An Evaluation of Malnutrition Status and Food Consumption of At-risk Aged Care Residents on Texture-Modified Diets

Abstract

Aim: To evaluate the malnutrition status and food consumption of at-risk aged care residents on texture-modified diets (TMDs). The study examines the screening practices in aged care facilities, food consumption patterns and nutritional intake of aged care residents on TMDs. The relationship between oral nutritional supplements (ONS) and TMDs are also explored. The outcomes will help inform health professionals and aged care staff to improve nutritional practice and support better health outcomes for at-risk older adults on TMDs. Methods: This observational, mixed methods study captures quantitative and qualitative data. Three aged care sites were included as part of a larger project study. The MNA®-SF was utilised to collect malnutrition status data, and hand grip strength measurements were assessed as an additional indicator. A combination of visual estimation and individual weights were utilised to quantitatively evaluate a typical one day’s worth of dietary intake for residents on TMDs, as part of the plate waste audit. Ethnographic field notes including conversations with staff and residents were included as part of the qualitative data to provide a more in-depth evaluation of dietary intake and food service practices. Results: Of 65 residents included in the study (mean age 83 years, 66% female), 33.8% were malnourished and 53.8% were at risk. Screening upon admission was consistent at two of the facilities, while all facilities showed inconsistent screening reviews. Most residents (77%) were unable to be assessed for grip strength. The total prevalence of TMDs was 24%. Almost half took an ONS and more than half required full feeding assistance. Dietary intake was highest for residents on minced and moist meals. The use of ONS showed a significant increase with intake, with an average total energy and protein benefit of 2036 kJ and 25g, respectively. The content analysis identified five main topics: 1) dining with dignity, 2) provision of ONS, 3) understaffing of feeding assistance, 4) dining environment, and 5) individual factors (health status and food preferences). Conclusion: This study advocates for aged care residents on TMDs. It provides valuable insights of the nutritional and food service practices in aged care. It also highlights areas for quality improvements within this field of research.