Bring on the baby boomers

The Aged Care Quality Standards are being rejigged and, at first glance, they appear pretty sexy -  but are they really? To understand these changes first let me first talk about the existing Quality of Care Principles (2014) and the current accreditation standards.

The existing Quality of Care Principles (2014) can be divided into two parts, the stuff relevant to aged care homes and the stuff relevant to community care. We’re going to discuss the stuff relevant to aged care homes which are (1) Care and services for residential care services (the stuff that aged care homes should provide to their residents); (2) Accreditation Standards (the stuff that aged care homes need to do if they want to stay in business.

In this entire document, meals are mentioned six times and food is mentioned twice. Colour me underwhelmed.

Schedule 1.10 states:

• that recipients must be offered meals of adequate variety, quality and quantity served each day at times generally acceptable to both recipients and management and generally consisting of three meals and three snacks
• that cultural, religious or special dietary requirements should be respected
• food, including fruit of adequate variety, quality and quantity and non alcoholic beverages be provided.

These sound lovely, but they are quality standards and not necessarily accreditation standards. There are currently four standards that Residental Aged Care homes must meet in order to stay in business and only one of these mentions meals:

2.10 Nutrition and hydration states:

• that care recipients (people living in aged care homes) receive adequate nourishment and hydration, this includes assistance with special diets (for health, religious or cultural reasons) and assistance to eat meals if necessary.

There are also a bunch of food safety requirements that have to be taken into consideration. Older people are more vulnerable to food borne pathogens and so extra care must be taken when preparing their food…. (but that’s a post for another time).

So, there’s what you should do (Quality of Care Principles) and what you have to do (Accreditation Standards).

The new and shiny draft Aged Care Standards Guidance Material mentions meals 41 times and food 25 times. Clearly, there has been a much greater focus in this iteration of the Standards. But what do they actually say?

Meals have their own section now, and requirement 4.5 states that ‘Where meals are provided, they are varied and of adequate quality and quantity’. The standard goes on to acknowledge that if meals are tasty, residents are given choice and the overall dining experience is positive that consumers (residents) are more likely to eat. So far, so good.

There follows a list of supporting strategies; actionable things that homes can do to help achieve the standard. There’s also a bunch of reflective questions that aged care providers can ask themselves to self-evaluation whether or not they are doing a good job. This is where I flipped an eyebrow.

If aged care facilities were capable of self-reflecting we wouldn’t have a Facebook group dedicated to 'The unacceptable food served in aged care' where photographs like the one below are shared.

Last year I was asked to give study tips to third-year dietetics students; I started with “Those of you with good study tips probably won’t learn anything new and those of you who need good study tips probably won’t listen to me anyway”. Self-reflection is a little like that. But I digress…

The supporting strategies are excellent. They include things like ensuring residents have access to food 24/7, engaging residents in meal preparation and cooking and consulting with dietitians. But these are just suggestions, not mandates.

The current generation of aged care residents is very polite and compliant, they don't like to complain. Despite paying 85% of their aged care pension for the 'privilege' of staying in an aged care home, many residents will suffer in silence. Indeed they have been dubbed the 'silent generation', discouraged against political activism and encouraged to conform with social norms.

I think aged care CEO's have a rude awakening coming. The baby boomers are coming! I think it's very exciting because it will mean an increase in the quality of care being demanded and therefore being offered.