying and screening for malnutrition, engaging and working with all required clinicians (dietitians, speech pathologists, tertiary care services) and implementing appropriate individualised interventions.’
 
The study said the next priority for governments and researchers is to develop an evidence-based intervention pathway which must enable a rapid nutritional response.
 
‘A structured screening or diagnosis program, collated within a national reporting system, is required to hold RACF providers accountable for providing effective care to residents,’ the study concluded.
 
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