Good nutritional care is an essential component in ensuring the wellbeing of care home residents.
According to the latest statistics, there are 426,000 elderly and disabled people in residential care in the UK, approximately 405,000 of whom are aged 65 and over. These residents often suffer from a range of illnesses and disabilities, and catering for their dietary needs can be extremely challenging.
We take a look at the issues facing care home caterers – and provide some helpful solutions.
Residential care – The Stats
The number of people aged 85 and over in the UK is expected to rise from 9.3million in 2000, to 16.8million in 2051, during the next five decades that’s an increase of 81%
93% of nursing home residents and 99% of people in residential homes are aged 65+
In the UK there are an estimated 5,153 nursing homes & 12,525 residential homes
Government statistics estimate that overall places in residential and care homes will have to increase from around 450,000 currently to approximately 1,130,000 in 2051, to cope with the demands of the growing ageing UK population – a rise of 39%
Battling Malnutrition
Malnutrition is caused by having an inadequate diet or a problem absorbing nutrients from food. There are many reasons why this might happen, including having reduced mobility, a long-term health condition, or a low income.
The Care Quality Commission’s Essential Standards of Quality and Safety clearly state that “individuals who use services should be supported to have adequate nutrition and hydration”. In spite of this, nearly a third of all older people admitted to hospital and care homes are at risk of malnutrition and 50% of people admitted to hospital from care homes were at risk of malnutrition, according to BAPEN. Women have a higher prevalence of malnutrition than men in all age groups.
The Country Range Group’s K2N software, which is exclusively available through CRG wholesalers, lets you create unique nutritional profiles for care home residents to monitor their daily requirements. It also creates recipes and menu plans.
For more details visit www.k2n.co.uk
Fortifying Effectively
For residents who struggle to get enough nourishment, it may be necessary to fortify their diet with nutrient-heavy food and drinks.
Simon Muschamp, head of marketing, Pritchitts explains: “Good nutrition, especially as we get older is vital. However ensuring people in care get those much-needed calories can be highly challenging as the statistics show – a lack of appetite, inability to swallow or simply failing to consume the calories sufficient for their needs can all contribute to malnutrition.”
With nutrition high on the agenda but catering budgets limited, using fresh dairy cream can add calories but also prove highly wasteful due to short shelf-life.
A great alternative is to use a long ambient shelf-life product such as Millac Gold Double to increase the calorific value of dishes. Use for cooking, pouring and whipping – it whips up to three times its volume providing superior yield – and is ideal for both sweet and savoury dishes.
Dealing with Dysphagia
Dysphagia refers to difficulty with or inability to swallow and often results from strokes, Parkinson’s disease, dementia and motor neurone disease.
The key consideration when catering for people with this condition is to make meals which are as easy to swallow as possible, whilst still looking appetising and meeting nutritional needs.
As part of its Healthcare Solutions Programme, Premier Foodservice has published a guide to help caterers deal with dysphagia, which includes a selection of texture modified recipes and key information to help them cater for those suffering with dementia or dysphagia. Created by their dedicated team of culinary advisors, the texture modified recipes include Meat Lasagne using Homepride Bolognese Sauce and Scones with Jam and Cream, made using McDougalls. The recipes are designed to use a range of everyday ingredients which many caterers will have available in their store cupboards.
Sarah Gray, channel marketing manager, Premier Foodservice, adds: “We also run a series of practical workshops as part of the programme, helping to ensure the nutritional needs of people with these conditions are met. We understand this can be a challenge and many factors need to be considered including the meal-time environment, the use of nutritional supplements and the provision of assistance to eat. Healthcare caterers have a key role in helping to reduce the risk of weight loss for people with dementia and dysphagia by providing a variety of different types of snacks and meals throughout the day to stimulate and motivate people to eat.”
Dehydration
Care home residents are five times more likely to be left thirsty, according to research by The Independent.
This problem is most prevalent for those residents who depend on others to provide their drinks, for example, dementia sufferers, many of whom have reduced thirst and are reluctant to drink.
As people get older their thirst sensation can lessen which can lead to them not drinking enough. 25% of the elderly suffer mild chronic dehydration. This can result in confusion, urinary tract infections, headaches, irritability and greater risk of pressure sores.
As people become less mobile, they may find it difficult to get up to get themselves a drink. Additionally fear of incontinence may also encourage individuals to drink less.
The average amount of water that people need to drink is 30ml per kg of body weight, but this increases in warm weather and during infection. The minimum amount of water most people should drink is 8 to 10 glasses per day.
Older people may need to be reminded, encouraged and even convinced to drink more. Using a positive approach often helps. “I’ve got some cool refreshing water for you” is often more productive than “Do you want something to drink?”
Keep it clean
Catering for the elderly and vulnerable puts even greater pressure on hygiene standards in the care home kitchen.
Although effective infection prevention measures are essential throughout a care home in the kitchens and food serving areas processes should focus on prevention of food poisoning. The objective is to remove pathogens before they have a chance to spread and contaminate other areas.
Most common infections encountered in the care home kitchen are likely to be most readily spread by person-to-person contact or by touching already contaminated surfaces and then touching a clean surface which then becomes contaminated.
According to cleaning experts Diversey, particular attention should be paid to three critical areas:
1. Any food contact surfaces such as work tops, preparation areas, equipment and fridges etc should be cleaned frequently with a disinfectant sanitiser product.
2. Any surfaces likely to be touched by hand should also be cleaned regularly with an effective disinfectant sanitiser. These surfaces will include items such as door handles, light switches, fridge and kitchen doors, utensils and portable appliances.
3. The third food safety consideration is hand hygiene. Staff should wash their hands frequently but in particular when passing in or out of the kitchen or food preparation area, when swapping between handling prepared food and raw ingredients, and always after visiting the toilet or washroom.
New packaging helps care caterers go green
The UK care sector is making significant strides on reducing waste to landfill, demonstrating the industry’s wider commitment to sustainability.
Nescafé is supporting the care caterers to reduce waste to landfill with its innovative new refill format that uses 87% lighter packaging than Nescafé catering tins.
Peter Lawson, care home manager of Barchester Healthcare (a care home group with over 200 care homes), says the refill packs have helped him to reduce waste management costs:
“Cost is such an important factor in all our purchasing decisions, but we don’t want to have to compromise on the quality of what we offer our residents.
“In Nescafé we have found a great partner, that offers a great product that delivers on taste, is value for money and the refill packs are a core part of our green commitment now.”