Recently we highlighted the need for mandatory meal and nutrition standards in aged care, to improve food quality and health of older adults as an important step forward in aged care reform.
To dig deeper into menu planning, we spoke with Dr Karen Murphy, accredited practising dietitian and senior research fellow at the University of South Australia.
Q. What are the most important considerations when planning a menu for older adults?
Karen: Many things need to be considered in menu planning for aged care. Firstly, are they in high level care or independent living facilities?
Dining facilities are important. Older adults are at risk of malnutrition because their energy needs drop and so does their appetite. We know that social dining increases food intake, and it’s important to consider the taste and flavour of foods.
Available cutlery and ability to eat the food. Can everyone use a knife and fork or are sporks better? People with arthritis and reduced mobility in their hands may need cutlery with curved handles.
Can meals and snacks be prepared on-site or does food need to be bought externally and brought in? Consider budgetary restraints.
Medical requirements: dysphagia requires different textures to avoid choking; chewing difficulties with dentition; loss of interest/depression; physical immobility.
Vegetarian options should be available. Some may need foods with higher protein and fat content to avoid malnutrition.
Q. What is “menu fatigue” and why is it considered?
Karen: Menu fatigue means getting sick of the same food. It can often be a problem in hospitals or aged care facilities where menus are rotated fortnightly or monthly and can get very boring. This impacts food intake.
Sometimes there are budgetary constraints on menu development, kitchen facilities for preparing large amounts of food, or the types of food that can be produced and kept at temperature.
Q. “Aged care” isn’t just about being in a facility, it could also mean taking care of your mum/dad or partner. How can family help with menu planning?
Karen: Get them involved. Ask them what can I/we do to make it easier for you? What do they like to eat? What can they prepare? Do they prefer smaller regular meals rather than big meals? Can they handle the food packaging?
Families can help in several ways. For instance, re-packaging foods if they are hard to open, or helping with bulk preparation of favourite meals and storing them as individual serves.
Q. What are some snack ideas if their appetite isn’t big enough for a full meal?
Karen: If they are at risk for malnutrition, needing high energy high protein foods, suggest prioritising food to meet the protein RDI.
Some ideas: milk drink or Sustagen, smooth peanut butter and banana or ricotta cheese and avocado on crumpets, cheese and crackers, hardboiled egg or omelette, full fat yoghurt, savoury cheese muffins, nuts (if chewing/swallowing isn’t a problem), dried fruit, baked beans, nutritious dips, mini puddings, pikelets with jam and cream.
Q. What are some aged care menu ideas?
Karen: Meals should focus on high nutrient density, soft textures, fibre and flavour. Milk powder and olive oil can be added for extra protein and calories if needed. Some examples:
- White fish or salmon with a creamy sauce, mashed potato and vegetables
- Tuna mornay with cheese and vegetables
- Vegetable cheese frittata with salad
- Cheesy, vegetable-packed lasagne with béchamel sauce
- Roast chicken, creamy mash and vegetables with olive oil
- Moroccan chick pea vegetable casserole
- White bean soup with vegetables and chorizo
- Slow cooked beef casserole with gravy and vegetables
- Pasta with vegetables and creamy sauces
Q. Where do you see the future for nutrition for aged care menus?
Karen: Attention is being given to increasing the social side of dining, improving the whole dining experience. Menus are becoming more creative; texture modified foods are advancing to make them tastier and more visually appealing.
The increase in reality cooking shows is drawing attention to the appearance of food to make it more appetising. The nutritional content of meals and using healthy fats like extra virgin olive oil I think will creep into menu planning, and using external meal services might receive more attention.
We would like to thank Dr Karen Murphy for her time.
