I’m Morgan Boughton, Optimum Intake Dietitians Residential Aged Care Team Leader. I have a specialised team who work within Residential Aged Care Facilities across Newcastle and the Central Coast. Our dietitians are the link between clinical staff and food service staff in your facility.
Optimum Intake Dietitians provide a resident-centred approach to all services and supports in line with the resident’s assessed needs, goals and preferences that are important to the resident’s well-being and quality of life.
With the implementation of the Aged Care Quality Standards it is essential that RACFs have adequate and experienced support from suitably quality Allied Health Professionals in order to ensure they are consistently providing effective services and supports for daily living that optimise the resident’s independence, health, well-being and quality of life.
Our newsletter has been developed to discuss current topics in Aged Care Nutrition and to better help Residential Aged Care staff to understand the role of a dietitian and how we can assist.
Covid 19 Update – Remote Dietitian Services Available where needed.
The world has changed rapidly since the beginning of the Covid 19 pandemic. It has affected many parts of our lives, including our economy, physical health, mental health, and social aspects of life. As parts of Australia head into lockdown during a second wave of the virus, New South Wales is bracing for a future increase in cases and to protect those who are most vulnerable. During the Covid 19 pandemic, allied health practitioners such as Dietitians are deemed an essential service to assist in managing the health needs of those who require it. Optimum Intake Dietitians have taken appropriate precautions in protecting our residents in Residential Aged Care Facilities. We have created the Three Modes of Service Delivery – including remote assessments.
To improve the current access for dietary services within residential aged care facilities’ and to support their residents who have complex nutritional needs we are offering services that allow for flexibility during this unstable time of Covid-19 Pandemic. Your facility is now able to choose between three different modes of nutritional service delivery, Standard On-Site, Limited-contact On-Site or Remote Telehealth Services. Residents who require higher level of Medical Nutrition Therapy and Dietary Management will receive a coordinated care approach via any of the three modes of service delivery.
Optimum Intake Dietitians will continue to update our policies and procedures aligned with NSW Health recommendations to protect our residents.
Please note: for all on-site visits our Dietitians comply with current government regulations relating to criminal record checks, personal hygiene, use of PPE, vaccinations and social distancing.
The nutritional quality of meals, snacks and drinks provided to residents will affect long term health, wellbeing, mental health and decrease risk of wounds and infections. Meals provided need to include the following.
A high-quality protein source such as meat, chicken, eggs, cheese, fish. Protein assists with maintaining healthy muscle mass to promote strength and independence.
An average person over the age of 65 will require approximately 85g of protein each day. If a serving of high-quality meat, chicken or fish is provided at lunch and dinner, this provides approximately 30-40g of protein. To provide enough protein to meet resident’s protein requirements, breakfast and midmeals (morning tea, afternoon tea and supper) need to be identified as an opportunity to increase protein of meals.
Tips on how to increase protein on the menu
Include a protein source at breakfast. Eggs are an excellent source of protein suitable for breakfast. Served as fried, scrambled, poached or in an egg-based dish such as omelette or zucchini slice, just two eggs at breakfast will add an additional 10g of protein per day. By adding cheese to omelettes or scrambled eggs, this will furthermore increase the protein quantity by 10-16 (fried, scrambled, poached) or an egg-based dish such as zucchini slice or omelette. By adding cheese to these dishes, this will furthermore increase the protein by up to 10g, providing an additional 20g of protein at breakfast.
Provide snacks such as yoghurt, milkshakes or smoothies, nuts or nut butters, fresh hummus made with chickpeas, cheese and crackers at morning tea and afternoon tea for residents.
Use high protein milk in breakfast cereals, milkshakes, tea, coffee, and hot drinks. This is an easy swap and the resident’s will not be able to taste the difference. By adding 4 tablespoons of skim milk powder to full cream milk, this will more than double the amount of protein.
1 litre of full cream milk provides 13.5g of protein 1 litre of high protein milk provides 33g of protein
An easy, inexpensive swap that provides double the protein and used in meals throughout the day. Keep scrolling to find a simple recipe for High Protein milk that can be used in your facility.
