Seniors' Health: A balanced diet isn't enough in nursing homes

Changing the way food is offered in nursing homes could reduce high rates of malnutrition, according to a study of 38 facilities across the Maritimes.

"It's not the quality of the food that's at issue," says Gale West, a sociologist at Laval University in Quebec City who co-authored the study with two nutritionists. "On a given day on a given plate, residents will only eat what they like and leave what they don't like. So a lot of an otherwise balanced diet gets thrown out."

According to West, several studies in Canada and the United States have shown that between 39 and 60 per cent of nursing home residents suffer from malnutrition, in particular a shortage of protein.

In an effort to better understand the nursing home-malnutrition phenomenon, the researchers studied 132 residents, finding that 37 per cent were at risk of being malnourished. West says the most surprising finding was that popular prepackaged food items such as cheese, apple sauce, Jell-O and cookies proved difficult to open for many seniors.

"In high schools and hospitals, where most people are functional, (packaging) is not an issue," she says. "But for seniors in a home, with arthritis, or other motor or cognitive impairments, it poses problems."

She adds that, because meal times are a flurry of activity in most residences, staff members are not readily available to help. As a result, many seniors simply leave the prepackaged food unopened and uneaten on their trays.

The researchers also found that seniors' eating habits are affected by menu cycles, a system used by hospitals, schools and many long-term care facilities in which menus are repeated in three-, four- or six-week cycles.

"It seems that the longer the cycle is, the better residents eat, particularly if they're lucid," says West. "We think it has to do with variety. If they see the same foods too frequently, they simply get bored and eat less."

She says the nutritional health of nursing home residents could be improved with a few simple actions, such as partly opening prepackaged food items, customizing food services to suit seniors and increasing the length of menu cycles.