Food is medicine and our aged-care providers must start treating it that way |
Aged care reform in Australia has focused heavily on staffing levels, regulation and funding. All of these matter.
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But there is another issue hiding in plain sight that affects the health, dignity and safety of hundreds of thousands of older Australians every day: food.
For too long, food in aged care has been treated as a hospitality service rather than a clinical one. Yet the evidence is clear: nutrition plays a central role in preventing illness, maintaining strength and keeping older people out of hospital.
The consequences of getting it wrong can be serious.
Recent findings from a NSW coronial investigation into choking deaths in aged care have again highlighted the risks facing residents with swallowing difficulties. Similar warnings have been issued elsewhere in Australia, including alerts from Safer Care Victoria about rising choking deaths linked to residents being served food inconsistent with their swallowing needs.
These incidents are tragic. They are also preventable.
A white paper released this month by The Pure Food Co has highlighted that swallowing disorders, known as dysphagia, are common among older people. According to Speech Pathology Australia, up to 50 per cent of aged-care residents in this country live with some form of swallowing difficulty. When food texture is not carefully managed, the risk of choking or aspiration increases dramatically.
This is why texture-modified diets - where food is prepared to precise safety standards - are a critical part of clinical care.
But preparing these meals correctly is technically complex. In many aged-care kitchens, texture-modified food is still made manually by blending and thickening standard meals. The process can involve dozens of preparation steps and relies heavily on staff training and consistency.
Even small variations in texture can create serious risk.
At the same time, nutrition itself remains one of the biggest challenges facing the sector. Studies have found that two-thirds of aged-care residents in Australia are malnourished or at risk of malnutrition. Many consume far less protein than is required to maintain muscle mass and immune function.
The results are predictable: more falls, more infections, slower wound healing and more hospital admissions. In other words, poor nutrition is not just a quality-of-life issue. It is a health system issue.
The Pure Food Co's white paper, "Feeding Strength and Dignity", argues that addressing this challenge requires practical, system-wide change - not just higher expectations. It sets out three targeted recommendations: improving access to timely speech pathology assessments; strengthening risk management practices for texture-modified meals; and introducing better visibility of nutrition in home care so providers can identify and respond to risk earlier.
The good news is that change is already under way.
Australia's strengthened Aged Care Quality Standards, introduced in November last year, recognise food and nutrition as a core component of care. For the first time, providers are required to demonstrate that meals support the health and wellbeing of residents, not just that they are served.
This is an important step forward, but regulation alone will not solve the problem. The sector must start treating food as medicine.
That means designing meals that are nutritionally fortified, clinically appropriate and appealing enough that residents actually want to eat them. It means ensuring texture-modified meals meet strict safety standards while still looking and tasting like real food. And it means integrating nutrition into clinical governance, staff training and care planning.
It also means closing critical gaps in the system. The white paper reveals that access to speech pathology remains inconsistent, particularly in regional and rural areas, leaving many aged-care providers without timely specialist support.
Addressing this will require targeted policy responses, including stronger incentives to attract and retain speech pathologists in regional areas, as well as greater use of telehealth-enabled assessments to ensure residents can be assessed quickly regardless of location.
At the same time, home-care providers have little visibility over what their clients are eating - making it difficult to monitor nutritional risk or intervene early.
These are solvable problems, but they require coordination between policy, providers and innovation.
As Australia's population ages, these challenges will only grow. By 2050 the number of Australians aged over 85 is expected to triple. If we want an aged-care system that supports independence, dignity and quality of life, we cannot continue treating food as an afterthought.
Every meal served in aged care is an opportunity to strengthen someone's health - or to undermine it.
Getting food right will not solve every problem facing aged care. But it is one of the most practical, immediate and cost-effective ways to improve safety, wellbeing and outcomes for older Australians.
And, as recent coronial findings remind us, the stakes could not be higher.
Chris Deed is the Australia director of The Pure Food Co, which provides texture modified food solutions to more than 500 aged-care facilities across Australia. To read the white paper visit thepurefoodco.com
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