Iron is an important element as it assists with moving oxygen around our body assisting with energy levels and reducing fatigue. Men and women over the age of 65 years require 8mg of iron each day. There are two types of iron in our diets: haem iron and non-haem iron. Haem iron is found in animal products such as red meat, chicken, kangaroo, fish, offal such as liver and kidney. Non-haem iron is found in plant products such as legumes, green leafy vegetables, wholegrains, and fortified breakfast cereals.
Tips on how to increase iron on the menu
Offer meals including red meat each day either at lunch or dinner
Serve meals including iron with vegetables high in Vitamin C as this will assist with absorption, such as capsicum, broccoli, sprouts, tomatoes
Include non-haem iron plant sources such as kidney beans, lentils, chickpeas to boost iron
Avoid consuming drinks such as tea, coffee and milk drinks at the same time as consuming a high iron meal. Calcium and polyphenols or phytates in tea and coffee are known to inhibit the absorption of iron
One of these first things to be affected when an elderly person becomes unwell is their hydration status. Therefore, providing opportunities for residents to consume fluids is important in maintaining health and wellbeing. Some foods are considered good sources of hydration for residents including custards, ice creams, water-based ice blocks, soups, cordial, jellies, milk shakes and yoghurt. Cups of tea, coffee and hot chocolate are also considered hydration sources.
It is recommended that residents have the opportunity for hydration every 1.5 hours and aim to reach 1.6 to 2 litres of fluid each day. Maintaining adequate hydration assists with healthy blood pressure, kidney function, regulate body temperature and promote healthy digestion.
Tips to improve hydration in residents
Ensure fluids are offered every 1.5 hours by water carts or care staff
Include a social event each day where residents are encouraged to drink fluids. A special drink such as iced tea or cordials may be offered to entice residents
Provide drinks at each meal occasion and encourage consumption
Include wet foods each day such as puddings, custard, jellies, ice cream, pureed fruit
Position drinks and wet foods within residents reach for ease of consumption and help as needed
Make notes of resident’s favourite drinks or wet foods and offer regularly throughout the day. This will both assist with hydration and resident’s wellbeing.
Medical Nutrition Therapy and Services
Dietitians provided Medical Nutrition Therapy to manage malnutrition to improve health outcomes for individual residents. Dietitians can also work with Food Service staff including chefs, kitchen hands and catering staff to improve recipes and processes within the facility to assist with malnutrition in Residential Aged Care Facilities.
Optimum Intake Dietitians are the professionals to provide nutrition screening, assessment and medical nutrition therapy to older Australians experiencing:
Malnutrition and dehydration,
Nourishing drinks such as high protein milk can be beneficial for aged care residents in meeting their energy and protein requirements. Adequate protein intake can assist with wound healing, decreased infections, and maintenance of lean muscle mass to assist with strength and independence. High Protein milk can be made in large amounts and provided to all residents replacing normal milk to assist them in meeting protein requirements.
Supplemental nutrition powders such as Sustagen, Advital or Ensure can also be used instead of milk powder. Ingredients:
1 litre of full cream milk
4 tablespoons of skim milk powder
Pour milk into a jug
Stir milk powder in or whisk until completely blended
Keep this high protein milk in fridge
Use instead of regular milk in cereals, tea, coffee, soups, desserts, baking
Accredited Practising Dietitian, Residential Aged Care Dietitian & Team Leader
Morgan graduated from The University of Newcastle in 2017 with Bachelor of Nutrition and Dietetics (Honours). She has worked in multiple areas of dietetics including private practice, medical centres, hospitals, and within residential aged care facilities. Morgan has a background in food service as she worked as a dietary technical assistant as a student at John Hunter Hospital. This role assisted her in understanding the complexities of food service including time restraints, cooking, and providing food for large numbers of people and the provision of food service & mealtimes. Morgan’s experience working as a clinical dietitian in private hospitals and her background in food service gives her a unique perspective of nutrition and has formed her passion for improving nutrition in Residential Aged Care facilities. As Team Leader at Optimum Intake Dietitians, Morgan consistently works with our specialised team to provide effective interventions to improve health outcomes for aged care residents.
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