Put in place a system for partnering with older people to make food, drink and dining experiences enjoyable.

Make sure this system focuses on older people’s needs, goals and preferences (Outcome 1.1). It should give older people choice and control over their food, drink and dining experiences. Consider how your broader processes, when partnering with older people, support them to exercise dignity of risk and eating and drinking with acknowledged risk. These should be in line with contemporary, evidence-based practice (Outcomes 1.2, 1.3 and 2.1).

Also, talk with older people about their eating, drinking and dining preferences. This can include:

• asking them about their food and drink likes, dislikes, intolerances and allergies. For example, find out if the older person has any specific cultural or religious beliefs that may influence what they want to eat and drink (Outcome 1.1). This should include considering:
  • culturally significant, local or native foods
  • shared meals
  • gatherings of cultural significance.
• having formal processes for consulting with older people about food, drink and the dining experience. For example, through a consumer advisory body or focus group (Outcome 2.1).

Use available resources to make sure you’re considering all the older person’s preferences. For example, the Commission has a food and dining preference sheet. You can use this to record each person’s preferences.

It’s important to partner with older people who need extra support. This makes sure you understand and can meet their eating, drinking and dining preferences. Some older people may have communication barriers and may need individualised and extra support. This can include older people who:

• are living with:
  • mental illness
  • cognitive impairment including dementia
  • disability.
• come from cultural and linguistically diverse (CALD) backgrounds
• identify as Aboriginal and/or Torres Strait Islander.

Also, make sure older people with communication barriers and who need extra support are represented and partnered with appropriately.

Your strategies to support enjoyable food, drink and dining experiences should be in line with contemporary, evidence-based practice and guidelines. For example, making sure allied health recommendations, like using adaptive equipment prescribed by an occupational therapist, are available (Outcome 6.2).

Include processes to identify risks associated with eating and drinking (Outcome 2.4). You also need processes to control the risks you find. For example, you may need to refer an older person to an allied health professional if they’re more likely to aspirate (accidentally breathe food or liquid into the lungs) (Outcomes 3.2 and 5.5). This should be done in partnership with older people to support their food, drink and dining needs and preferences (Outcome 2.1) while also managing risk where possible. Consider the older person’s right to exercise eating and drinking with acknowledged risk (EDAR) (Outcome 1.3).

Document the older person’s nutritional needs and preferences in their care and services plans following assessments (Outcomes 3.1, 5.4 and 6.2). Regularly review plans to make sure their nutritional needs and preferences are documented accurately. Make sure you communicate their needs and preferences with all relevant workers (Outcome 3.3). For example, catering and care workers who provide mealtime support with eating and drinking.

To make sure you’re meeting older people’s food, drink, and dining preferences, include processes to monitor:

• how satisfied they are with food, drinks and the dining experience This can include food satisfaction surveys, feedback forums and other monitoring strategies such as considering plate wastage (served food that remains uneaten).  
• that they’re consuming enough food and drink to meet their nutritional needs (Outcomes 5.4, 5.5 and 6.3).

Share information about older people’s food, drink and nutrition through a confidential process between your organisation, hospitals and external services. This is to make sure you provide continuity of care during transitions of care (Outcomes 2.7, 3.3, 3.4 and 7.2). For example, changes to dietary requirements recommendations by an allied health professional. For older people transitioning back into your care, review this information and update their care and services plans if their dietary needs have changed (Outcome 3.1, 3.4 and 7.2). This includes you referring an older person to an allied health professional for assessment, if appropriate (Outcomes 3.2 and 5.5).

Make sure workers have the time, support, resources and skills to partner with older people on their food, drink, and dining experiences.

Provide workers with guidance and training on how to partner with older people on their food, nutrition and dining experiences. This needs to be in line with:

• the organisation’s policies and procedures. These should be in line with contemporary, evidence-based practice.
• workers’ roles and responsibilities.

Make sure workers are in line with, understand and provide appropriate assistance when:

• partnering with older people on their food, nutrition and dining needs
• delivering and improving food, nutrition and hydration services
• recognising clinical change that impacts food intake and nutrition (Outcome 5.5)
• supporting older people with modified diets and thickened fluids (Outcome 6.4)
• helping older people with eating and drinking
• using the communication system (Outcome 3.3) to:
  • make sure nutrition and hydration information is up-to-date
  • escalate any risks, changes, deterioration or incidents affecting the older person’s nutrition, hydration or ability to eat and drink.

The guidance for Outcomes 2.8 and 2.9 has more information on workforce planning and worker training.

Monitor how well you partner with older people to create enjoyable food, drink and dining experiences.

To check if you are partnering with older people effectively on food, nutrition and dining needs, you can review:

• older people’s funded aged care service documents (Outcome 3.1). For example, making sure care provided in the progress notes aligns with the older person’s needs outlined in their care and services plan.
• data on malnutrition, diet-related diseases and unplanned weight loss. This includes malnutrition screening (Outcome 5.5).
• complaints and feedback for trends (Outcome 2.6a and 2.6b)
• incident information for trends (Outcome 2.5).

Look for situations where:

• there have been incidents involving the older person while eating and drinking (Outcomes 2.5 and 5.5). For example, coughing, aspiration, choking or an allergic reaction
• an older person has become malnourished, dehydrated or lost weight unexpectedly
• the organisation has not partnered with the older person to provide enjoyable food, drinks and dining experiences tailored to the person’s needs, goals and preferences. You may be able to find this information by speaking with older people and analysing feedback trends.

Also, talk with older people, their supporters and others they may want to involve, such as families and carers, about the aged care services they receive (Outcome 2.1). For example, ask them if their provider partners with them to provide food, drinks and dining experiences they enjoy. These conversations can then inform continuous improvement actions and planning (Outcome 2.1).

Assess if workers are following your quality system (Outcome 2.9). You can do this through quality assurance and system reviews.

If you find any issues or ways you can improve through your reviews and assessments, you need to address them. If things go wrong, you need to:

• practise open disclosure (Outcome 2.3). This means being open about what has gone wrong. Share what went wrong with older people, their supporters and others they may want to involve, such as family and carers.
• have strategies to mitigate the risk of things going wrong again.

The guidance for Outcome 2.3 has more information on monitoring the quality system.

The guidance for Outcome 5.5 has more information on managing unplanned weight loss and malnutrition.