Alzheimer’s Australia NSW has called for national nutrition guidelines to be developed for meal delivery services funded under the Commonwealth Home Support Program and targeted training of home care workers to support the early identification of malnutrition among older people with dementia.

Older people with dementia, especially those living alone, are at higher risk of poor nutrition and malnutrition, which has significant impacts on cognitive and functional symptoms, and on the overall clinical prognosis.

The state peak body said what came through very strongly in its interviews with expert stakeholders is that nutrition risk and malnutrition in people with dementia is not identified early.

“[People with dementia are meeting their nutritional needs] in a very ad hoc way. It is more good luck than anything,” said an ACAT staff member respondent to the research project.

In response to its investigation, Alzheimer’s Australia NSW has released a discussion paper, Dementia and Nutrition in the Home, to bring attention to nutrition issues and make a series of policy recommendations including improved staff training, guidelines and referral pathways.

Impact of CDC

A survey conducted by Alzheimer’s Australia NSW showed community care service providers were concerned about the prioritisation of meals and nutrition support services under CDC.

“As the aged care and disability reforms unfold and Australia progresses to fully consumer led and managed models, we need to ensure that consumers have access to meals and dietitians through policy changes and consumer awareness of the importance of these,” the report said.

Alzheimer’s Australia NSW said the Home Care Package guidelines should also be amended to allow for the purchase of meals.

“Our findings indicate that service providers will need to highlight the fundamental role good nutrition plays in living well with dementia and the risks of poor nutrition (including increased risk of falls and other health complications) to their clients in establishing client goals and plans.”

Respondents were also concerned about future funding for HACC-funded dietitians.

Nearly 80 per cent of home care workers surveyed as part of the project said they were concerned about the nutrition of people with dementia.

Other recommendations in the report included rolling out dementia training to Meals on Wheels volunteers and developing an app for home care service providers which would include a checklist, mini-nutritional assessment and referral pathway.

Alzheimer’s Australia NSW CEO John Watkins said proper nutrition was a basic human right, however it was being overlooked in people with dementia living at home

“Every person with dementia will have difficulty with nutrition at some point,” he said.

“That may be either difficulty with eating or in being able to ensure they are getting balanced, nutritious meals on a day-to-day basis. It’s a universal issue.”

The discussion paper was co-funded by Calvary Community Care and Anglican Retirement Villages (ARV) and conducted with the assistance of Meals on Wheels NSW.

Cheryl De Zilwa, the CEO of Calvary Community Care and the national director of community care, said it was evident through the research that community care support workers and other professionals who provide in-home support could play a key role in identifying the warning signs that a person is not eating correctly.

“Training and education on nutrition and menu planning will be enormously beneficial and could have an immediate impact,” she said.

Read the discussion paper in full on the Alzheimer’s Australia NSW website

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