Shining a light on food in aged care

Cherie with client Chas Beutel. Picture via www.goldcoast.com.au
Cherie with client Chas Beutel. Picture via www.goldcoast.com.au

In the twilight of your life sometimes the highlight of the day is your meals. But what happens when the food being served is bland, reheated and lacking nutrition? A Gold Coast dietician is leading the charge to inject flavour and nutrition into the aged care diet.

This story first appeared in the Gold Coast Eye Magazine

GOLD Coast dietician Cherie Hugo knew things weren’t great but it wasn’t until George said something that she decided it was time to make a change.

Her elderly patient bemoaned the quality and flavor of the food he was being served at his nursing home.

Surely injecting flavor and freshness into his meals wasn’t too much to ask for, he asked his dietician.

“George was a feisty old character, passionate about food and he said, ‘Why can’t we do this?’ recalls Cherie, whose business My Nutrition consults to more than 15 aged care facilities.

“He gave me fire in my belly about bringing flavour back into food.”

Cherie has worked as a dietician in hospitals and aged care facilities for the past 14 years and she knew things could be better.

The statistics reveal between 50 and 80 per cent of aged care residents in Australia are malnourished.

“My passion is seeing my aged care residents well nourished and excited about eating,” she says.

“Sadly I don’t see this often enough.”

Cherie says the healthy eating rules and guidelines that apply to most of us don’t have any place in the lives of the elderly.

It’s a sad statistic, but most nursing home residents have a life expectancy of 2.6 years, so weight watching isn’t a big priority.

Elderly residents have far simpler issues to overcome – they struggle to swallow and taste their food.

Too often aged care facilities are run as businesses and that means the meal budgets are set without the residents’ nutritional wellbeing in mind.

Cherie – with encouragement from George – decided to change the way the industry responds to the nutritional needs of their clients.

Cherie had some great ideas but she wanted the changes to be industry wide, so this determined businesswoman drew up a ‘hit list’ of the people she wanted to work with and then she picked up the phone.

Top of her list was TV chef Maggie Beer, whose Maggie Beer Foundation is focused on providing a ‘good food life’ for all.

She rang Maggie’s publicist, explained who she was and discovered Maggie was due to have a holiday on the Gold Coast.

“I rang Maggie’s publicity manager who said, ‘She’s staying there next week.’ I asked ‘Would she be willing to meet me?’ Maggie said, ‘Give me a lift to the airport and we can talk.’ We ended up having three hours together.

Buoyed by Maggie’s involvement Cherie worked her way down the list of industry and media heavy hitters.

Every person she approached said ‘Yes’, including, Ita Buttrose in her capacity as National President for Alzheimer’s Australia; Bond University Professor of Nutrition and Dietetics Liz Isenring; Malnutrition expert Maree Ferguson; Executive Chef with Hammond Care, Peter Morgan Jones; Director of Dementia Collaborative Research Centre QUT, Elizabeth Beattie; managing principal FoodLegal, Joe Lederman; and Ange Barry, CEO of The Stephanie Alexander Kitchen Garden Foundation.

“Everyone of these people came on board pro-bono because we’re all driven by passion to make a change,” says Cherie.

“Ita has been amazing. She’s given me a lot of guidance along the way. She’s been very generous with her time, as has Glen Rees the CEO of Alzheimer’ Australia.”

This formidable group is working under the banner The Lantern Project. They’re a not-for-profit group that sits under the Maggie Beer Foundation.

Cherie decided on the name because an old-fashioned lantern shines light in all directions.

“I believe we need to shine the light on the issue of food in aged care, using good old fashioned fresh, local produce, utilising the wisdom of our older residents (some have been cooking for well over 80 years) and do this in a collaborative way,” she says.

“The malnutrition figures have been the same for the length of my career and I thought, ‘Really what impact have I had personally?’ I could be doing a lot better as a dietician and I don’t think I by any means have all the answers.

“We’re a very diverse group of people and we’re trying to pool our expertise together and find that common ground and move forward.

“The Australian healthy eating guidelines are not applicable to aged care.  As you get older your taste acuity reduces so older people need to have amplified flavours in their food.

“We should be asking, ‘How can we fortify and really enhance the flavour of the food?’”

The Lantern Project has seven key objectives, the first of which is to quantify the value of good nutrition in aged care. Cherie and the other participants know that in most facilities meal planning is driven by budget constraints.

Cherie says what is often overlooked are the costs related to a poor diet, which can lead to health and digestion problems

She believes a healthy, balanced diet, packed with fresh, local food could prove more expensive in the short term but cheaper in the long term.

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“We want to quantify the value of good nutrition,” says Cherie.

“That hasn’t been done in aged care before. I want to be able to say ‘For every $1 spent on food you can expect this many dollars in health savings.’

“Wounds, falls, mood are all related to food. The residents develop all these things that are treated with more medication.

“This cascade of problems develops from a person being undernourished.  If we can reverse that we can really work on increasing their joy of food and if residents are enjoying their meals they’re going to eat more and the chance of malnutrition is less.”

It’s surprising to discover the criteria for the Aged Care Funding Instrument (ACFI) which determines how much funding a centre receives per resident does not include nutrition.

The Lantern Project team wants to change this, just as they want to introduce edible gardens to aged care facilities as a way to create a connection between residents and their food and give them an enjoyable source of outdoor activity.

Cherie says while some nursing homes do ask their residents for feedback on the meals being served, many residents are from an era where they don’t like to make waves, nor do they like to waste food.

“We have a different mentality today,” says Cherie.

“They are accepting of what they are given. I think we can do a whole heap better

“Budget is one of the drivers and the first objective of the project is to quantify the value of the nutrition. My driver is quality of life, there’s great joy to be had from good food. I want people to look forward to food in the course of their day. Food is that thing, when a lot of other things have gone, that should be their enjoyment. A lot of facilities are doing as best as they can with the guidelines and the budget they are given.

“But there’s a lot of frozen, bought and packaged foods served which the elderly aren’t familiar with.”

Add to that the common problems experienced by the elderly, including difficulty swallowing and chewing food and it’s clear the needs of this important group of people are complex.

Maggie Beer agrees and recently set six South Australian aged care chefs a challenge – to create signature dishes using premium fresh produce and an increase of just $4 to their normal budget.

“It is such a huge thing to change,” Maggie explained.

“It is going to be the rest of my life. I am on this journey and I am gathering my forces with like-minded people around Australia.

“Good food is important for everyone, but more so for someone who has limited control over their future. What can be more immediate than giving people beautiful food and the difference it makes to every day in their life.”

Sadly George has passed away and will never enjoy the benefits of Cherie’s drive and passion for the cause.

But she remains inspired by his memory and the thought that she can improve the quality of life of our oldest residents in their final years.

“I was treating a 104-year-old lady and when I walked into her room she would be sitting up in bed on her laptop, engaged and connected. The first thing she would talk to me about was, ‘Can you believe what they’ve done to this cut of meat?’,” recalls Cherie.

“We have these people with more than 80 years of experience under their belt and we’re not talking to them. Why aren’t we engaging them more in getting their feedback and having two-way conversations?

“This is my BHAG – my big, hairy, audacious goal. This is certainly driving me but it wouldn’t have happened without this amazing team of people willing to come together and get a bit carried away.”